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American Family Physician May 2017
Topics: Adverse Childhood Experiences; Ambulatory Care Facilities; Female; Humans; Middle Aged; Papanicolaou Test; Physician-Patient Relations; Vaginal Discharge; Wounds and Injuries
PubMed: 28671409
DOI: No ID Found -
Asian Pacific Journal of Cancer... 2016Nurses are the most visible, frontline personnel providing health education to patients. In particular, nurse experience with Pap examinations have the potential to...
BACKGROUND
Nurses are the most visible, frontline personnel providing health education to patients. In particular, nurse experience with Pap examinations have the potential to influence women's attitudes toward screening for cervical cancer. However, nurses in Taiwan have lower rates of Pap testing than the general population. Understanding the factors predicting nurse intent to have a Pap exam and Pap exam status would inform interventions and policies to increase their Pap exam uptake. Therefore, the present study was undertaken.
MATERIALS AND METHODS
Data were collected by questionnaire from a convenient sample of 504 nurses at a regional hospital in central Taiwan between August and October 2011 and analyzed by descriptive statistics, confirmatory factor analysis, and logistic regression.
RESULTS
Nurse intention to have a Pap exam was predicted by younger age, less negative attitudes toward Pap exams, and greater influence of others recommendations. However, nurses were more likely to actually have had a Pap exam if they were older, married, had sexual experience, and had a high intention to have a Pap exam.
CONCLUSIONS
Nurses who are younger than 34 years old, unmarried, sexually inexperienced, and with low intention to have a Pap exam should be targeted with interventions to educate them not only about the importance of Pap exams in detecting cervical cancer, but also about strategies to decrease pain and embarrassment during exams. Nurses with less negative attitudes and experiences related to Pap exams would serve as role models to persuade women to have Pap exams, thus increasing the uptake rate of Pap exams in Taiwan.
Topics: Adult; Cross-Sectional Studies; Female; Health Education; Health Knowledge, Attitudes, Practice; Humans; Intention; Middle Aged; Nurses; Papanicolaou Test; Physical Examination; Sexual Behavior; Surveys and Questionnaires; Taiwan; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 26838204
DOI: 10.7314/apjcp.2016.17.1.165 -
Mathematical Biosciences and... Apr 2022Cervical cancer is the second most commonly seen cancer in women. It affects the cervix portion of the vagina. The most preferred diagnostic test required for screening...
Cervical cancer is the second most commonly seen cancer in women. It affects the cervix portion of the vagina. The most preferred diagnostic test required for screening cervical cancer is the pap smear test. Pap smear is a time-consuming test as it requires detailed analysis by expert cytologists. Cytologists can screen around 100 to 1000 slides depending upon the availability of advanced equipment. Due to this reason Artificial intelligence (AI) based computer-aided diagnosis system for the classification of pap smear images is needed. There are some AI-based solutions proposed in the literature, still an effective and accurate system is under research. In this paper, the deep learning-based hybrid methodology namely DeepCyto is proposed for the classification of pap smear cytology images. The DeepCyto extracts the feature fusion vectors from pre-trained models and passes these to two workflows. Workflow-1 applies principal component analysis and machine learning ensemble to classify the pap smear images. Workflow-2 takes feature fusion vectors as an input and applies an artificial neural network for classification. The experiments are performed on three benchmark datasets namely Herlev, SipakMed, and LBCs. The performance measures of accuracy, precision, recall and F1-score are used to evaluate the effectiveness of the DeepCyto. The experimental results depict that Workflow-2 has given the best performance on all three datasets even with a smaller number of epochs. Also, the performance of the DeepCyto Workflow 2 on multi-cell images of LBCs is better compared to single cell images of other datasets. Thus, DeepCyto is an efficient method for accurate feature extraction as well as pap smear image classification.
Topics: Artificial Intelligence; Cervix Uteri; Female; Humans; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35730264
DOI: 10.3934/mbe.2022301 -
BMC Women's Health Aug 2021Cervical cancer is one of the most frequent types of cancer in females. The Pap smear is one of the most essential ways of diagnosing and screening for this malignancy,...
BACKGROUND
Cervical cancer is one of the most frequent types of cancer in females. The Pap smear is one of the most essential ways of diagnosing and screening for this malignancy, and any failure can be caused by a number of causes. The current study sought to investigate barriers to Pap smear in Iranian women.
METHOD
This qualitative content analysis study was conducted in Iran in 2019. Data was gathered through focus groups and individual semi-structured interviews with 32 women and health professionals. The interviewees were chosen using a combination of purposive and theoretical sampling. The data was then analyzed using the content analysis approach developed by Graneheim and Lundman. Guba and Lincoln's criteria for establishing trustworthiness were explored.
RESULTS
Data analysis resulted in the identification of four primary categories, seventeen subcategories, and 186 original concepts. The main categories include weakness of health system, difficult accessibility, low health literacy, and socio-cultural factors.
