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Computational and Mathematical Methods... 2014Cervical cancer is one of the most deadly and common forms of cancer among women if no action is taken to prevent it, yet it is preventable through a simple screening... (Review)
Review
Cervical cancer is one of the most deadly and common forms of cancer among women if no action is taken to prevent it, yet it is preventable through a simple screening test, the so-called PAP-smear. This is the most effective cancer prevention measure developed so far. But the visual examination of the smears is time consuming and expensive and there have been numerous attempts at automating the analysis ever since the test was introduced more than 60 years ago. The first commercial systems for automated analysis of the cell samples appeared around the turn of the millennium but they have had limited impact on the screening costs. In this paper we examine the key issues that need to be addressed when an automated analysis system is developed and discuss how these challenges have been met over the years. The lessons learned may be useful in the efforts to create a cost-effective screening system that could make affordable screening for cervical cancer available for all women globally, thus preventing most of the quarter million annual unnecessary deaths still caused by this disease.
Topics: Algorithms; Artifacts; Cell Nucleus; DNA; Early Detection of Cancer; Electronic Data Processing; False Negative Reactions; Female; Humans; Mass Screening; Papanicolaou Test; Ploidies; Signal Processing, Computer-Assisted; Time Factors; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 24772188
DOI: 10.1155/2014/842037 -
Indian Journal of Cancer 2011Cervical cancer is one of the major causes of deaths due to cancer among women in India. Pap smear is one of the best methods to detect early changes in cervix. However,...
BACKGROUND
Cervical cancer is one of the major causes of deaths due to cancer among women in India. Pap smear is one of the best methods to detect early changes in cervix. However, there is lack of data on awareness level of women about Pap smear and various risk factors for cervical cancer.
OBJECTIVES
To study the awareness about various risk factors for cervical cancer, health-seeking behavior and hygienic practices among women and to assess the distress experienced by these women before the Pap smear examination.
MATERIALS AND METHODS
This cross-sectional study was carried out on women coming for a Pap smear examination in a tertiary teaching hospital in New Delhi. A pretested interview schedule was used to get information after obtaining their informed consent.
RESULTS
Fifty-seven percent stated that they did not consult a doctor when they noticed the symptoms the first time. Sixty-one percent did not know what a cervical cancer is and a same percentage of women did not know what a Pap smear examination was. Older age group, Muslim and literate women had higher number of abnormal Pap smear results. Women who reported being stressed in their lives had higher number of abnormal smears as compared to women who claimed to lead a stress free life. Poor hygienic practices among these women from urban areas were also associated with abnormal Pap smear results.
CONCLUSION
The study concluded that factors such as poor awareness, shyness, poor hygiene, and old age could be responsible for abnormal Pap smears and this needs special attention in cancer prevention activities of the government.
Topics: Adult; Age Factors; Early Detection of Cancer; Female; Hospitals; Humans; India; Papanicolaou Test; Perception; Risk Factors; Socioeconomic Factors; Stress, Psychological; Urban Population; Uterine Cervical Neoplasms; Vaginal Smears; Women's Health
PubMed: 22293264
DOI: 10.4103/0019-509X.92261 -
Technology in Cancer Research &... 2023Pap smear is considered to be the primary examination for the diagnosis of cervical cancer. But the analysis of pap smear slides is a time-consuming task and tedious as...
Pap smear is considered to be the primary examination for the diagnosis of cervical cancer. But the analysis of pap smear slides is a time-consuming task and tedious as it requires manual intervention. The diagnostic efficiency depends on the medical expertise of the pathologist, and human error often hinders the diagnosis. Automated segmentation and classification of cervical nuclei will help diagnose cervical cancer in earlier stages. The proposed methodology includes three models: a Residual-Squeeze-and-Excitation-module based segmentation model, a fusion-based feature extraction model, and a Multi-layer Perceptron classification model. In the fusion-based feature extraction model, three sets of deep features are extracted from these segmented nuclei using the pre-trained and fine-tuned VGG19, VGG-F, and CaffeNet models, and two hand-crafted descriptors, Bag-of-Features and Linear-Binary-Patterns, are extracted for each image. For this work, Herlev, SIPaKMeD, and ISBI2014 datasets are used for evaluation. The Herlev datasetis used for evaluating both segmentation and classification models. Whereas the SIPaKMeD and ISBI2014 are used for evaluating the classification model, and the segmentation model respectively. The segmentation network enhanced the precision and ZSI by 2.04%, and 2.00% on the Herlev dataset, and the precision and recall by 0.68%, and 2.59% on the ISBI2014 dataset. The classification approach enhanced the accuracy, recall, and specificity by 0.59%, 0.47%, and 1.15% on the Herlev dataset, and by 0.02%, 0.15%, and 0.22% on the SIPaKMed dataset. The experiments demonstrate that the proposed work achieves promising performance on segmentation and classification in cervical cytopathology cell images..
