WorldWideScience

Sample records for attend cervical screening

  1. Self-Sampling for Human Papillomavirus Testing among Non-Attenders Increases Attendance to the Norwegian Cervical Cancer Screening Programme

    DEFF Research Database (Denmark)

    Enerly, Espen; Bonde, Jesper; Schee, Kristina;

    2016-01-01

    Increasing attendance to screening offers the best potential for improving the effectiveness of well-established cervical cancer screening programs. Self-sampling at home for human papillomavirus (HPV) testing as an alternative to a clinical sampling can be a useful policy to increase attendance....... To determine whether self-sampling improves screening attendance for women who do not regularly attend the Norwegian Cervical Cancer Screening Programme (NCCSP), 800 women aged 25-69 years in the Oslo area who were due to receive a 2nd reminder to attend regular screening were randomly selected and invited...... alternative for increasing cervical cancer screening coverage in Norway....

  2. Motivators for women to attend cervical screening: the influential role of GPs.

    LENUS (Irish Health Repository)

    O'Connor, Mairead

    2014-08-01

    Participation in organized cervical cancer screening has declined recently. While research has focussed on barriers to screening participation, less attention has been paid to what motivates women to attend. Moreover, little is known about health care provider\\/practitioner-level barriers and facilitators to participation. Better understanding of these issues could help inform strategies to improve participation.

  3. Factors associated with non-attendance, opportunistic attendance and reminded attendance to cervical screening in an organized screening program: a cross-sectional study of 12,058 Norwegian women

    Directory of Open Access Journals (Sweden)

    Eriksen Tormod

    2011-04-01

    Full Text Available Abstract Background Cervical cancer incidence and mortality may be reduced by organized screening. Participant compliance with the attendance recommendations of the screening program is necessary to achieve this. Knowledge about the predictors of compliance is needed in order to enhance screening attendance. Methods The Norwegian Co-ordinated Cervical Cancer Screening Program (NCCSP registers all cervix cytology diagnoses in Norway and individually reminds women who have no registered smear for the past three years to make an appointment for screening. In the present study, a questionnaire on lifestyle and health was administered to a random sample of Norwegian women. The response rate was 68%. To address the predictors of screening attendance for the 12,058 women aged 25-45 who were eligible for this study, individual questionnaire data was linked to the cytology registry of the NCCSP. We distinguished between non-attendees, opportunistic attendees and reminded attendees to screening for a period of four years. Predictors of non-attendance versus attendance and reminded versus opportunistic attendance were established by multivariate logistic regression. Results Women who attended screening were more likely than non-attendees to report that they were aware of the recommended screening interval, a history of sexually transmitted infections and a history of hormonal contraceptive and condom use. Attendance was also positively associated with being married/cohabiting, being a non-smoker and giving birth. Women who attended after being reminded were more likely than opportunistic attendees to be aware of cervical cancer and the recommended screening interval, but less likely to report a history of sexually transmitted infections and hormonal contraceptive use. Moreover, the likelihood of reminded attendance increased with age. Educational level did not significantly affect the women's attendance status in the fully adjusted models. Conclusions The

  4. Poor Cervical Cancer Screening Attendance and False Negatives. A Call for Organized Screening

    OpenAIRE

    Castillo, Marta; Astudillo, Aurora; Clavero, Omar; Velasco, Julio; Ibáñez, Raquel; de Sanjosé, Silvia

    2016-01-01

    Objective The objective of this study was to describe prior negative screening history and symptoms around the time of diagnosis of incident cervical cancer (CC) cases diagnosed between 2000 and 2010 within the Asturias public health system. Methods Records from 374 women diagnosed with CC between 2000 and 2010 from all public hospitals in Asturias were retrieved. Clinical information, FIGO stage and all previous cytological data were extracted from clinical and histopathological records. Pro...

  5. Cervical Cancer Screening Knowledge and Behavior among Women Attending an Urban HIV Clinic in Western Kenya.

    Science.gov (United States)

    Rosser, Joelle I; Njoroge, Betty; Huchko, Megan J

    2015-09-01

    Cervical cancer is a highly preventable disease that disproportionately affects women in developing countries and women with HIV. As integrated HIV and cervical cancer screening programs in Sub-Saharan Africa mature, we have an opportunity to measure the impact of outreach and education efforts and identify areas for future improvement. We conducted a cross-sectional survey of 106 women enrolled in care at an integrated HIV clinic in the Nyanza Province of Kenya 5 years after the start of a cervical cancer screening program. Female clinic attendees who met clinic criteria for cervical cancer screening were asked to complete an oral questionnaire assessing their cervical cancer knowledge, attitudes, and screening history. Ninety-nine percent of women had heard of screening, 70 % felt at risk, and 84 % had been screened. Increased duration of HIV diagnosis was associated with feeling at risk and with a screening history. Nearly half (48 %) of women said they would not get screened if they had to pay for it.

  6. High-grade cervical lesions among women attending a reference clinic in Brazil: associated factors and comparison among screening methods.

    Directory of Open Access Journals (Sweden)

    Neide T Boldrini

    Full Text Available Although screening for cervical cancer is recommended for women in most countries, the incidence of cervical cancer is greater in developing countries. Our goal was to determine the prevalence and factors associated with high-grade lesions/cervical cancer among women attending a reference clinic in Brazil and evaluate the correlation of histology with cytology, colposcopy and the high-risk HPV (HR-HPV tests.A cross-sectional study of women attending a colposcopy clinic was carried out. The patients were interviewed to collect demographic, epidemiological and clinical data. Specimens were collected for cervical cytology, Chlamydia trachomatis and HPV testing using the Hybrid Capture (HC and PCR tests. Colposcopy was performed for all patients and biopsy for histology when cell abnormalities or cervical intraepithelial neoplasia (CIN were present.A total of 291 women participated in the study. The median age was 38 years (DIQ: 30-48 years. The prevalence of histologically confirmed high-grade lesions/cervical cancer was 18.2% (95%, CI: 13.8%-22.6%, with 48 (16.5% cases of CIN-2/CIN-3 and 5 (1.7% cases of invasive carcinoma. In the final logistic regression model, for ages between 30 and 49 years old [OR = 4.4 (95%: 1.01-19.04, history of smoking [OR = 2.4 (95%, CI: 1.14-5.18], practice of anal intercourse [OR = 2.4 (95%, CI: 1.10-5.03] and having positive HC test for HR-HPV [OR = 11.23 (95%, CI: 4 0.79-26, 36] remained independently associated with high-grade lesions/cervical cancer. A total of 64.7% of the cases CIN-3\\Ca in situ were related to HPV-16. Non-oncogenic HPV were only found in CIN-1 biopsy results. Compared to histology, the sensitivity of cytology was 31.8%, the specificity 95.5%; the sensitivity of colposcopy for high-grade lesions/cervical cancer was 51.0%, specificity was 91.4% and the concordance with HPV testing was high.The results confirm an association of HR-HPV with precursor lesions for cervical cancer

  7. Home-based urinary HPV DNA testing in women who do not attend cervical cancer screening clinics.

    Science.gov (United States)

    Ducancelle, Alexandra; Reiser, Justine; Pivert, Adeline; Le Guillou-Guillemette, Hélène; Le Duc-Banaszuk, Anne Sophie; Lunel-Fabiani, Françoise

    2015-09-01

    In France, cervical cancer screening is currently based on cytological examination of a Pap smear for women aged 25 to 65, but screening coverage is unsatisfactory. Previous studies have shown that self-sampling for human papillomavirus (HPV) testing increases rates of compliance. With this purpose in mind, we performed the CapU study to evaluate the acceptance of a urinary HPV test. Letters proposing a new cervical cancer screening method using at-home urine self-sampling were sent to 5000 women aged 40-65 years who had not had a Pap smear over the past three years. The participating patients had to send their urine samples to the Angers Hospital Virology Laboratory for analysis using real-time PCR. Of the 771 samples received, 687 were analyzed. High-risk HPV were detected in 29 women. In follow-up, 28 women with positive urinary HPV results had a Pap smear or colposcopy done. The cytological results showed nine abnormal Pap smears, among which histology studies confirmed three cases of cervical intraepithelial neoplasia grade III lesions. Our study shows that urinary HPV testing may be pertinent to women who do not have cervical Pap smears done and lead to the diagnosis of high-grade cervical lesions.

  8. Cervical Cancer Screening

    Science.gov (United States)

    ... Cancer found early may be easier to treat. Cervical cancer screening is usually part of a woman's health ... may do more tests, such as a biopsy. Cervical cancer screening has risks. The results can sometimes be ...

  9. Cervical cancer - screening and prevention

    Science.gov (United States)

    Cancer cervix - screening; HPV - cervical cancer screening; Dysplasia - cervical cancer screening; Cervical cancer - HPV vaccine ... Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that spreads through sexual contact. Certain ...

  10. Cervical Cancer Screening

    Science.gov (United States)

    ... are at increased risk for HPV infections. Other risk factors for cervical cancer include: Giving birth to many children. Smoking cigarettes. Using oral contraceptives ("the Pill"). Having a weakened immune system . Cervical Cancer Screening ...

  11. Encouraging the right women to attend for cervical cancer screening: results from a targeted television campaign in Victoria, Australia.

    Science.gov (United States)

    Mullins, Robyn; Wakefield, Melanie; Broun, Kate

    2008-06-01

    The study assessed whether a mass media campaign could encourage women who were overdue for a Papanicolaou (Pap) test to have one, without prompting unnecessary early re-screening. A telephone survey of a representative sample of 1000 Victorian women aged 25-65 years assessed recall of the advertisement and intention to act after seeing it. The television advertisement was recalled by 61.5% of women. Significantly more who said 'I mean to have a test every two years, but I usually leave it longer' indicated they would have a Pap test more often as a result of seeing the advertisement (63%), than women who had Pap tests every 1 (6%) or 2 (12%) years. Negative binomial regression analysis on data from the Victorian Cervical Cytology Registry from the middle of 2002 to the end of 2004 showed that during the campaign the number of Pap tests conducted increased by 18% (coeff = 0.169, df campaign to encourage screening which is specific to women whose test is due or overdue.

  12. Risks of Cervical Cancer Screening

    Science.gov (United States)

    ... are at increased risk for HPV infections. Other risk factors for cervical cancer include: Giving birth to many children. Smoking cigarettes. Using oral contraceptives ("the Pill"). Having a weakened immune system . Cervical Cancer Screening ...

  13. Attendance in cancer screening programmes in Italy

    Directory of Open Access Journals (Sweden)

    Grazia Grazzini

    2008-06-01

    Full Text Available

    Background: The European Community recommends mammography, cervical and colorectal cancer screening programmes. In Italy, cancer screening programmes have been included in the Basic Healthcare Parameters (Livelli Essenziali di Assistenza since 2001. Full national coverage of a population-based organized screening programme has been planned for in Italy and is being implemented. Since 2005, the Ministry of Health - Department of Prevention has formally charged The National Centre for Screening Monitoring (Osservatorio Nazionale Screening –ONS- with monitoring and promoting screening programmes nationwide. Participation of target populations is a key indicator of the impact and efficacy of a screening programme in reducing cancer mortality.

    Methods: Attendance of invitees is one of the indicators calculated every year in the quality control of Italian screening programmes. Data collection is organized by means of a structured questionnaire, sent by ONS to the referent for data collection in each Region, who then returns the completed questionnaires to the Regional Centre. Questionnaires are then sent to the National Centre. Logical and epidemiologic checks are performed at both levels. Every year ONS publishes reports on the results of the surveys. A feasibility study for a National data warehouse based on individual records is in progress. The national survey “Multiscopo sulle famiglie” and the Passi Study (Progetti delle Aziende Sanitarie per la Salute in Italia provided additional information regarding spontaneous preventive health care activities in the Italian population.

    Results: Mammography screening: In 2006, 78.2% of Italian women aged 50-69 lived in areas where organised screening was in place (theoretical extension, however, the distribution of the screening activity is not uniform (higher in Northern/Central Italy compared with Southern

  14. Cervical cancer screening at crossroads

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Rygaard, Carsten; Baillet, Miguel Vazquez-Prada;

    2014-01-01

    Cervical screening has been one of the most successful public health prevention programmes. For 50 years, cytology formed the basis for screening, and detected cervical intraepithelial lesions (CIN) were treated surgically to prevent progression to cancer. In a high-risk country as Denmark......, screening decreased the incidence of cervical cancer from 34 to 11 per 100,000, age-standardized rate (World Standard Population). Screening is, however, also expensive; Denmark (population: 5.6 million) undertakes close to half a million tests per year, and has 6-8 CIN-treated women for each prevented...... cancer case. The discovery of human papillomavirus (HPV) as the cause of cervical cancer dramatically changed perspectives for disease control. Screening with HPV testing was launched around 1990, and preventive HPV vaccination was licensed in 2006. Long-term randomized controlled trials (RCT...