CONCLUSION
By informing women about the necessity and importance of Pap smear, providing the conditions, facilities, and equipment to facilitate the testing process, and paying more attention to cultural and social factors in cervical cancer and Pap smear planning, interventions, and policies, barriers to Pap testing can be eliminated.
Topics: Female; Health Knowledge, Attitudes, Practice; Humans; Iran; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 34362366
DOI: 10.1186/s12905-021-01428-9 -
PloS One 2017Healthcare in Thailand is not equally distributed, and not all people can equally access healthcare resources even if they are covered by health insurance. To examine...
Healthcare in Thailand is not equally distributed, and not all people can equally access healthcare resources even if they are covered by health insurance. To examine factors associated with the utilization of mammography examination for breast cancer and Pap smear screening for cervical cancer, data from the national reproductive health survey conducted by the National Statistical Office of Thailand in 2009 was examined. The survey was carried out on 15,074,126 women aged 30-59 years. The results showed that the wealthier respondents had more mammograms than did the lower-income groups. The concentration index was 0.144. The data on Pap smears for cervical cancer also showed that the wealthier respondents were more likely to have had a Pap smear than their lower-income counterparts. The concentration index was 0.054. Determinants of mammography examination were education, followed by health welfare and wealth index, whereas the determinants of Pap smear screening were wealth index, followed by health welfare and education. The government should support greater education for women because education was associated with socioeconomic status and wealth. There should be an increase in the number of screening campaigns, mobile clinics, and low-cost mammograms and continued support for accessibility to mammograms, especially in rural areas and low-income communities.
Topics: Adult; Breast Neoplasms; Family Characteristics; Female; Health Surveys; Humans; Mammography; Mass Screening; Middle Aged; Mobile Health Units; Papanicolaou Test; Regression Analysis; Social Class; Thailand; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 28282430
DOI: 10.1371/journal.pone.0173656 -
Taiwanese Journal of Obstetrics &... May 2019This study aimed to compare the diagnostic value of VIA with Pap smear in screening for cervical cancer. (Comparative Study)
Comparative Study
OBJECTIVE
This study aimed to compare the diagnostic value of VIA with Pap smear in screening for cervical cancer.
MATERIALS AND METHODS
In this cross-sectional study, 440 women who had eligibility criteria, in Kashan city were assessed. All women underwent Pap smear test and then a visual inspection with acetic acid and colposcopy-biopsy (Gold Standard). Then, the diagnostic value indices including the specificity, sensitivity, positive and negative predictive values for the results of VIA and Pap smear were analyzed by SPSS V16 software.
RESULTS
Finding showed that 29.9% of women had abnormal Pap smear. The false positive rate of Pap smear was 40.2%, and its false negative rate was 37.4%. For VIA, the false positive and false negative rates were 21.2% and 4.6%. The sensitivity, specificity, NPV and PPV of Pap smear was 29.7%, 85.5%, 59.8%, 62.6%, and these values for VIA was 94.6%, 81.6%, 78.8%, 95.4% respectively. Combination of Pap smear and VIA showed the sensitivity of 97.3% and 100% in low grade and high grade cervical lesions.
CONCLUSION
VIA has a higher sensitivity than Pap smear in detection of low and high grade cervical lesions, however, its specificity is less than Pap smears. Therefore it is recommended to use of VIA along with Pap smear to reach a higher sensitivity.
Topics: Acetic Acid; Adult; Aged; Colposcopy; Cross-Sectional Studies; Early Detection of Cancer; Female; Humans; Iran; Middle Aged; Papanicolaou Test; Physical Examination; Sensitivity and Specificity; Uterine Cervical Neoplasms; Young Adult; Uterine Cervical Dysplasia
PubMed: 31122522
DOI: 10.1016/j.tjog.2019.03.010 -
Public Health Sep 2022To systematically appraise the existing published literature on cervical cancer screening utilization, and associated barriers and facilitators, in Nepal. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To systematically appraise the existing published literature on cervical cancer screening utilization, and associated barriers and facilitators, in Nepal.
STUDY DESIGN
Systematic literature review and meta-analysis.
METHODS
PubMed/MEDLINE, CINAHL, Scopus, Embase, and, Google Scholar were systematically searched using Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. All quantitative and qualitative studies reporting cervical cancer screening (using the Pap smear test or visual inspection with acetic acid or human papillomavirus test) utilization, barriers, and facilitators for screening were identified. A meta-analysis was performed to estimate Nepal's pooled cervical cancer screening utilization proportion.
RESULTS
The search yielded 97 records, of which 17 studies were included. Fifteen studies were quantitative and two were qualitative. Of the 17 studies, six were hospital-based and six were community-based. The pooled cervical cancer screening utilization proportion (using Pap smear test) among Nepalese women was 17% from the studies in the hospital settings, and 16% in the community. Six studies reported barriers to cervical cancer screening, of which four reported embarrassments related to the gynecological examination and a low level of knowledge on cervical cancer. Three (of four) studies reported health personnel, and two studies reported screening services-related facilitators for cervical cancer screening.