Topics: Female; Humans; Uterine Cervical Neoplasms; Cytology; Cervix Uteri; Papanicolaou Test; Neural Networks, Computer; Image Processing, Computer-Assisted
PubMed: 36744768
DOI: 10.1177/15330338221134833 -
International Journal of Environmental... Sep 2022Cervical cancer continues to be a major health problem in developing countries. Educational programs, as well as Pap and HPV screening and vaccination, are important...
BACKGROUND
Cervical cancer continues to be a major health problem in developing countries. Educational programs, as well as Pap and HPV screening and vaccination, are important tools to reduce the morbidity and mortality rates associated with this disease. The objective of this study is to explore the diverse knowledge and perceptions about cervical cancer and the different diagnostic tests for HPV of populations living in the rural parish "El Valle".
METHOD
A qualitative study was conducted through eight focus groups, which included 46 participants from mixed ethnic groups. A phenomenological analysis was performed.
RESULTS
Four topics and seven sub-topics were identified. By analyzing all the narratives, it was possible to identify that the perception of cervical cancer was focused on its severity, secondary to its infectious process and screening periodicity. However, despite the diverse knowledge, indigenous people do not relate it to the human papilloma virus; in addition, there is also certain resistance to undergo the Pap smear test, for reasons such as inaccessibility and its sampling process.
CONCLUSIONS
It is necessary to develop educational programs for the prevention of cervical cancer and to implement diagnostic alternatives to reach populations with precarious accessibility, as well as women who refuse to undergo the Pap smear test.
Topics: Early Detection of Cancer; Ecuador; Female; Health Knowledge, Attitudes, Practice; Humans; Mass Screening; Papanicolaou Test; Papillomaviridae; Papillomavirus Infections; Qualitative Research; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 36078764
DOI: 10.3390/ijerph191711053 -
Indian Journal of Cancer 2016Cytology smears and guided biopsies are the most widely used diagnostic standards for cervical cancer (CC) screening in the developing countries.
BACKGROUND
Cytology smears and guided biopsies are the most widely used diagnostic standards for cervical cancer (CC) screening in the developing countries.
AIM
To evaluate the performance of conventional cytology in estimating the presence and grade of cervical disease against the reference standard of histopathology.
SETTINGS AND DESIGN
After primary screening for CC, directed biopsies were performed and compared with histopathology results.
MATERIALS AND METHODS
Papanicolaou (Pap) smears and biopsies from 3194 women in the age group of 14-98 years were included. Cytology results were provided by doctors who performed the cervical biopsies.
STATISTICAL ANALYSIS
The accuracy of Pap smear was measured by sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) calculated using the statistical analysis program PSPP 0.7.8.
RESULTS
The sensitivity of conventional cytology (Pap smear) for women with low-grade cervical intraepithelial neoplasia or less serious lesions (CIN1-) was 93% and specificity was 73%. The sensitivity and specificity of cytology for women with high-grade cervical intraepithelial neoplasia or cancer (CIN2+) was 64% and 84%, respectively.
CONCLUSION
Cytology is a sufficiently sensitive test for detection of cervical lesions and can be used as a primary testing tool to triage.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Female; Humans; Middle Aged; Papanicolaou Test; Squamous Intraepithelial Lesions of the Cervix; Young Adult
PubMed: 27146747
DOI: 10.4103/0019-509X.180825 -
Medical Archives (Sarajevo, Bosnia and... Oct 2020Cervical cancer can be successfully prevented by timely detection of changes that precede it such as atypical (ASC-H) and high grade squamous lesions (HSIL). (Comparative Study)
Comparative Study
INTRODUCTION
Cervical cancer can be successfully prevented by timely detection of changes that precede it such as atypical (ASC-H) and high grade squamous lesions (HSIL).
AIM
To investigate the correlation between Pap smear and colposcopy in the detection of premalignant and malignant cervical lesions based on a pathohistological finding.
METHODS
In a retrospective study 118 patients with HSIL and ASC-H findings were examined. A Pap smear, colposcopic examination and cervical canal biopsy were performed. The study was conducted at the Gynecological Center "Dr Mahira Jahic" Tuzla and the Clinical Center Tuzla, Department of Gynecology and Obstetrics.