  15. Offering Self-Sampling Kits for HPV Testing to Reach Women Who Do Not Attend in the Regular Cervical Cancer Screening Program.

    Science.gov (United States)

    Arbyn, Marc; Castle, Philip E

    2015-05-01

    In 2016, the Netherlands will switch, as first European country, from cytology-based to HPV-based cervical cancer screening, with cytology triage for those with a positive HPV test. The new Dutch program includes sending self-sampling devices to women who do not respond to an invitation to have a cervical sample taken by their general practitioner. The cost-effectiveness of this additional strategy will depend on its capacity to recruit nonscreened women and in particular those at increased risk of cervical (pre)cancer, the possible switch of previous responders to self-sampling, the accuracy and cost of the HPV assay-self-sampler combination, and the compliance of women being self-sample HPV-positive with further follow-up. Validated PCR-based assays, detecting high-risk HPV DNA, are as accurate on self-samples as on clinician-collected samples. On the contrary, HPV assays, based on signal amplification, are less sensitive and specific on self-samples. The introduction of self-sampling strategies should be carefully prepared and evaluated in pilot studies integrated in well-organized settings before general rollout. Opt-in procedures involving a request for a self-sampler may reduce response rates. Therefore, an affordable device that can be included with the invitation to all nonattendees may yield a stronger effect on participation.

  16. Knowledge about Cervical Cancer and Barriers of Screening Program among Women in Wufeng County, a High-Incidence Region of Cervical Cancer in China

    OpenAIRE

    Yao Jia; Shuang Li; Ru Yang; Hang Zhou; Qunying Xiang; Ting Hu; Qinghua Zhang; Zhilan Chen; Ding Ma; Ling Feng

    2013-01-01

    PURPOSE: Cervical cancer screening is an effective method for reducing the incidence and mortality of cervical cancer, but the screening attendance rate in developing countries is far from satisfactory, especially in rural areas. Wufeng is a region of high cervical cancer incidence in China. This study aimed to investigate the issues that concern cervical cancer and screening and the factors that affect women's willingness to undergo cervical cancer screening in the Wufeng area. PARTICIPANTS ...

  17. Comparative performance of novel self-sampling methods in detecting high-risk human papillomavirus in 30,130 women not attending cervical screening.

    Science.gov (United States)

    Bosgraaf, Remko P; Verhoef, Viola M J; Massuger, Leon F A G; Siebers, Albert G; Bulten, Johan; de Kuyper-de Ridder, Gabriëlle M; Meijer, Chris J M; Snijders, Peter J F; Heideman, Daniëlle A M; IntHout, Joanna; van Kemenade, Folkert J; Melchers, Willem J G; Bekkers, Ruud L M

    2015-02-01

    We determined whether the participation rate for a brush-based cervicovaginal self-sampling device is noninferior to the participation rate for a lavage-based one for testing for hrHPV (high-risk human papillomavirus). Additionally, positivity rates for hrHPV, the detection rates for cervical intraepithelial neoplasia grades 2 and 3 or worse (CIN2+/3+), and user comfort were compared. A total of 35,477 non-responders of the regular cervical screening program aged 33-63 years were invited to participate. Eligible women (n = 30,130) were randomly assigned to receive either a brush-based or a lavage-based device, and a questionnaire for reporting user convenience. Self-sampling responders testing hrHPV-positive were invited for a physician-taken sample for cytology; triage-positive women were referred for colposcopy. A total of 5,218 women participated in the brush-based sampling group (34.6%) and 4809 women in the lavage-based group (31.9%), i.e. an absolute difference of 2.7% (95%CI 1.8-4.2). The hrHPV-positivity rates in the two groups were identical (8.3%, relative risk (RR) 0.99, 95%CI 0.87-1.13). The detection of CIN2+ and CIN3+ in the brush group (2.0% for CIN2+; 1.3% for CIN3+) was similar to that in the lavage group (1.9% for CIN2+; 1.0% for CIN3+) with a cumulative RR of 1.01, 95%CI 0.83-1.24 for CIN2+ and 1.25, 95%CI 0.92-1.70 for CIN3+. The two self-sampling devices performed similarly in user comfort. In conclusion, offering a brush-based device to non-responders is noninferior to offering a lavage-based device in terms of participation. The two self-sampling methods are equally effective in detecting hrHPV, CIN2+/CIN3+ and are both well accepted.

  18. How does HPV vaccination status relate to risk perceptions and intention to participate in cervical screening?

    DEFF Research Database (Denmark)

    Hestbech, Mie Sara; Gyrd-Hansen, Dorte; Kragstrup, Jakob;

    2016-01-01

    Background: Women in several countries will soon be covered by two preventive programmes targeting cervical cancer: HPV vaccination and cervical screening. The HPV vaccines are expected to prevent approximately 70 % of cervical cancers. It has been speculated, that HPV vaccinated women...... will not attend screening because they falsely think that the vaccine has eliminated their cervical cancer risk. The aim of this study was to investigate the association between HPV vaccination status and perceptions of cervical cancer risk; perceptions of vaccine effect; and intention to participate in cervical...... and intentions to participate in cervical screening. Main outcomes were: perceived lifetime-risk of cervical cancer; perceived HPV vaccine effect; and intention to participate in cervical screening. Results: HPV vaccinated women more often than unvaccinated women intended to participate in screening: adjusted...

  19. Methods for Cervical Cancer Screening

    Directory of Open Access Journals (Sweden)

    Tatiana Vargas-Revilla

    2014-12-01

    This article is divided in three sections: the first one focuses on the general impact of cervical cancer has hadin CostaRica, these condsection gathers information about different methodologies used around the world to detect this cancer and the third one makes reference to the current development of the screening devise in Mexico that works as a monitoring system and can used by women without external assistance.

  20. Cervical cancer: screening, diagnosis and staging.

    Science.gov (United States)

    Tsikouras, Panagiotis; Zervoudis, Stefanos; Manav, Bachar; Tomara, Eirini; Iatrakis, George; Romanidis, Constantinos; Bothou, Anastasia; Galazios, George

    2016-01-01

    Purpose: Despite the widespread screening programs, cervical cancer remains the third most common cancer in developing countries. Based on the implementation of cervical screening programs with the referred adoption of improved screening methods in cervical cytology with the knowledge of the important role of the human papilloma virus (HPV) it's incidence is decreased in the developed world. Even if cervical HPV infection is incredibly common, cervical cancer is relatively rare. Depending on the rarity of invasive disease and the improvement of detection of pre-cancerous lesions due to the participation in screening programs, the goal of screening is to detect the cervical lesions early in order to be treated before cancer is developed. In populations with many preventive screening programs, a decrease in cervical cancer mortality of 50-75% is mentioned over the past 50 years. The preventive examination of vagina and cervix smear, Pap test, and the HPV DNA test are remarkable diagnostic tools according to the American Cancer Association guidelines, in the investigation of asymptomatic women and in the follow up of women after the treatment of pre-invasive cervical cancer. The treatment of cervical cancer is based on the FIGO 2009 cervical cancer staging.

  1. Cervical cancer screening in the Faroe Islands

    DEFF Research Database (Denmark)

    Hammer, Turið; Lynge, Elsebeth; Djurhuus, Gisela W;

    2014-01-01

    Background. The Faroe Islands have had nationally organised cervical cancer screening since 1995. Women aged 25-60 years are invited every third year. Participation is free of charge. Although several European overviews on cervical screening are available, none have included the Faroe Islands. Our...... aim was to provide the first description of cervical cancer screening, and to determine the screening history of women diagnosed with cervical cancer in the Faroe Islands. Material and methods. Screening data from 1996 to 2012 were obtained from the Diagnostic Centre at the National Hospital...... 1999. At present, 7.0% of samples have abnormal cytology. Of all ASCUS samples, 76-95% were tested for HPV. A total of 58% of women diagnosed with cervical cancer did not participate in screening prior to their diagnosis, and 32% had normal cytology in the previous four years. Conclusion. Despite...

  2. Improving cervical cancer screening rates in an urban HIV clinic.

    Science.gov (United States)

    Cross, Sara L; Suharwardy, Sanaa H; Bodavula, Phani; Schechtman, Kenneth; Overton, E Turner; Onen, Nur F; Lane, Michael A

    2014-01-01

    Human immunodeficiency virus (HIV)-infected women are at increased risk of invasive cervical cancer; however, screening rates remain low. The objectives of this study were to analyze a quality improvement intervention to increase cervical cancer screening rates in an urban academic HIV clinic and to identify factors associated with inadequate screening. Barriers to screening were identified by a multidisciplinary quality improvement committee at the Washington University Infectious Diseases clinic. Several strategies were developed to address these barriers. The years pre- and post-implementation were analyzed to examine the clinical impact of the intervention. A total of 422 women were seen in both the pre-implementation and post-implementation periods. In the pre-implementation period, 222 women (53%) underwent cervical cancer screening in the form of Papanicolaou (Pap) testing. In the post-implementation period, 318 women (75.3%) underwent cervical cancer screening (p screening included fewer visits attended (pre: 4.2 ± 1.5; post: 3.4 ± 1.4; p screening rates in an urban academic HIV clinic.

  3. Psychosocial predictors of first attendance for organised mammography screening

    DEFF Research Database (Denmark)

    Aro, A R; de Koning, H J; Absetz, P

    1999-01-01

    not had a mass mammogram recently, but who regularly visited gynaecologists, attended for Pap smear screening, practised breast self examination, and who did not smoke. Low confidence in their own capabilities in breast cancer prevention, overoptimism about the sensitivity of mammography, and perception...... of breast cancer risk as moderate were also predictive of attendance. Expectation of pain at mammography was predictive of non-attendance. CONCLUSION: Mammography screening organised as a public health service was well accepted. A recent mammogram, high reliance on self control of breast cancer......, and an expectation of pain at mammography deterred attendance at screening. Further information about these factors and health information on screening are needed....

  4. Adherence to the cervical cancer screening program in women living with HIV in Denmark

    DEFF Research Database (Denmark)

    Thorsteinsson, Kristina; Ladelund, Steen; Jensen-Fangel, Søren;

    2014-01-01

    BACKGROUND: Women living with HIV (WLWH) are at increased risk of invasive cervical cancer (ICC). International HIV guidelines suggest cervical screening twice the first year after HIV diagnosis and thereafter annually. Adherence to the HIV cervical screening program in Denmark is unknown. METHODS...... to guidelines were estimated. Pathology specimens were identified from The Danish Pathology Data Bank. RESULTS: We followed 1143 WLWH and 17,145 controls with no prior history of ICC for 9,509 and 157,362 person-years. The first year after HIV diagnosis 2.6% of WLWH obtained the recommended two cervical......: We studied women from a population-based, nationwide HIV cohort in Denmark and a cohort of age-matched females from the general population. Screening behaviour was assessed from 1999-2010. Adjusted odds ratios (OR's) for screening attendance in the two cohorts and potential predictors of attendance...

  5. Costs Associated with Cervical Cancer Screening

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Tom Cox, a practicing gynecologist and president of the American Society of Colposcopy and Cervical Pathology, provides a brief introduction to cervical cancer screening guidelines and human papillomavirus (HPV) DNA testing.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  6. Cervical Cancer Screening with HPV Test

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Stewart Massad, a professor in the Division of Gynecologic Oncology at Washington University in Saint Louis and a board member of the American Society for Colposcopy and Cervical Cancer Prevention (ASCCP), talks about cotesting with human papillomavirus (HPV) as part of a cervical cancer screening program.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  7. Cervical cancer: screening and therapeutic perspectives.