CONCLUSION
Our review reported that cervical cancer screening utilization (16%) is more than four times lower than the national target (70%) in Nepal. Multiple barriers such as low levels of knowledge and embarrassment are associated with cervical cancer screening utilization. Health personnel's gender, counseling, and privacy of screening services were commonly reported facilitators. These findings could help to inform future research, and policy efforts to increase cervical cancer screening utilization in Nepal.
Topics: Early Detection of Cancer; Female; Humans; Mass Screening; Nepal; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35863158
DOI: 10.1016/j.puhe.2022.06.007 -
International Quarterly of Community...Estimates of the percentage of women who have had Pap smears in Peru vary between 7% and 43%. This study explores what women know about cervical cancer and Pap smears,...
Estimates of the percentage of women who have had Pap smears in Peru vary between 7% and 43%. This study explores what women know about cervical cancer and Pap smears, as well as their barriers to obtaining Pap smears. Focus group discussions (FGD) were conducted with a total of 177 women in four Peruvian cities. Discussions reveal that most women did not know what causes cervical cancer. Most women did not know the purpose of Pap smears, although knowledge about Pap smears was higher than knowledge about cervical cancer. Fear, embarrassment, and lack of knowledge were the main barriers identified for not getting Pap smears. Programs and policies aiming to increase Pap smear coverage must start by educating women on cervical cancer and its prevention in order to improve women's perceptions about the screening test and increase Pap smear seeking behaviors in the long term.
Topics: Female; Health Education; Health Knowledge, Attitudes, Practice; Health Services Accessibility; Humans; Interviews as Topic; Papanicolaou Test; Patient Acceptance of Health Care; Peru; Residence Characteristics; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 21988870
DOI: 10.2190/IQ.31.3.d -
Journal of Ayub Medical College,... 2018One of the common causes of mortality and morbidity among young women is cervical cancer. Following a wash of cervix through acetic acid, the Papanicolaou (PAP) smears... (Comparative Study)
Comparative Study
BACKGROUND
One of the common causes of mortality and morbidity among young women is cervical cancer. Following a wash of cervix through acetic acid, the Papanicolaou (PAP) smears and the visual inspection with acetic acid (VIA), are compared. Objective of the study was to check the level of agreement between the PAP smear for cancer of cervix and VIA.
METHODS
It is a cross-sectional study and was carried out in Obstetrics and Gynaecology department, Sheikh Zaid Hospital, Lahore, Pakistan. All patients were put in lithotomy position and vaginal speculum was applied and pap smear taken followed by 5% acetic acid application to cervix and changes in the cervix noted down.
RESULTS
Patients with mean age 48±7.795 years were included. In 30 (12%) and 61 (24.4%) patients diagnosis of cervical cancer was positive on PAP smear and VIA respectively. The agreement between two test was significant with Kappa value = 0.322 and p-value ≤ 0.00.
CONCLUSION
Our study revealed that agreement of PAP smear is almost 80%. VIA on the other hand can be used when there is no access to PAP smear.
Topics: Acetic Acid; Adult; Cross-Sectional Studies; Early Detection of Cancer; Female; Humans; Middle Aged; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 30838828
DOI: No ID Found -
BMC Health Services Research Jun 2014This study examines the Pap smear usage conditions and relevant influential factors for 18,204 women aged 30 years and above with intellectual disabilities, using...
BACKGROUND
This study examines the Pap smear usage conditions and relevant influential factors for 18,204 women aged 30 years and above with intellectual disabilities, using nationwide data from 2008.
METHODS
The research method of this study is secondary data analysis. The data was obtained from three nationwide databases from 2006 to 2008. This study employed descriptive statistics to analyze the use and rate of Pap smear testing by women with intellectual disabilities. Chi-square test was used to assess the correlation between Pap smear test usage and several variables. Logistic regression analysis was employed to explore the factors that influence Pap smear test usage.
RESULTS
The results show that 4.83% (n =880) of women with intellectual disabilities underwent Pap smear tests. Pap smear test usage rates exhibit a declining trend with increases in age. Factors that significantly influence Pap smear test use include age, urbanization level of resident area, monthly salary, aboriginal status, marital status, existence of DM, severity of disability.
CONCLUSIONS
The women with intellectual disabilities had a low use rate of Pap smear test, which is significantly less than the 28.8% usage rate for the general population of women aged 30 years and above.
Topics: Adult; Aged; Databases, Factual; Female; Humans; Logistic Models; Middle Aged; Motivation; Papanicolaou Test; Persons with Mental Disabilities; Preventive Health Services; Taiwan; Uterine Cervical Neoplasms
PubMed: 24890828
DOI: 10.1186/1472-6963-14-240