RESULTS
1049 abnormal Pap tests were analyzed, ASCUS in 51,8% (N-544), LSIL 32,1% (N-337), HSIL 7,7% (N-81) and ASC-H 3,5% (N-37), AGC 4,8% (N-51). The mean age of the subjects with the abnormal Pap test was 46.33 ± 3.2. The age of patients with ASCUS lesion was 38,6 , LSIL 41,0, ASC-H was 47,3 , HSIL (CIN II and CIN III) 45,8 , while patients with CIS were 51,2 years. Pathological histology HSIL confirmed a high grade lesion in 67,7% (CIN II, CIN III and CIS) (N-55), in 32% (N-26) a lower grade CIN I in 18,5% and chronic cervicitis in 13,5% (N-11). In ASC-H lesion pathohistological HSIL was found in 13,5% (N-5), CIN I 13,5% (N-5) and chronic cervicitis 48,6 % (N-18). Abnormal colposcopic imaging with HSIL lesion was found in 72,9% (N-69), in 8,6% (N-7) was unsatisfactory and in 18,5% (N-15) the colposcopic finding was normal. In ASC-H lesions, abnormal colposcopic imaging was found in 40,5% (N-15), unsatisfactory findings in 10,8% (N-4), and normal findings in 48,6% (N-18).
CONCLUSION
Colposcopy has proven to be better method than cytology with an accuracy of 72,9% in high-grade lesion such as HSIL and ASC-H.
Topics: Adult; Atypical Squamous Cells of the Cervix; Bosnia and Herzegovina; Colposcopy; Female; Histological Techniques; Humans; Middle Aged; Neoplasms; Papanicolaou Test; Retrospective Studies; Squamous Intraepithelial Lesions; Uterine Cervical Dysplasia
PubMed: 33424094
DOI: 10.5455/medarh.2020.74.381-383 -
Acta Cytologica 2021Gastric-type endocervical adenocarcinoma (GAS) is a recently described, uncommon, and aggressive tumor with distinct morphologic features and HPV-independent etiology....
OBJECTIVE
Gastric-type endocervical adenocarcinoma (GAS) is a recently described, uncommon, and aggressive tumor with distinct morphologic features and HPV-independent etiology. Data on GAS in liquid-based cytology (LBC) Papanicolaou (Pap) test preparations from a North American patient population are scant. We systematically assessed the cytomorphologic characteristics of GAS in LBC from patients in Ontario and examined if glandular cell nuclear area could represent a readily assessable feature which may aid in GAS detection.
STUDY DESIGN
Pap test slides preceding the diagnosis of GAS were retrieved locally or requested from outside laboratories. A structured review of 15 cytomorphologic features was performed using the available LBC Pap test slides of GAS and a set of usual-type endocervical adenocarcinomas (UEA). Morphometry of the glandular cell nuclear area was performed, and normalized values were compared to UEA and benign endocervical cells.
RESULTS
At least 1 Pap test (5 ThinPrep®, 11 SurePath®, and 1 direct smear) was available for 14 patients. Original LBC Pap test diagnoses were negative for intraepithelial lesion or malignancy (NILM) (7), adenocarcinoma/carcinoma (6), atypical glandular cells (2), and adenocarcinoma in situ (1). Review detected abnormal glandular cells in 6/7 NILM cases. Honeycomb-like sheets, nuclear enlargement, and microvesicular cytoplasm were the single most common architectural, nuclear, and cytoplasmic features, respectively. Microvesicular cytoplasm (100 vs. 17%), honeycomb-like sheets (87 vs. 8%), prominent nucleoli (93 vs. 25%), and anisonucleosis (93 vs. 50%) were most discriminatory for GAS versus UEA, respectively. Yellow mucin, intranuclear cytoplasmic pseudoinclusions, and goblet/Paneth-like cells were uncommon, but unique for GAS. Glandular cell nuclear area normalized to neutrophils was found to be significantly increased in GAS compared to benign endocervical cells.
CONCLUSIONS
GAS is under-recognized and may mimic reactive endocervical cells. Awareness of the tumor type and its cytomorphology is critical for early detection. Identification of glandular cells with uniform nuclear enlargement in conjunction with any of the other cytologic features may help avoid false-negative Pap results. Neutrophils may serve as convenient size reference and visual aid.