    Science.gov (United States)

    Sankaranarayanan, Rengaswamy; Thara, Somanathan; Esmy, Pulikottil Okkuru; Basu, Partha

    2008-01-01

    Cervical cancer is a major cause of mortality and premature death among women in their most productive years in low- and medium-resourced countries in Asia, Africa and Latin America, despite the fact that it is an eminently preventable cancer. While cytology screening programmes have resulted in a substantial reduction of cervical cancer mortality in developed countries, they have been shown to have a wide range of sensitivity in most routine settings including in developing countries. Although liquid-based cytology improves sample adequacy, claims on improved sensitivity remain controversial. Human papillomavirus testing is more sensitive than cytology, but whether this gain represents protection against future cervical cancer is not clear. Recently, in a randomized trial, the use of visual inspection with 4% acetic acid was shown to reduce cervical cancer incidence and mortality. Cryotherapy and large loop excision of the transformation zone are effective and safe treatment methods for cervical intraepithelial neoplasia. The clinical stage of cancer is the single most important prognostic factor and should be carefully evaluated in choosing optimal treatment between surgery and radiotherapy, with or without chemotherapy. At the public health level, health care infrastructure, affordability and capacity for initiating and sustaining vaccination and screening programmes are critical factors in cervical cancer control. On the other hand, an informed practitioner can utilize the multiple opportunities in routine primary care interactions for prevention, screening, early detection and prompt referral for treatment.

  8. Community-Based Health Education has Positive Influence on the Attitude to Cervical Cancer Screening among Women in Rural Nepal.

    Science.gov (United States)

    Shakya, Sunila; Karmacharya, Biraj Man; Afset, Jan Egil; Bofin, Anna; Åsvold, Bjørn Olav; Syversen, Unni; Tingulstad, Solveig

    2016-09-01

    The main purpose of this study was to assess the knowledge of cervical cancer among women in rural Nepal and explore the feasibility and impact of a community-based awareness program on cervical cancer. Community-based educational meetings on cervical cancer and its prevention were conducted among women's groups in rural Nepal. Through a questionnaire, the women's baseline knowledge of risk factors, symptoms, and perceived risk of cervical cancer were identified. The willingness to participate in cervical cancer screening was compared before and after the educational meeting. The meetings were followed by a cervical cancer screening program. Among the 122 participants at the educational meeting, only 6 % had heard of cervical cancer. Their baseline knowledge of risk factors and symptoms was poor. The proportion of women willing to participate in cervical screening increased from 15.6 to 100 % after attending the educational meeting. All the study subjects participated in the screening program. Additionally, the study participants recruited a further 222 of their peers for screening. Poor knowledge of cervical cancer among women in rural Nepal highlights the urgency of public awareness programs for cervical cancer at a national level. A community-based awareness program can change women's attitude to cervical screening, and women's groups can play a major role in promoting participation in cervical cancer screening programs.

  9. The Participation of HPV-Vaccinated Women in a National Cervical Screening Program: Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Eva Herweijer

    Full Text Available Concerns have been raised that HPV-vaccination might affect women's cervical screening behavior. We therefore investigated the association between opportunistic HPV-vaccination and attendance after invitation to cervical screening.A cohort of all women resident in Sweden, born 1977-1987 (N=629,703, and invited to cervical screening, was followed October 2006 - December 2012. Invitations to screening were identified via the National Quality Register for Cervical Cancer Prevention, as was the primary outcome of a registered smear. Vaccination status was obtained from two nationwide health data registers. Hazard ratios (HR were estimated using Cox regression adjusted for age, education level and income (HRadj. Women were individually followed for up to 6 years, of which the first and second screening rounds were analyzed separately.Screening attendance after three years of follow-up was 86% in vaccinated women (N=4,897 and 75% in unvaccinated women (N=625,804. The crude HR of screening attendance in vaccinated vs. unvaccinated women was 1.31 (95% CI 1.27-1.35 in the first screening round. Adjustment for education and income reduced but did not erase this difference (HRadj=1.09, 95% CI 1.05-1.13. In the second screening round, attendance was likewise higher in HPV-vaccinated women (crude HR=1.26, 95% CI 1.21-1.32; HRadj=1.15, 95% CI 1.10-1.20.HPV-vaccination is so far associated with equal or higher attendance to cervical screening in Sweden in a cohort of opportunistically vaccinated young women. Most but not all of the difference in attendance was explained by socioeconomic differences between vaccinated and unvaccinated women. HPV vaccine effectiveness studies should consider screening attendance of HPV-vaccinated women when assessing incidence of screen-detected cervical lesions.

  10. The Participation of HPV-Vaccinated Women in a National Cervical Screening Program: Population-Based Cohort Study

    Science.gov (United States)

    Herweijer, Eva; Feldman, Adina L.; Ploner, Alexander; Arnheim-Dahlström, Lisen; Uhnoo, Ingrid; Netterlid, Eva; Dillner, Joakim; Sparén, Pär; Sundström, Karin

    2015-01-01

    Background Concerns have been raised that HPV-vaccination might affect women’s cervical screening behavior. We therefore investigated the association between opportunistic HPV-vaccination and attendance after invitation to cervical screening. Methods A cohort of all women resident in Sweden, born 1977-1987 (N=629,703), and invited to cervical screening, was followed October 2006 - December 2012. Invitations to screening were identified via the National Quality Register for Cervical Cancer Prevention, as was the primary outcome of a registered smear. Vaccination status was obtained from two nationwide health data registers. Hazard ratios (HR) were estimated using Cox regression adjusted for age, education level and income (HRadj). Women were individually followed for up to 6 years, of which the first and second screening rounds were analyzed separately. Results Screening attendance after three years of follow-up was 86% in vaccinated women (N=4,897) and 75% in unvaccinated women (N=625,804). The crude HR of screening attendance in vaccinated vs. unvaccinated women was 1.31 (95% CI 1.27-1.35) in the first screening round. Adjustment for education and income reduced but did not erase this difference (HRadj=1.09, 95% CI 1.05-1.13). In the second screening round, attendance was likewise higher in HPV-vaccinated women (crude HR=1.26, 95% CI 1.21-1.32; HRadj=1.15, 95% CI 1.10-1.20). Conclusions HPV-vaccination is so far associated with equal or higher attendance to cervical screening in Sweden in a cohort of opportunistically vaccinated young women. Most but not all of the difference in attendance was explained by socioeconomic differences between vaccinated and unvaccinated women. HPV vaccine effectiveness studies should consider screening attendance of HPV-vaccinated women when assessing incidence of screen-detected cervical lesions. PMID:26218492

  11. Increasing Cervical Cancer Awareness and Screening in Jamaica: Effectiveness of a Theory-Based Educational Intervention

    Directory of Open Access Journals (Sweden)

    Evelyn Coronado Interis

    2015-12-01

    Full Text Available Despite declines in cervical cancer mortality in developed countries, cervical cancer incidence and mortality rates remain high in Jamaica due to low levels of screening. Effective interventions are needed to decrease barriers to preventive behaviors and increase adoption of behaviors and services to improve prospects of survival. We enrolled 225 women attending health facilities in an intervention consisting of a pre-test, educational presentation and post-test. The questionnaires assessed attitudes, knowledge, risk factors, and symptoms of cervical cancer among women. Changes in knowledge and intention to screen were assessed using paired t-tests and tests for correlated proportions. Participants were followed approximately six months post-intervention to determine cervical cancer screening rates. We found statistically significant increases from pre-test to post-test in the percentage of questions correctly answered and in participants’ intention to screen for cervical cancer. The greatest improvements were observed in responses to questions on knowledge, symptoms and prevention, with some items increasing up to 62% from pre-test to post-test. Of the 123 women reached for follow-up, 50 (40.7% screened for cervical cancer. This theory-based education intervention significantly increased knowledge of and intention to screen for cervical cancer, and may be replicated in similar settings to promote awareness and increase screening rates.

  12. Intelligent Screening Systems for Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Yessi Jusman

    2014-01-01

    Full Text Available Advent of medical image digitalization leads to image processing and computer-aided diagnosis systems in numerous clinical applications. These technologies could be used to automatically diagnose patient or serve as second opinion to pathologists. This paper briefly reviews cervical screening techniques, advantages, and disadvantages. The digital data of the screening techniques are used as data for the computer screening system as replaced in the expert analysis. Four stages of the computer system are enhancement, features extraction, feature selection, and classification reviewed in detail. The computer system based on cytology data and electromagnetic spectra data achieved better accuracy than other data.

  13. Human papillomavirus detection in cervical scrapes from women attended in the Family Health Program

    Directory of Open Access Journals (Sweden)

    Everton Faccini Augusto

    2014-01-01

    Full Text Available OBJECTIVES: to survey the prevalence of human papillomavirus, associated risk factors and genotype distribution in women who were referred to cervical cancer screening when attended in a Family Health Program. METHOD: we conducted a cross-sectional survey, investigating 351 women. Polymerase chain reaction for DNA amplification and restriction fragment length polymorphism analysis were used to detect and typify the papillomavirus. RESULTS: virus infection was detected in 8.8% of the samples. Among the 21 different genotypes identified in this study, 14 were high risk for cervical cancer, and the type 16 was the most prevalent type. The infection was associated with women who had non-stable sexual partners. Low risk types were associated with younger women, while the high risk group was linked to altered cytology. CONCLUSION: in this sample attended a Family Health Program, we found a low rate of papillomavirus infection. Virus frequency was associated to sexual behavior. However, the broad range of genotypes detected deserves attention regarding the vaccine coverage, which includes only HPV prevalent types.

  14. [Cervical cancer screening in Switzerland - current practice and future challenges].

    Science.gov (United States)

    Untiet, Sarah; Schmidt, Nicole; Low, Nicola; Petignat, Patrick

    2013-04-01

    At the beginning of the 20th Century, cervical cancer was the leading cause of death from cancer in women. A marked decline in cervical cancer has been observed since the 1960s, in parallel with the introduction of the Papanicolau (Pap) test as a cytological screening method. Today, Pap smear screening is still the most widely used tool for cervical cancer prevention. Testing for human papillomavirus (HPV) in cervical specimens or a combination of Pap and HPV testing are also now available. In this article we compare current guidelines for cervical cancer screening in Switzerland with those in other European countries. In view of the opportunities offered by HPV testing and, since 2008, HPV vaccination, current guidelines for cervical cancer screening should be updated. Both the choice of screening tests and general organization of cervical cancer screening should be reviewed.

  15. Cervical Cancer Screening in Underserved Populations

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Lisa Flowers, a specialist in human papillovarius (HPV)-related diseases and Director of Colposcopy at Emory University School of Medicine, talks about cervical cancer screening in underinsured or uninsured women.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  16. Correlates of Cervical Cancer Screening among Vietnamese American Women

    Directory of Open Access Journals (Sweden)

    Grace X. Ma

    2012-01-01

    Full Text Available Objective. Vietnamese American women are at the greatest risk for cervical cancer but have the lowest cervical cancer screening rates. This study was to determine whether demographic and acculturation, healthcare access, and knowledge and beliefs are associated with a prior history of cervical cancer screening among Vietnamese women. Methods. Vietnamese women (n=1450 from 30 Vietnamese community-based organizations located in Pennsylvania and New Jersey participated in the study and completed baseline assessments. Logistic regression analyses were performed. Results. Overall levels of knowledge about cervical cancer screening and human papillomavirus (HPV are low. Factors in knowledge, attitude, and beliefs domains were significantly associated with Pap test behavior. In multivariate analyses, physician recommendation for screening and having health insurance were positively associated with prior screening. Conclusion. Understanding the factors that are associated with cervical cancer screening will inform the development of culturally appropriate intervention strategies that would potentially lead to increasing cervical cancer screening rates among Vietnamese women.

  17. Screening history in women with cervical cancer in a Danish population-based screening program

    DEFF Research Database (Denmark)

    Kirschner, Benny; Poll, Susanne; Rygaard, Carsten;

    2011-01-01

    The aim of this study was to explore the screening histories of all cervical cancers in a Danish screening population. The intention was to decide suboptimal sides of the screening program and to evaluate the significance of routine screening in the development of cervical cancer....

  18. European cervical cancer screening:experiences and results

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Europe has devoted great efforts to cervical cancer screening over 30 years.The mortality was generally declining although incidence rates of cervical cancer among young women have been increasing in many countries of Europe.The efficiency of screening,however,needs to be addressed by planners for an improved cost-effectiveness in the future.

  19. An overview of innovative techniques to improve cervical cancer screening

    NARCIS (Netherlands)

    Nijhuis, Esther R.; Reesink-Peters, Nathalie; Wisman, G. Bea A.; Nijman, Hans W.; van Zanden, Jelmer; Volders, Haukeline; Hollema, Harry; Suurmeijer, Albert J. H.; Schuuring, Ed; van der Zee, Ate G. J.

    2006-01-01

    Although current cytomorphology-based cervical cancer screening has reduced the incidence of cervical cancer, Pap-smears are associated with high false positive and false negative rates. This has spurred the search for new technologies to improve current screening. New methodologies are automation o

  20. Willingness and acceptability of cervical cancer screening among HIV positive Nigerian women

    Directory of Open Access Journals (Sweden)

    Ezechi Oliver C

    2013-01-01

    Full Text Available Abstract Background The proven benefit of integrating cervical cancer screening programme into HIV care has led to its adoption as a standard of care. However this is not operational in most HIV clinics in Nigeria. Of the various reasons given for non-implementation, none is backed by scientific evidence. This study was conducted to assess the willingness and acceptability of cervical cancer screening among HIV positive Nigerian women. Methods A cross sectional study of HIV positive women attending a large HIV treatment centre in Lagos, Nigeria. Respondents were identified using stratified sampling method. A pretested questionnaire was used to obtain information by trained research assistants. Obtained information were coded and managed using SPSS for windows version 19. Multivariate logistic regression model was used to determine independent predictor for acceptance of cervical cancer screening. Results Of the 1517 respondents that returned completed questionnaires, 853 (56.2% were aware of cervical cancer. Though previous cervical cancer screening was low at 9.4%, 79.8% (1210 accepted to take the test. Cost of the test (35.2% and religious denial (14.0% were the most common reasons given for refusal to take the test. After controlling for confounding variables in a multivariate logistic regression model, having a tertiary education (OR = 1.4; 95% CI: 1.03-1.84, no living child (OR: 1.5; 95% CI: 1.1-2.0, recent HIV diagnosis (OR: 1.5; 95% CI: 1.1-2.0 and being aware of cervical cancer (OR: 1.5; 95% CI: 1.2-2.0 retained independent association with acceptance to screen for cervical cancer. Conclusions The study shows that HIV positive women in our environment are willing to screen for cervical cancer and that the integration of reproductive health service into existing HIV programmes will strengthen rather than disrupt the services.

  1. Impact of cervical screening on cervical cancer mortality: estimation using stage-specific results from a nested case–control study

    Science.gov (United States)

    Landy, Rebecca; Pesola, Francesca; Castañón, Alejandra; Sasieni, Peter

    2016-01-01

    Background: It is well established that screening can prevent cervical cancer, but the magnitude of the impact of regular screening on cervical cancer mortality is unknown. Methods: Population-based case–control study using prospectively recorded cervical screening data, England 1988–2013. Case women had cervical cancer diagnosed during April 2007–March 2013 aged 25–79 years (N=11 619). Two cancer-free controls were individually age matched to each case. We used conditional logistic regression to estimate the odds ratio (OR) of developing stage-specific cancer for women regularly screened or irregularly screened compared with women not screened in the preceding 15 years. Mortality was estimated from excess deaths within 5 years of diagnosis using stage-specific 5-year relative survival from England with adjustment for age within stage based on SEER (Surveillance, Epidemiology and End Results, USA) data. Results: In women aged 35–64 years, regular screening is associated with a 67% (95% confidence interval (CI): 62–73%) reduction in stage 1A cancer and a 95% (95% CI: 94–97%) reduction in stage 3 or worse cervical cancer: the estimated OR comparing regular (⩽5.5yearly) screening to no (or minimal) screening are 0.18 (95% CI: 0.16–0.19) for cancer incidence and 0.08 (95% CI: 0.07–0.09) for mortality. It is estimated that in England screening currently prevents 70% (95% CI: 66–73%) of cervical cancer deaths (all ages); however, if everyone attended screening regularly, 83% (95% CI: 82–84%) could be prevented. Conclusions: The association between cervical cancer screening and incidence is stronger in more advanced stage cancers, and screening is more effective at preventing death from cancer than preventing cancer itself. PMID:27632376

  2. Update on prevention and screening of cervical cancer

    Science.gov (United States)

    McGraw, Shaniqua L; Ferrante, Jeanne M

    2014-01-01

    Cervical cancer is the third most common cause of cancer in women in the world. During the past few decades tremendous strides have been made toward decreasing the incidence and mortality of cervical cancer with the implementation of various prevention and screening strategies. The causative agent linked to cervical cancer development and its precursors is the human papillomavirus (HPV). Prevention and screening measures for cervical cancer are paramount because the ability to identify and treat the illness at its premature stage often disrupts the process of neoplasia. Cervical carcinogenesis can be the result of infections from multiple high-risk HPV types that act synergistically. This imposes a level of complexity to identifying and vaccinating against the actual causative agent. Additionally, most HPV infections spontaneously clear. Therefore, screening strategies should optimally weigh the benefits and risks of screening to avoid the discovery and needless treatment of transient HPV infections. This article provides an update of the preventative and screening methods for cervical cancer, mainly HPV vaccination, screening with Pap smear cytology, and HPV testing. It also provides a discussion of the newest United States 2012 guidelines for cervical cancer screening, which changed the age to begin and end screening and lengthened the screening intervals. PMID:25302174

  3. Screening for cervical cancer: when theory meets reality

    Directory of Open Access Journals (Sweden)

    Nygård Mari

    2011-06-01

    Full Text Available Abstract Cervical cancer screening reduces morbidity and mortality due to cervical cancer. However, there are many factors that determine the success of any cervical cancer prevention effort: the prevalence of human papillomavirus infection in general population, the existence of an organized screening program and the corresponding coverage, the existence and quality of the field and laboratory facilities for screening and diagnostic follow-up, and the facilities available for treating diagnosed lesions. Monitoring the patient path or "chain of action" for each patient with an abnormal screening result is of crucial importance. Cost-effectiveness models are widely used by decision-makers to determine which cervical cancer screening program would maximize health benefits within a given, usually limited, set of resources. Regardless of their level of sophistication, however, these models cannot replace empirical evaluations of the effectiveness of screening programs. Cervical cancer prevention activities need to be monitored and evaluated in each country where they are introduced to see that they meet performance standards. Policy-makers responsible for allocating resources for cervical cancer prevention have a duty to allocate resources not only for cervical cancer screening, but also for screening program surveillance.

  4. Breast and cervical cancer screening programme implementation in 16 countries

    DEFF Research Database (Denmark)

    Dowling, Emily C; Klabunde, Carrie; Patnick, Julietta;

    2010-01-01

    There is a continuing need to monitor and evaluate the impact of organized screening programmes on cancer incidence and mortality. We report results from a programme assessment conducted within the International Cancer Screening Network (ICSN) to understand the characteristics of cervical screening...... programmes within countries that have established population-based breast cancer screening programmes....

  5. Cervical cancer screening policies and coverage in Europe

    DEFF Research Database (Denmark)

    Anttila, Ahti; von Karsa, Lawrence; Aasmaa, Auni;

    2009-01-01

    The aim of the study was to compare current policy, organisation and coverage of cervical cancer screening programmes in the European Union (EU) member states with European and other international recommendations. According to the questionnaire-based survey, there are large variations in cervical...... with education, training and communication among women, medical professionals and authorities are required, accordingly. The study indicates that, despite substantial efforts, the recommendations of the Council of the EU on organised population-based screening for cervical cancer are not yet fulfilled. Decision......-makers and health service providers should consider stronger measures or incentives in order to improve cervical cancer control in Europe....

  6. Cervical cancer screening in Greenland, 1997-2011

    DEFF Research Database (Denmark)

    Holst, Signe; Wohlfahrt, Jan; Kjær, Susanne K;

    2016-01-01

    OBJECTIVE: In spite of the high incidence of cervical cancer in Greenland, no assessment has been made of the impact of organized cervical screening, introduced in 1998, in relation to occurrence of high-grade cervical lesions. The objectives of the present study were to estimate coverage...... of the screening program and to examine possible changes in cervical intraepithelial neoplasia (CIN3) incidence in Greenland during 1997-2011 according to calendar period and age. METHODS: Using nationwide registries, we calculated age-standardized incidence rates for all women born and living in Greenland...

  7. Human papillomavirus testing and genotyping in cervical screening

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Lynge, Elsebeth; Bonde, Jesper

    2011-01-01

    the incidence of cervical cancer, but has a low sensitivity for high-grade cervical intraepithelial neoplasia (CIN) and requires frequent testing. Several HPV tests have become available commercially. They appear to be more sensitive for high-grade CIN, and may further reduce the incidence of cervical cancer......Mass vaccination against human papillomavirus (HPV) genotypes 16 and 18 will, in the long term, reduce the incidence of cervical cancer, but screening will remain an important cancer control measure in both vaccinated and unvaccinated women. Since the 1960s, cytology screening has helped to reduce...

  8. Human papillomavirus self-sampling for screening non-attenders

    DEFF Research Database (Denmark)

    Lam, Janni Uyen Hoa; Rebolj, Matejka; Ejegod, Ditte Møller

    2017-01-01

    Region of Denmark were identified via the organized national invitation module. Screening history was obtained via the nationwide pathology registry. 24,000 women were invited, and as an alternative to the regular communication platforms (letter and phone), women could request a home test via a mobile...... the invitation. Stratified by screening history, long-term unscreened women were less likely to participate than intermittently screened women (28% vs 16%, pmobile-app. Self-sampling was well-accepted among...... non-attenders. Adopting modern technology-based platforms into the current organized screening program would serve as a convenient communication method between health authority and citizens, allowing easy access for the citizen and reducing the work load in administrating self-sampling approaches...

  9. Cost-effectiveness of cervical cancer screening: comparison of screening policies

    NARCIS (Netherlands)

    M.E. van den Akker-van Marle; M. van Ballegooijen (Marjolein); G.J. van Oortmarssen (Gerrit); R. Boer (Rob); J.D.F. Habbema (Dik)

    2002-01-01

    textabstractBACKGROUND: Recommended screening policies for cervical cancer differ widely among countries with respect to targeted age range, screening interval, and total number of scheduled screening examinations (i.e., Pap smears). We compared the efficiency of cervical cancer-sc

  10. Women's opinions about attending for breast cancer screening: Stability of cognitive determinants during three rounds of screening.

    NARCIS (Netherlands)

    Drossaert, C.H.C.; Boer, H.; Seydel, E.R.

    2005-01-01

    Examines women's opinions about attending breast cancer screening. Stability of beliefs and intentions towards repeat attendance at breast cancer screening; Assessment of whether cognitions changed in the course of the programme; Increase of attendance in subsequent rounds of breast cancer screening

  11. HPV-based cervical cancer screening- facts, fiction, and misperceptions.

    Science.gov (United States)

    Wentzensen, Nicolas; Arbyn, Marc

    2017-05-01

    Several randomized trials have demonstrated that HPV-based cervical cancer screening is more effective than cytology-based screening. A pooled analysis of long-term follow-up data from these trials has shown reduced cervical cancer mortality in women screened with HPV compared to cytology. As a consequence, many health systems are currently transitioning to HPV-based screening programs. However, there are several controversies that influence whether and how HPV-based cervical cancer screening is implemented in different settings. Here, we discuss the most important controversies surrounding cervical cancer screening using primary HPV testing in light of published data from clinical trials and large observational studies. Overall, there is strong and uniform evidence for the efficacy of HPV-based screening, and little evidence for the usefulness of adding cytology to primary screening. However, there is currently limited data on optimal triage strategies for HPV-positive women, a critical component of an HPV-based screening program. There will likely be multiple choices for integrated screening programs and implementation may differ depending on risk perception, healthcare funds, assay costs, and available infrastructure, among other factors, in different settings. A particular challenge is the integration of screening and vaccination programs, since increasingly vaccinated populations will have a continuous decrease of cervical cancer risk.

  12. Cost-benefit analysis of selective screening criteria for Chlamydia trachomatis infection in women attending Colorado family planning clinics.

    Science.gov (United States)

    Humphreys, J T; Henneberry, J F; Rickard, R S; Beebe, J L

    1992-01-01

    Women attending family planning clinics in Colorado during 1988 were screened for Chlamydia trachomatis infection by enzyme immunoassay (EIA, Chlamydiazyme, Abbott Laboratories; Abbott Park, IL). Cervical specimens from 11,793 women attending 22 family planning clinics were analyzed. Patient history and physical exams were used to assess risk factors for infection. A total of 913 individuals (7.7%) had positive culture results for C. trachomatis. Multivariate analysis showed that infection was significantly related to endocervical bleeding, cervical mucopurulent discharge, a new sexual partner in the last 3 months or multiple previous sexual partners (greater than 3) in the last year, pregnancy, the use of oral contraceptives, and age. Increased odd ratios were observed for the combination of endocervical bleeding and mucopurulent discharge and sexual history that included partners over the previous year as well as the most recent 3 months. A combination of these criteria was used to selectively screen women attending Colorado family planning clinics on an ongoing basis. A cost-benefit analysis employing a model reported previously showed a significant financial benefit associated with universal screening over either selective screening or no screening for C. trachomatis in this population.