Topics: Adenocarcinoma; Adult; Aged; Cell Nucleus; Cervix Uteri; Epithelial Cells; Female; Humans; Middle Aged; Papanicolaou Test; Papillomaviridae; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 33152741
DOI: 10.1159/000511003 -
Asian Pacific Journal of Cancer... 2014To determine the status of women's perception and attitudes about cervical cancer and their thoughts on Kato's self-sampling device.
AIMS
To determine the status of women's perception and attitudes about cervical cancer and their thoughts on Kato's self-sampling device.
MATERIALS AND METHODS
This descriptive research was conducted between July- December 2012 with a study populationof married women older than 18 years.
RESULTS
A total of 246 women volunteered, with a mean age of 34.9±9.22 (19-52). In the last year, 52.0% had been examined by a gynecologist to address a complaint or for a periodic health check. Of the 118 who had not had a gynecological examination, 42.4% indicated negligence, 26.3% stated the reason was no complaint, 14.4% feared they might receive bad results from the examination, and 8.5% stated that were shy or embarrassed. Of all of the women, 35.0% answered that they had information about cervical cancer, and 0.7% had heard about the HPV vaccine. No one in their families had received the vaccine. Of the women, 28.5% had had a Pap smear, and 71.4% of those had normal results. Of those who had never had a Pap smear, 47.2% had never heard about the test; 18.8% explained the reason for not having a test as shyness or embarrassment with a male doctor. None of the women had heard about Kato's device. Once the women were informed, 73.6% expresseed interest in use; 51.9% answered they could use it and not be embarrassed, 30.9% would use it because they did not have to see a doctor, and 17.1% would use it as it allows them to take a smear in all conditions and whenever they want. Of the women, 60.0% thought that they could not successfully use Kato's device; 40.0% thought that a smear should be taken by a doctor.
CONCLUSIONS
Most of the women in our population had never had a Pap smear and wanted to use the Kato's device.
Topics: Adult; Female; Follow-Up Studies; Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; Papanicolaou Test; Perception; Prognosis; Self Care; Specimen Handling; Surveys and Questionnaires; Turkey; Uterine Cervical Neoplasms; Vaginal Smears; Women's Health; Young Adult
PubMed: 24568517
DOI: 10.7314/apjcp.2014.15.2.905 -
Journal of the Formosan Medical... Dec 2016Under-utilization of Papanicolaou (Pap) smear causes a gap in the prevention of cervical neoplasms. A prospective population-based study was conducted investigating...
BACKGROUND/PURPOSE
Under-utilization of Papanicolaou (Pap) smear causes a gap in the prevention of cervical neoplasms. A prospective population-based study was conducted investigating whether a self-sampling human papillomavirus (HPV) test was feasible for under-users of Pap smear and factors associated with under-screening in Taiwan.
METHODS
Women not having Pap smear screening for > 5 years were invited to participate in this study. Invitation letters and educational brochures were mailed to 4% of randomly selected eligible women from Taoyuan City, Taiwan, and responders received an HPV self-sampling kit. Those with HPV-positive results were recalled for a Pap smear and colposcopy.
RESULTS
Between March 2010 and June 2012, 10,693 women were invited, 354 responded (3.3%), and 282 (2.6%) gave valid informed consent, answered the questionnaire, and submitted HPV samples. The median age of enrolled women was 48.1 years. Forty-seven women (16.7%) had a positive HPV test, and 14 women accepted further survey to find two CIN2+. Another two cases of CIN2+ were identified from a national registry database. The cost of direct mailing self-samplers was less than that done on request (from NT$434,866 to NT$164,229, response rate of 5% to 15%, respectively, versus NT$683,957 for detecting 1 CIN2+). Reasons for not attending screening included lack of time, embarrassment, assumed low risk, fear of positive results, and perceived potential pain. Among the responders, 90.8% found the method acceptable.
CONCLUSION
Our study indicated that different approaches (e.g., direct mailing self-samplers to under-users and/or various educational interventions) must be explored to improve coverage in populations with culture characteristics similar to Taiwan.
Topics: Adult; Female; Humans; Mass Screening; Middle Aged; Papanicolaou Test; Papillomaviridae; Papillomavirus Infections; Patient Acceptance of Health Care; Prospective Studies; Self Care; Surveys and Questionnaires; Taiwan; Vaginal Smears; Young Adult
PubMed: 26723863
DOI: 10.1016/j.jfma.2015.10.014 -
Revista Brasileira de Enfermagem 2016
Review
Topics: Female; Health Education; Humans; Papanicolaou Test; Patient Compliance; Uterine Cervical Neoplasms
PubMed: 27280579
DOI: 10.1590/0034-7167.2016690226i