  13. WELL WOMAN CLINIC - SCREENING PROGRAM FOR CERVICAL C ARCINOMAS

    OpenAIRE

    Vani Padmaja

    2014-01-01

    Cervical cancer is a common cancer occurring in women in the reproductive age group. It is also a cancer that can be easily prevented by taking Cervical Smears, staining them by the Papanicalou’s stain, diagnosing and treating them at an early stage . It is a very cost effective, sensitive, specific and easy method of early detection of cervical canc er and thereby helps in preventing the mortality and morbidity caused by invasive carcinomas. This screening program ...

  14. Teenage cervical screening in a high risk American population

    OpenAIRE

    Songlin Zhang; Jaiyeola Thomas; Joel Thibodeaux; Ami Bhalodia; Fleurette Abreo

    2011-01-01

    Background: The new 2009 ACOG guideline for cervical cytology screening changed the starting age to 21 years regardless of the age of onset of sexual intercourse. However, many recent studies have shown a dramatic increase in the incidence of cervical epithelial abnormalities among adolescents within the past two decades. Materials and Methods: For this study, the reports of 156,342 cervical cytology were available of which 12,226 (7.8%) were from teenagers. A total of 192 teenagers with high...

  15. Evaluation of a Worksite Cervical Screening Initiative to Increase Pap Smear Uptake in Malaysia: A Cluster Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Fauziah Abdullah

    2013-01-01

    Full Text Available Background. Despite the significant burden of cervical cancer, Malaysia like many middle-income countries relies on opportunistic cervical screening as opposed to a more organized population-based program. The aim of this study was to ascertain the effectiveness of a worksite screening initiative upon Papanicolaou smear test (Pap test uptake among educated working women in Malaysia. Methods. 403 female teachers who never or infrequently attended for a Pap test from 40 public secondary schools in Kuala Lumpur were recruited into a cluster randomized trial conducted between January and November 2010. The intervention group participated in a worksite cervical screening initiative whilst the control group received usual care from the existing cervical screening program. Multivariate logistic regression was performed to determine the impact of the intervention program on Pap smear uptake after 24 weeks of followup. Results. The proportion of women attending for a Pap test was significantly higher in the intervention than in the control group (18.1% versus 10.1%, P value < 0.05 with the worksite screening initiative doubling the Pap smear uptake, adjusted odds ratio 2.44 (95% CI: 1.29–4.62. Conclusion. Worksite health promotion interventions can effectively increase cervical smear uptake rates among eligible workers in middle-income countries. Policy makers and health care providers in these countries should include such interventions in strategies for reducing cervical cancer burden. This trial is registered with IRCT201103186088N1.

  16. Women's perspectives on illness in being screened for cervical cancer

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Augustussen, Mikaela; Møller, Helle;

    2013-01-01

    Background In Greenland, the incidence of cervical cancer caused by human papillomavirus (HPV) is 25 per 100,000 women; 2.5 times the Danish rate. In Greenland, the disease is most frequent among women aged 30–40. Systematic screening can identify women with cervical cell changes, which...... if untreated may cause cervical cancer. In 2007, less than 40% of eligible women in Greenland participated in screening. Objective To examine Greenlandic women's perception of disease, their understanding of the connection between HPV and cervical cancer, and the knowledge that they deem necessary to decide...... whether to participate in cervical cancer screening. Study design The methods used to perform this research were 2 focus-group interviews with 5 Danish-speaking women and 2 individual interviews with Greenlandic-speaking women. The analysis involved a phenomenological-hermeneutic approach with 3 levels...

  17. Women's perspectives on illness when being screened for cervical cancer

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Augustussen, Mikaela; Møller, Helle;

    2013-01-01

    BACKGROUND: In Greenland, the incidence of cervical cancer caused by human papillomavirus (HPV) is 25 per 100,000 women; 2.5 times the Danish rate. In Greenland, the disease is most frequent among women aged 30-40. Systematic screening can identify women with cervical cell changes, which...... if untreated may cause cervical cancer. In 2007, less than 40% of eligible women in Greenland participated in screening. OBJECTIVE: To examine Greenlandic women's perception of disease, their understanding of the connection between HPV and cervical cancer, and the knowledge that they deem necessary to decide...... whether to participate in cervical cancer screening. STUDY DESIGN: The methods used to perform this research were 2 focus-group interviews with 5 Danish-speaking women and 2 individual interviews with Greenlandic-speaking women. The analysis involved a phenomenological-hermeneutic approach with 3 levels...

  18. Women's perspectives on illness in being screened for cervical cancer

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Augustussen, Mikaela; Møller, Helle;

    2013-01-01

    Background In Greenland, the incidence of cervical cancer caused by human papillomavirus (HPV) is 25 per 100,000 women; 2.5 times the Danish rate. In Greenland, the disease is most frequent among women aged 30–40. Systematic screening can identify women with cervical cell changes, which if untrea......Background In Greenland, the incidence of cervical cancer caused by human papillomavirus (HPV) is 25 per 100,000 women; 2.5 times the Danish rate. In Greenland, the disease is most frequent among women aged 30–40. Systematic screening can identify women with cervical cell changes, which...... of analysis: naive reading, structural analysis and critical interpretation. Results These revealed that women were unprepared for screening results showing cervical cell changes, since they had no symptoms. When diagnosed, participants believed that they had early-stage cancer, leading to feelings...

  19. The Effects of New Screening Tests in the Dutch Cervical Cancer Screening Programme

    NARCIS (Netherlands)

    K. Rozemeijer (Kirsten)

    2016-01-01

    markdownabstractCervical cancer is the fourth most common cancer in women all over the world, mainly affecting young women. As cervical cancer is easy to prevent by early detection and treatment of the disease, screening was introduced in the Netherlands in the 1970s. The number of cervical cancer c

  20. Acceptability of Cervical Cancer Screening in Rural Mozambique

    Science.gov (United States)

    Audet, Carolyn M.; Matos, Carla Silva; Blevins, Meridith; Cardoso, Aventina; Moon, Troy D.; Sidat, Mohsin

    2012-01-01

    In Zambezia province, Mozambique, cervical cancer (CC) screening was introduced to rural communities in 2010. Our study sought to determine whether women would accept screening via pelvic examination and visual inspection with acetic acid (VIA) at two clinical sites near the onset of a new CC screening program. A cross-sectional descriptive study…

  1. Influences on uptake of reproductive health services in Nsangi community of Uganda and their implications for cervical cancer screening

    Directory of Open Access Journals (Sweden)

    Mirembe Florence

    2007-06-01

    Full Text Available Abstract Background Cervical cancer is the most common female cancer in Uganda. Over 80% of women diagnosed or referred with cervical cancer in Mulago national referral and teaching hospital have advanced disease. Plans are underway for systematic screening programmes based on visual inspection, as Pap smear screening is not feasible for this low resource country. Effectiveness of population screening programmes requires high uptake and for cervical cancer, minimal loss to follow up. Uganda has poor indicators of reproductive health (RH services uptake; 10% postnatal care attendance, 23% contraceptive prevalence, and 38% skilled attendance at delivery. For antenatal attendance, attendance to one visit is 90%, but less than 50% for completion of care, i.e. three or more visits. Methods We conducted a qualitative study using eight focus group discussions with a total of 82 participants (16 men, 46 women and 20 health workers. We aimed to better understand factors that influence usage of available reproductive health care services and how they would relate to cervical cancer screening, as well as identify feasible interventions to improve cervical cancer screening uptake. Results Barriers identified after framework analysis included ignorance about cervical cancer, cultural constructs/beliefs about the illness, economic factors, domestic gender power relations, alternative authoritative sources of reproductive health knowledge, and unfriendly health care services. We discuss how these findings may inform future planned screening programmes in the Ugandan context. Conclusion Knowledge about cervical cancer among Ugandan women is very low. For an effective cervical cancer-screening programme, awareness about cervical cancer needs to be increased. Health planners need to note the power of the various authoritative sources of reproductive health knowledge such as paternal aunts (Sengas and involve them in the awareness campaign. Cultural and economic

  2. Are Fewer Cervical Cancer Screenings Needed After HPV Vaccine?

    Science.gov (United States)

    ... html Are Fewer Cervical Cancer Screenings Needed After HPV Vaccine? Less testing could reduce risk of false positives ... said. Women vaccinated with earlier versions of the HPV vaccine -- which protect against the two worst cancer-causing ...

  3. Screening, HPV Vaccine Can Prevent Cervical Cancer: FDA

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_163464.html Screening, HPV Vaccine Can Prevent Cervical Cancer: FDA Agency recommends ... cancer, which is caused by the human papillomavirus (HPV). An FDA-approved vaccine called Gardasil 9 protects ...

  4. Grantee Spotlight: Dr. Kolawole Okuyemi - Improving Cervical Cancer Screening Attitudes

    Science.gov (United States)

    Dr. Kolawole Okuyumi is studying cervical cancer screening attitudes and behaviors of African immigrants and refugees in Minnesota, and introducing “cancer” and “cervix” to their everyday vocabulary.

  5. Pathways of cervical cancer screening among Chinese women

    Directory of Open Access Journals (Sweden)

    Ma GX

    2013-06-01

    Full Text Available Grace X Ma,1 Min Qi Wang,2 Xiang S Ma,3 Steven E Shive,4 Yin Tan,5 Jamil I Toubbeh51Department of Public Health, College of Health Professions, Temple University, Philadelphia, PA, 2Department of Public and Community Health, University of Maryland, College Park, MD, 3College of Health Professions and School of Medicine, Temple University, Philadelphia, PA, 4Center for Asian Health, Temple University, and Department of Health, East Stroudsburg University, East Stroudsburg, PA, 5Center for Asian Health, Department of Public Health, College of Health Professions, Temple University, Philadelphia, PA, USABackground: The purpose of this community-based study was to develop a structural equation model for factors contributing to cervical cancer screening among Chinese American women.Methods: A cross-sectional design included a sample of 573 Chinese American women aged 18 years and older. The initial step involved use of confirmatory factor analysis, that included the following variables: access to and satisfaction with health care, and enabling and predisposing cultural and health beliefs. Structural equation model analyses were conducted on factors related to cervical cancer screening.Results: Age, marital status, employment, household income, and having health insurance, but not educational level, were significantly related to cervical screening status. Predisposing and enabling factors were positively associated with cervical cancer screening. The cultural factor was significantly related to the enabling factor or the satisfaction with health care factor.Conclusion: This model highlights the significance of sociocultural factors in relation to cervical cancer screening. These factors were significant, with cultural, predisposing, enabling, and health belief factors and access to and satisfaction with health care reinforcing the need to assist Chinese American women with poor English fluency in translation and awareness of the importance of cervical

  6. Screening and cervical cancer cure: population based cohort study

    OpenAIRE

    Andrae, B.; Andersson, T. M.-L.; Lambert, P C; Kemetli, L.; Silfverdal, L.; Strander, B.; Ryd, W.; Dillner, J.; Tornberg, S.; Sparen, P.

    2012-01-01

    Objective To determine whether detection of invasive cervical cancer by screening results in better prognosis or merely increases the lead time until death. Design Nationwide population based cohort study. Setting Sweden. Participants All 1230 women with cervical cancer diagnosed during 1999-2001 in Sweden prospectively followed up for an average of 8.5 years. Main outcome measures Cure proportions and five year relative survival ratios, stratified by screening history, mode of detection, age...

  7. Frequency of Human Papillumavirus among Women with High-Grade Squamous Intraepithelial Lesions and Invasive Cervical Cancer Attending Shahid Beheshti University of Medical Sciences Clinics, Tehran, Iran

    OpenAIRE

    Nahid Khodakarami; Afshin Moradi; Hamidreza Mirzaei; Farah Farzaneh; Parvin Yavari; Mohamad Esmaeil Akbari

    2014-01-01

    Abstract Background The previous studies reported some information about prevalence release of high-risk HPV types in HSIL or cervical cancer globally and in Iran, however, this information is not enough for final judgment about vaccination against HPV or any screening program. The aim of the present study was to assess the HPV type distribution in HSIL and ICC specimens of women attending Shahid Beheshti University of Medical Sciences teaching hospitals, Tehran, Iran for treatment during 10 ...

  8. Epidemiology and costs of cervical cancer screening and cervical dysplasia in Italy

    Directory of Open Access Journals (Sweden)

    Valle Sabrina

    2009-02-01

    Full Text Available Abstract Background We estimated the number of women undergoing cervical cancer screening annually in Italy, the rates of cervical abnormalities detected, and the costs of screening and management of abnormalities. Methods The annual number of screened women was estimated from National Health Interview data. Data from the Italian Group for Cervical Cancer Screening were used to estimate the number of positive, negative and unsatisfactory Pap smears. The incidence of CIN (cervical intra-epithelial neoplasia was estimated from the Emilia Romagna Cancer Registry. Patterns of follow-up and treatment costs were estimated using a typical disease management approach based on national guidelines and data from the Italian Group for Cervical Cancer Screening. Treatment unit costs were obtained from Italian National Health Service and Hospital Information System of the Lazio Region. Results An estimated 6.4 million women aged 25–69 years undergo screening annually in Italy (1.2 million and 5.2 million through organized and opportunistic screening programs, respectively. Approximately 2.4% of tests have positive findings. There are approximately 21,000 cases of CIN1 and 7,000–17,000 cases of CIN2/3. Estimated costs to the healthcare service amount to €158.5 million for screening and €22.9 million for the management of cervical abnormalities. Conclusion Although some cervical abnormalities might have been underestimated, the total annual cost of cervical cancer prevention in Italy is approximately €181.5 million, of which 87% is attributable to screening.

  9. Low adherence to cervical cancer screening after subtotal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Møller, Lars Mikael Alling; Gimbel, Helga Margrethe

    2015-01-01

    have unnecessary tests performed after total hysterectomy. Clarification of the use of cervical/vaginal smears after hysterectomy is needed to identify women at risk of cervical dysplasia or cancer. FUNDING: Research Foundation of Region Zealand, University of Southern Denmark, Nykøbing Falster......INTRODUCTION: A reason for not recommending subtotal hysterectomy is the risk of cervical pathology. We aimed to evaluate cervical cancer screening and to describe cervical pathology after subtotal and total hysterectomy for benign indications. METHODS: Data regarding adherence to screening...... and pathology results from the national Danish registry (Patobank) were obtained on women from a randomised clinical trial and an observational study of subtotal versus total abdominal hysterectomy from the time of surgery until 2014. RESULTS: We included 501 women (259 subtotal hysterectomies and 242 total...

  10. DNA probes for papillomavirus strains readied for cervical cancer screening

    Energy Technology Data Exchange (ETDEWEB)

    Merz, B.

    1988-11-18

    New Papillomavirus tests are ready to come to the aid of the standard Papanicolauo test in screening for cervical cancer. The new tests, which detect the strains of human papillomavirus (HPV) most commonly associated with human cervical cancer, are designed to be used as an adjunct to rather than as a replacement for the Papanicolaou smears. Their developers say that they can be used to indicated a risk of developing cancer in women whose Papanicolaou smears indicate mild cervical dysplasia, and, eventually, to detect papillomavirus infection in normal Papanicolaou smears. The rationale for HPV testing is derived from a growing body of evidence that HPV is a major factor in the etiology of cervical cancer. Three HPV tests were described recently in Chicago at the Third International Conference on Human Papillomavirus and Squamous Cervical Cancer. Each relies on DNA probes to detect the presence of papillomavirus in cervical cells and/or to distinguish the strain of papillomavirus present.

  11. Risk factors for VIA positivity and determinants of screening attendances in Dar es Salaam, Tanzania

    DEFF Research Database (Denmark)

    Kahesa, Crispin; Kjaer, Susanne Kruger; Ngoma, Twalib;

    2012-01-01

    ABSTRACT: BACKGROUND: Tanzania is among the countries in the world where the cervical cancer incidence is estimated to be highest. Acknowledging an increase in the burden of cervical cancer, VIA was implemented as a regional cervical cancer screening strategy in Tanzania in 2002. With the aim of ...

  12. Cervical cancer screening programs in Latin America and the Caribbean.

    Science.gov (United States)

    Murillo, Raul; Almonte, Maribel; Pereira, Ana; Ferrer, Elena; Gamboa, Oscar A; Jerónimo, José; Lazcano-Ponce, Eduardo

    2008-08-19

    Latin America and the Caribbean (LAC) have a significant burden of cervical cancer. Prophylactic human papillomavirus (HPV) vaccines are an opportunity for primary prevention and new screening methods, such as new HPV DNA testing, are promising alternatives to cytology screening that should be analyzed in the context of regional preventive programs. Cytology-based screening programs have not fulfilled their expectations and coverage does not sufficiently explain the lack of impact on screening in LAC. While improved evaluation of screening programs is necessary to increase the impact of screening on the reduction of incidence and mortality, other programmatic aspects will need to be addressed such as follow-up of positive tests and quality control. The implementation of new technologies might enhance screening performance and reduce mortality in the region. The characteristics, performance and impact of cervical cancer screening programs in LAC are reviewed in this article.

  13. The impact of HPV vaccination on future cervical screening

    DEFF Research Database (Denmark)

    Hestbech, Mie Sara; Lynge, Elsebeth; Kragstrup, Jakob;

    2015-01-01

    OBJECTIVES: To explore the interplay between primary and secondary prevention of cervical cancer by estimating future screening outcomes in women offered human papillomavirus (HPV) vaccination when they were sexually naïve. DESIGN: Estimation of outcome of liquid-based cytology screening for a post......-HPV vaccination cohort using pre-vaccination screening data combined with HPV vaccination efficacy data reported in the literature. SETTING: Denmark. DATA: The number of screening diagnoses at first screen in a pre-vaccination birth cohort was multiplied by reported risk reductions expected for women who were...... vaccinated for HPV before sexual debut. All identified studies were reviewed by two authors, and weighted pooled estimates of vaccine efficacies were used. MAIN OUTCOME MEASURES: Proportions of positive and false-positive cervical cytologies and positive predictive value (PPV) were calculated using cervical...

  14. 'Organised' cervical screening 45 years on: How consistent are organised screening practices?

    Science.gov (United States)

    Williams, Jane H; Carter, Stacy M; Rychetnik, Lucie

    2014-11-01

    Organised screening programmes have been remarkably successful in reducing incidence and mortality from cervical cancer, while opportunistic screening varies in its effectiveness. Experts recommend that cervical screening or HPV testing be carried out only in the context of an organised programme. We sought to answer the following study questions: What does it mean for a cervical screening programme to be organised? Is there a place for opportunistic screening (in an organised programme)? We reviewed 154 peer-reviewed papers on organised and opportunistic approaches to cervical screening published between 1970 and 2014 to understand how the term 'organised' is used, formally and in practice. We found that despite broad recognition of a prescriptive definition of organisation, in practice the meaning of organisation is much less clear. Our review revealed descriptions of organised programmes that differ significantly from prescribed norms and from each other, and a variety of ways that opportunistic and organised programmes intersect. We describe the breadth of the variation in cervical cancer screening programmes and examine the relationships and overlaps between organised and opportunistic screening. Implications emerging from the review include the need to better understand the breadth of organisation in practice, the drivers and impacts of opportunistic screening and the impact of opportunistic screening on population programme outcomes. Appreciation of the complexity of cervical screening programmes will benefit both screeners and women as programmes are changed to reflect a partially vaccinated population, new evidence and new technologies.

  15. Two distinct groups of non-attenders in an organized mammography screening program

    DEFF Research Database (Denmark)

    Aro, A R; de Koning, H J; Absetz, P

    2001-01-01

    OBJECTIVE: To find out reasons for non-attendance and to study subgroup differences of the non-attenders in an organized mammography screening program. DESIGN: Prospective for background and psychosocial factors, retrospective for reasons of non-attendance. SETTING: Finnish screening based...

  16. "Inside and outside": Sikh women's perspectives on cervical cancer screening.

    Science.gov (United States)

    Oelke, Nelly D; Vollman, Ardene Robinson

    2007-03-01

    Cervical cancer can be detected at an early stage through regular screening. The literature suggests that cervical cancer in immigrant women, a growing population in Canada, is less likely to be detected early than it is in the general population, as immigrant women tend not to take advantage of screening. Culturally appropriate screening services for immigrant women are few. A qualitative descriptive study was conducted with female members of an urban Sikh community in Canada to explore perspectives on cervical cancer screening. In-depth interviews (13) and focus groups (3) were carried out to uncover challenges to cervical cancer screening. The researchers identified a prevailing theme of "inside/outside" whereby the women felt confined to their community, finding it difficult to move "outside" into Canadian society in order to participate in screening. Lack of knowledge about the importance of prevention, influence of family and community, and health-provider issues affected the women's access to screening. The results will be helpful for nurses planning and delivering screening services to Sikh women.

  17. Predictors of non-participation in cervical screening in Denmark

    DEFF Research Database (Denmark)

    Kristensson, Jenny Hansen; Sander, Bente Braad; von Euler-Chelpin, My;

    2014-01-01

    PURPOSE: The aims of this study were to identify demographic and socio-economic predictors of non-participation in cervical screening in Denmark, and to evaluate the influence of health care use on screening participation. METHODS: A population based register study was undertaken using data from ...

  18. Diagnostic and treatment procedures induced by cervical cancer screening

    NARCIS (Netherlands)

    M. van Ballegooijen (Marjolein); M.A. Koopmanschap (Marc); G.J. van Oortmarssen (Gerrit); J.D.F. Habbema (Dik); N. van der Lubbe (Nils); H.M.A. van Agt (H. M A)

    1990-01-01

    markdownabstractAbstract The amount of diagnostic and treatment procedures induced by cervical cancer screening has been assessed prospectively and related to mortality reduction. Assumptions are based on data from Dutch screening programmes and on a scenario for future developments. With 5 invita

  19. Attitudes of women about breast cancer and cervical cancern screening

    Directory of Open Access Journals (Sweden)

    ilknur Aydin Avci

    2015-06-01

    Conclusion: This research revealed that the women had moderate knowlege about breast and cervical cancer screening and artcipation in screening is low. Beside, the women who had BSE and mammography had more PAP smear. [TAF Prev Med Bull 2015; 14(3.000: 235-239

  20. False-positive Human Papillomavirus DNA tests in cervical screening

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Pribac, Igor; Lynge, Elsebeth

    2011-01-01

    Based on data from randomised controlled trials (RCT) on primary cervical screening, it has been reported that the problem of more frequent false-positive tests in Human Papillomavirus (HPV) DNA screening compared to cytology could be overcome. However, these reports predominantly operated...

  1. Value for money from HPV vaccination and cervical screening

    DEFF Research Database (Denmark)

    Ashton, Toni; Sopina, Elizaveta (Liza)

    2012-01-01

    Introduction of human papillomavirus (HPV) vaccination programs raises some important questions about the future organization of cervical screening programs. Two studies - from NZ and Canada - have addressed the question of what combination of vaccination and screening strategies might be most cost......-effective in preventing cervical cancer. Both studies indicate that some modifications to existing screening programs may be desirable as immunized females enter these programs. Variables in HPV vaccination that are likely to be particularly important for determining the future cost-effectiveness of cervical screening...... programs include: vaccine uptake rate, compliance with full doses, timely completion of doses, duration of protection, male vaccination and HPV infection rate. If value for money is to be achieved, it is important that the appropriate data are collected so that policy makers can consider the combined...

  2. Adapting the Australian system: is an organized screening program feasible in Malaysia?--an overview of cervical cancer screening in both countries.

    Science.gov (United States)

    Rashid, Rima Ma; Dahlui, Maznah; Mohamed, Majdah; Gertig, Dorota

    2013-01-01

    Cervical cancer is the third most common form of cancer that strikes Malaysian women. The National Cancer Registry in 2006 and 2007 reported that the age standardized incidence (ASR) of cervical cancer was 12.2 and 7.8 per 100,000 women, respectively. The cumulative risk of developing cervical cancer for a Malaysian woman is 0.9 for 74 years. Among all ethnic groups, the Chinese experienced the highest incidence rate in 2006, followed by Indians and Malays. The percentage cervical cancer detected at stage I and II was 55% (stage I: 21.0%, stage II: 34.0%, stage III: 26.0% and stage IV: 19.0%). Data from Ministry of Health Malaysia (2006) showed a 58.9% estimated coverage of pap smear screening conducted among those aged 30-49 years. Only a small percentage of women aged 50-59 and 50-65 years old were screened, 14% and 13.8% coverage, respectively. Incidence of cervical cancer was highest (71.6%) among those in the 60-65 age group (MOH, 2003). Currently, there is no organized population-based screening program available for the whole of Malaysia. A pilot project was initiated in 2006, to move from opportunistic cervical screening of women who attend antenatal and postnatal visits to a population based approach to be able to monitor the women through the screening pathway and encourage women at highest risk to be screened. The project was modelled on the screening program in Australia with some modifications to suit the Malaysian setting. Substantial challenges have been identified, particularly in relation to information systems for call and recall of women, as well as laboratory reporting and quality assurance. A cost-effective locally-specific approach to organized screening, that will provide the infrastructure for increasing participation in the cervical cancer screening program, is urgently required.

  3. Cervical cancer screening in primary health care setting in Sudan

    DEFF Research Database (Denmark)

    Ibrahim, Ahmed; Aro, Arja R.; Rasch, Vibeke;

    2012-01-01

    OBJECTIVE: To determine the feasibility of visual inspection with the use of acetic acid (VIA) as a screening method for cervical cancer, an alternative to the Pap smear used in primary health care setting in Sudan, and to compare sensitivity, specificity, positive and negative predictive values....../119 (73.9%) were positive for cervical intraepithelial neoplasia. VIA had higher sensitivity than Pap smear (74.2% versus 72.9%; P = 0.05) respectively. Out of 88 confirmed positive cases, 22 (25.0%) cases were invasive cervical cancer in stage 1, of which 19 versus three were detected by VIA and Pap...... of this study showed that VIA has higher sensitivity and lower specificity compared to Pap smear, but a combination of both tests has greater sensitivity and specificity than each test independently. It indicates that VIA is useful for screening of cervical cancer in the primary health care setting in Sudan...

  4. Point: cervical cancer screening guidelines should consider observational data on screening efficacy in older women.

    Science.gov (United States)

    Rustagi, Alison S; Kamineni, Aruna; Weiss, Noel S

    2013-10-01

    Recent guidelines from the American Cancer Society, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology recommend cessation of cervical cancer screening at age 65 years for women with an "adequate" history of negative Papanicolaou smears. In our view, those who formulated these guidelines did not consider a growing body of evidence from nonrandomized studies that provides insight into the efficacy of cervical cancer screening among older women. First, older women are not at indefinitely low risk following negative screening results. Second, recent data from the United States, the United Kingdom, and Sweden suggest that screening of older women is associated with substantial reductions in cervical cancer incidence and mortality, even among previously screened women. It may be that after consideration of the reduced incidence of (and reduced mortality from) cervical cancer that may result from screening older women, the harms and economic costs of screening will be judged to outweigh its benefits. However, it is essential to consider the now-documented benefits of cervical screening when formulating screening guidelines for older women, and recommendations that do not do so will lack an evidence base.

  5. Triage of HPV positive women in cervical cancer screening.

    Science.gov (United States)

    Wentzensen, Nicolas; Schiffman, Mark; Palmer, Timothy; Arbyn, Marc

    2016-03-01

    Despite HPV vaccines, screening will remain central for decades to control cervical cancer. Recently, HPV testing alone or with cytology was introduced as an alternative to cytology screening. However, most HPV infections are harmless and additional tests are required to identify women with progressing infections or precancer. With three options for primary screening, and without clear strategies for triage of screen-positive women, there is great confusion about the best approach. Also, increasing HPV vaccination coverage will lead to lower disease prevalence, and force new screening approaches. Currently recommended triage strategies for primary HPV screening include HPV genotyping for HPV16 and HPV18 and cytology. Other alternatives that are currently evaluated include p16/Ki-67 dual stain cytology, host methylation, and viral methylation testing. Clinical management of women with cervical cancer screening results is moving to use risk thresholds rather than individual test results. Specific risk thresholds have been defined for return to primary screening, repeat testing, referral to colposcopy, and immediate treatment. Choice of test algorithms is based on comparison of absolute risk estimates from triage tests with established clinical thresholds. Importantly, triage tests need to be evaluated together with the primary screening test and the downstream clinical management. An optimal integrated screening and triage strategy should reassure the vast majority of women that they are at very low risk of cervical cancer, send the women at highest risk to colposcopy at the right time, when disease can be colposcopically detected, and minimize the intermediate risk group that requires continued surveillance.

  6. Review of the Cervical Cancer Burden and Population-Based Cervical Cancer Screening in China.

    Science.gov (United States)

    Di, Jiangli; Rutherford, Shannon; Chu, Cordia

    2015-01-01

    Cervical cancer continues to be a serious public health problem in the developing world, including China. Because of its large population with geographical and socioeconomic inequities, China has a high burden of cervical cancer and important disparities among different regions. In this review, we first present an overview of the cervical cancer incidence and mortality over time, and focus on diversity and disparity in access to care for various subpopulations across geographical regions and socioeconomic strata in China. Then, we describe population-based cervical cancer screening in China, and in particular implementation of the National Cervical Cancer Screening Program in Rural Areas (NACCSPRA) and the challenges that this program faces. These include low screening coverage, shortage of qualified health care personnel and limited funds. To improve prevention of cervical cancer and obtain better cancer outcomes, the Chinese government needs to urgently consider the following key factors: reducing disparities in health care access, collecting accurate and broadly representative data in cancer registries, expanding target population size and increasing allocation of government funding for training of personnel, improving health education for women, enhancing quality control of screening services and improving a system to increase follow up for women with positive results.

  7. CERVICAL ACID PHOSPHATASE: EVALUATION AS AN ADJUVANT TO PAPANICOLAOU SMEAR SCREENING IN CERVICAL CANCER DETECTION

    Directory of Open Access Journals (Sweden)

    Niranjan

    2015-02-01

    Full Text Available INTRODUCTION: Carcinoma of cervix accounts for 15% of all cancers diagnosed worldwide and is the second most common cancer in women. In the year 2000 there were over 4,71,000 new cases diagnosed and 2,88,000 deaths from cervical cancer. (1 Approximately 79% of these deaths occurred in developing countries. (2 Cervical cancer is preventable, but most women in poorer countries do not have access to effective screening programs. In India it is estimated that approximately 100,000 women develop cervical cancer each year. (3 Cancer cervix occupies either the top r ank or second among cancers in women in developing countries, whereas, in the developed countries cancer cervix does not find a place even in top five leading cancers in women. This is due to routine screening by cervical smear. Cervical smear cytology scr eening by Papanicolaou (Pap stained smears is the most efficacious and cost - effective method of cancer screening, decreasing the incidence and mortality from cervical cancer. (4 However, cervical smear screening has significant rates of false - positive and false - negative results, ranging from 10.3% for false positive cases to 5.6% for false negative cases. (5,6 To improve the detection and screening of cancerous and precancerous lesions of the cervix a number of sophisticated tests are available which are e xpensive and can be done only in a tertiary laboratory. To over - come this problems a cost effective cytochemical stain was introduced to measure the acid phosphatase activity in the cervical epithelium. (7 Since the description of the new Cervical Acid Phosphatase Test (CAP Test for visualization of cervical acid phosphatase activity (CAP inside abnormal cervical cells on smears, it has become possible to explore this enzyme as a biomarker for cervical dys plasia, and as a possible surrogate for PAP smear in detection of cervical intraepithelial neoplasia (CIN. AIMS AND OBJECTIVES: To assess the utility of Cervical Acid

  8. Two cytological methods for screening for cervical cancer

    DEFF Research Database (Denmark)

    Kirschner, B.; Simonsen, K.; Junge, J.

    2008-01-01

    INTRODUCTION: Denmark has had an organized screening programme for cervical cancer since the 1960s. In spite of this, almost 150 Danish women die from the disease each year. There are currently two different methods for preparation of cervical samples: conventional Papanicolaou smear and liquid......-based cytology. MATERIALS AND METHODS: In 2002, the Department of Pathology, Hvidovre Hospital changed over from the conventional Papanicolaou smear screening method to SurePath liquid-based cytology. This article is based on a retrospective comparison on data from the population screening programme for cervical...... cancer in the Municipality of Copenhagen. RESULTS: The number of tests with the diagnosis of "normal cells" decreased 1% after the conversion to liquid-based cytology, whilst the number of tests with "atypical cells" and "cells suspicious for malignancy" increased by 64.3% and 41.2% respectively...

  9. Coverage of cervical cancer screening in Catalonia for the period 2008-2011 among immigrants and Spanish-born women.

    Directory of Open Access Journals (Sweden)

    Vanesa eRodriguez-Sales

    2013-12-01

    Full Text Available Background: The Public Health system in Catalonia, Spain provides a free of charge opportunistic cervical cancer screening. In June 2006 a revised recommendations for cervical cancer screening was introduced to increase coverage and to promote a three-year interval between screening tests. Aim: This study examines cervical cancer screening coverage and prevalence of cytology abnormalities in Catalonia by immigration status.Methods: The study analyses the cytologies registered among women aged 25-65 that have been attended at the Primary Health Centers (PHC for any reason (n=1,242,105 during 2008-11. Coverage was estimated from Governmental data base Information System Primary Care (SISAP that includes 77% of PHC. The database is anonymous, and includes information on age, country of birth, diagnostic center and cytology results Results: During the period 2008-2011, 758,690 smears were performed in a total of 595,868 women over 14 years, of whom 18.3% were immigrants. Cytology coverage was higher among immigrant women compared to Spanish born (51.2% and 39% respectively. Immigrant women also had a higher prevalence of abnormal Paps compared to the Spanish population, 4.9% and 3.3% respectively.Conclusion: Immigrant women in Catalonia have a good access to the Public Health Services and to cervical cancer screening facilities. The higher prevalence of abnormal cytologies in immigrant women compared to native women indicates the relevance to prioritize cervical cancer screening activities on a regular base in new comers.

  10. Cervical intraepithelial lesions in females attending Women′s Health Clinics in Alexandria, Egypt

    Directory of Open Access Journals (Sweden)

    Mona Abdel-Hadi

    2015-01-01

    Full Text Available Background: Data from Egyptian studies provide widely varying estimates on the prevalence of preinvasive cervical lesions. The aim of this study was to estimate the rate of cervical intraepithelial neoplasia (CIN   in Egyptian women living in Alexandria to clarify the need for implementing a national organized screening program and a vaccination program in our community. Materials and Methods: The study was conducted over a 6 years period and covered the different socioeconomic levels to have a representative sample for women living in Alexandria. All women included did not have any cervical disorder related complaints. Conventional Pap smears were obtained and diagnosed using the Bethesda system. Women with abnormal Pap smears were managed according to the 2006 consensus guidelines within the available facilities. Persistent abnormal cytological results were referred for colposcopic biopsy. Histological results were grouped into: Reactive changes, CIN 1, CIN 2/CIN 3 and adenocarcinoma in-situ (AIS. Results: Out of the 6173 smears included in the study 6072 (98.36% were normal and only 101 (1.63% were abnormal. After colposcopic biopsies, 0.08% had CIN 1, 0.03% had CIN 2, 3 and 0.01% had AIS. Conclusion: We concluded that cervical cancer screening programs, although life-saving for a number of women, are not a sufficiently high priority in our community. Money for national health screening programs should preferably be directed more towards recruiting women for breast cancer screening, since breast cancer accounts for about 33% of all female cancers in Egypt ranking number one, while cervical cancer ranks number 13.

  11. Cervical cancer screening by visual inspection in Côte d'Ivoire, operational and clinical aspects according to HIV status

    Directory of Open Access Journals (Sweden)

    Horo Apollinaire

    2012-03-01

    Full Text Available Abstract Background Cervical cancer screening is not yet standard of care of women attending HIV care clinics in Africa and presents operational challenges that need to be addressed. Methods A cervical cancer screening program based on visual inspection methods was conducted in clinics providing antiretroviral treatment (ART in Abidjan, Côte d'Ivoire. An itinerant team of midwives was in charge of proposing cervical cancer screening to all HIV-positive women enrolled in ART clinics as well as to HIV-negative women who were attending the Abidjan national blood donor clinic. Positively screened women were systematically referred to a colposcopic examination. A phone-based tracking procedure was implemented to reach positively screened women who did not attend the medical consultation. The association between HIV status and cervical cancer screening outcomes was estimated using a multivariate logistic model. Results The frequency of positive visual inspection was 9.0% (95% CI 8.0-10.0 in the 2,998 HIV-positive women and 3.9% (95% CI 2.7-5.1 in the 1,047 HIV-negative ones (p -4. In multivariate analysis, HIV infection was associated with a higher risk of positive visual inspection [OR = 2.28 (95% CI 1.61-3.23] as well as more extensive lesions involving the endocervical canal [OR = 2.42 (95% CI 1.15-5.08]. The use of a phone-based tracking procedure enabled a significant reduction of women not attending medical consultation after initial positive screening from 36.5% to 19.8% (p -4. Conclusion The higher frequency of positive visual inspection among HIV-positive women supports the need to extend cervical cancer screening program to all HIV clinics in West Africa. Women loss to follow-up after being positively screened is a major concern in cervical screening programs but yet, partly amenable to a phone tracking procedure.

  12. Human papillomavirus testing versus cytology in primary cervical cancer screening: End-of-study and extended follow-up results from the Canadian cervical cancer screening trial.

    Science.gov (United States)

    Isidean, Sandra D; Mayrand, Marie-Hélène; Ramanakumar, Agnihotram V; Gilbert, Laura; Reid, Stephanie L; Rodrigues, Isabel; Ferenczy, Alex; Ratnam, Sam; Coutlée, François; Franco, Eduardo L

    2016-12-01

    The Canadian Cervical Cancer Screening Trial was a randomized controlled trial comparing the performance of human papillomavirus (HPV) testing and Papanicolaou cytology to detect cervical intraepithelial neoplasia of grades 2 or worse (CIN2+) among women aged 30-69 years attending routine cervical cancer screening in Montreal and St. John's, Canada (n = 10,154). We examined screening and prognostic values of enrollment cytologic and HPV testing results. Extended follow-up data were available for St. John's participants (n = 5,754; 501,682.6 person-months). HPV testing detected more CIN2+ than cytology during protocol-defined (82.9 vs. 44.4%) and extended (54.2 vs. 19.3%) follow-up periods, respectively. Three-year risks ranged from 0.87% (95% CI: 0.37-2.05) for HPV-/Pap- women to 35.77% (95% CI: 25.88-48.04) for HPV+/Pap+ women. Genotype-specific risks ranged from 0.90% (95% CI: 0.40-2.01) to 43.84% (95% CI: 32.42-57.24) among HPV- and HPV16+ women, respectively, exceeding those associated with Pap+ or HPV+ results taken individually or jointly. Ten-year risks ranged from 1.15% (95% CI: 0.60-2.19) for HPV-/Pap- women to 26.05% (95% CI: 15.34-42.13) for HPV+/Pap+ women and genotype-specific risks ranged from 1.13% (95% CI: 0.59-2.14) to 32.78% (95% CI: 21.15-48.51) among women testing HPV- and HPV16+, respectively. Abnormal cytology stratified risks most meaningfully for HPV+ women. Primary HPV testing every 3 years provided a similar or greater level of reassurance against disease risks as currently recommended screening strategies. HPV-based cervical screening may allow for greater disease detection than cytology-based screening and permit safe extensions of screening intervals; genotype-specific testing could provide further improvement in the positive predictive value of such screening.

  13. Understanding women's hesitancy to undergo less frequent cervical cancer screening.

    Science.gov (United States)

    Gerend, Mary A; Shepherd, Melissa A; Kaltz, Emily A; Davis, Whitney J; Shepherd, Janet E

    2017-02-01

    Inappropriate cervical cancer screening (e.g., screening too often) can result in unnecessary medical procedures, treatment, and psychological distress. To balance the benefits and harms, cervical cancer screening guidelines were recently modified in favor of less frequent screening (i.e., every 3 to 5 years). This study investigated women's acceptance of less frequent cervical cancer screening and their primary concerns about extending the screening interval beyond one year. A national sample of 376 U.S. women ages 21-65 completed an online survey in 2014. Predictors of willingness to get a Pap test every 3 to 5 years were identified using logistic regression. We also examined perceived consequences of less frequent screening. Over two thirds were willing to undergo less frequent screening if it was recommended by their healthcare provider. Nevertheless, nearly 20% expressed discomfort with less frequent screening and 45% were either in opposition or unsure whether they would be comfortable replacing Pap testing with primary HPV testing. Women whose most recent Pap test was (vs. was not) within the past year and women who ever (vs. never) had an abnormal Pap test were less willing to extend the screening interval. Additionally, women who typically saw an obstetrician/gynecologist or nurse practitioner for their Pap test (vs. a family physician) were less accepting of the guidelines. Hesitancy about the longer screening interval appears to stem from concern about developing cancer between screenings. Findings contribute to the growing body of research on cancer overscreening and may inform interventions for improving adherence to cancer screening guidelines.

  14. Screening cervical lesions with Fourier transform infrared spectroscopy

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The screening results were reported based on the Fourier transform infrared spectroscopy (FTIR) analysis of the samples of exfoliated cervical cells from 354 women. Their spectra can be sorted into two types based on the emerging or not of the absorption bands near 970 cm-1 and 1 170 cm-1: T1 (83.1%) type without emerging, and T2 (16.9%) type with obviously emerging. All of the samples assigned to T1 were cytologically diagnosed as normal or within normal limits (PapⅠ). 28.9% and 71.1% of samples exhibiting T2 profile, were cytologically evaluated as Pap Ⅰand abnormal respectively. 3 women in the abnormal group were diagnosed as to have cervical cells with changes associated with high grade of inflammation, cervical scar and cervical erosion. Furthermore, based on the progressive change of the relative intensities of the absorption bands, both T1 and T2 profiles can be categorized into 6 subtypes. The observed heterogeneous spectra and the progressive changes in the absorption frequencies and the relative intensities exhibit features suggestive of the progressive process of cervical lesion. The FTIR method has the potential to complement the cytological smear for large-volume screening of cervical lesions.

  15. Burden of cervical cancer and role of screening in India

    Science.gov (United States)

    Bobdey, Saurabh; Sathwara, Jignasa; Jain, Aanchal; Balasubramaniam, Ganesh

    2016-01-01

    Background: Cervical cancer is a major cause of cancer mortality in women and more than a quarter of its global burden is contributed by developing countries. In India, in spite of alarmingly high figures, there is no nationwide government-sponsored screening program. This study was conducted to assess the burden of cervical cancer in India and review the performance characteristics of available cervical cancer screening tools, so as to provide evidence-based recommendations for application of most practically suited screening test to be used in resource-poor field settings. Materials and Methods: MEDLINE and Web of Science electronic database were searched from January 1990 to December 2015, using the keywords such as “cervical cancer”, “screening”, “early detection”, “cervical cytology” and “visual inspection”, and their corresponding MeSH terms in combination with Boolean operators “OR, AND.” Two authors independently selected studies that are published in English and conducted in India. A total of 11 studies were found to be relevant and eligible to be included in the present study. Results: In India, cervical cancer contributes to approximately 6–29% of all cancers in women. The age-adjusted incidence rate of cervical cancer varies widely among registries; highest is 23.07/100,000 in Mizoram state and the lowest is 4.91/100,000 in Dibrugarh district. The pooled estimates of sensitivity and specificity of visual inspection with acetic acid (VIA), magnified VIA, visual inspection with Lugol's iodine (VILI), cytology (Pap smear), and human papillomavirus DNA were found to be 67.65% and 84.32%, 65.36% and 85.76%, 78.27% and 87.10%, 62.11% and 93.51%, and 77.81% and 91.54%, respectively. Conclusions: In developing countries because of lack of necessary infrastructure and quality control, high-quality cytology screening may not be feasible for wide-scale implementation. Hence, cervical cancer screening program based on visual screening test

  16. Burden of cervical cancer and role of screening in India

    Directory of Open Access Journals (Sweden)

    Saurabh Bobdey

    2016-01-01

    Full Text Available Background: Cervical cancer is a major cause of cancer mortality in women and more than a quarter of its global burden is contributed by developing countries. In India, in spite of alarmingly high figures, there is no nationwide government-sponsored screening program. This study was conducted to assess the burden of cervical cancer in India and review the performance characteristics of available cervical cancer screening tools, so as to provide evidence-based recommendations for application of most practically suited screening test to be used in resource-poor field settings. Materials and Methods: MEDLINE and Web of Science electronic database were searched from January 1990 to December 2015, using the keywords such as “cervical cancer”, “screening”, “early detection”, “cervical cytology” and “visual inspection”, and their corresponding MeSH terms in combination with Boolean operators “OR, AND.” Two authors independently selected studies that are published in English and conducted in India. A total of 11 studies were found to be relevant and eligible to be included in the present study. Results: In India, cervical cancer contributes to approximately 6–29% of all cancers in women. The age-adjusted incidence rate of cervical cancer varies widely among registries; highest is 23.07/100,000 in Mizoram state and the lowest is 4.91/100,000 in Dibrugarh district. The pooled estimates of sensitivity and specificity of visual inspection with acetic acid (VIA, magnified VIA, visual inspection with Lugol's iodine (VILI, cytology (Pap smear, and human papillomavirus DNA were found to be 67.65% and 84.32%, 65.36% and 85.76%, 78.27% and 87.10%, 62.11% and 93.51%, and 77.81% and 91.54%, respectively. Conclusions: In developing countries because of lack of necessary infrastructure and quality control, high-quality cytology screening may not be feasible for wide-scale implementation. Hence, cervical cancer screening program based on

  17. Teenage cervical screening in a high risk American population

    Directory of Open Access Journals (Sweden)

    Songlin Zhang

    2011-01-01

    Full Text Available Background: The new 2009 ACOG guideline for cervical cytology screening changed the starting age to 21 years regardless of the age of onset of sexual intercourse. However, many recent studies have shown a dramatic increase in the incidence of cervical epithelial abnormalities among adolescents within the past two decades. Materials and Methods: For this study, the reports of 156,342 cervical cytology were available of which 12,226 (7.8% were from teenagers. A total of 192 teenagers with high grade intraepithelial lesion (HSIL cervical cytology were identified. The ages ranged from 13 to 19 years with a mean of 17.7 years and a median of 18 years. Among them, 31.3% were pregnant, 12.0% were postpartum, and 13.5% were on oral contraceptive. Ninety-eight had prior cervical cytology. Results: The teenagers had statistically significant higher detection rates of overall abnormal cervical cytology (23.6% vs. 6.6%, P = 0, with 15.4% vs. 3.2% (P = 0 of low grade intraepithelial lesion (LSIL and 1.8% vs. 1.0% (P = 2.56 Χ 10 -13 of HSIL compared to women ≥20 years. The teenage group had the highest abnormal cytology among all age groups. The LSIL/HSIL ratio was 8.5:1 for teenagers and 3.1:1 for women ≥20 years. A total of 131 teenagers had cervical biopsies within 12 months of the HSIL cytology, with diagnoses of 39 CIN 3, 1 VAIN 3, 15 CIN 2, 62 CIN 1, and 14 had a negative histology (CIN 0. Only in 19 of these 39 women, the CIN 2/3 lesion proved to be persistent. Conclusion: We conclude that cytology screening of high risk teenagers is effective in detecting CIN 2/3 lesions. Moreover, treatment and careful follow-up can be realized.

  18. European guidelines for quality assurance in cervical cancer screening: recommendations for cervical cytology terminology.

    NARCIS (Netherlands)

    Herbert, A.; Bergeron, C.; Wiener, H.; Schenck, U.; Klinkhamer, P.; Bulten, J.; Arbyn, M.

    2007-01-01

    There are many different systems of cytology classification used in the member states of the European Union (EU) and many different languages. The following short annexe to Chapter 3 of the European Guidelines for Quality Assurance in Cervical Cancer Screening provides a framework that will allow di

  19. Cervical screening and cervical cancer death among older women: a population-based, case-control study.

    Science.gov (United States)

    Rustagi, Alison S; Kamineni, Aruna; Weinmann, Sheila; Reed, Susan D; Newcomb, Polly; Weiss, Noel S

    2014-05-01

    Recent research suggests that cervical screening of older women is associated with a considerable decrease in cervical cancer incidence. We sought to quantify the efficacy of cervical cytology screening to reduce death from this disease. Among enrollees of 2 US health plans, we compared Papanicolaou smear screening histories of women aged 55-79 years who died of cervical cancer during 1980-2010 (cases) to those of women at risk of cervical cancer (controls). Controls were matched 2:1 to cases on health plan, age, and enrollment duration. Cytology screening during the detectable preclinical phase, estimated as the 5-7 years before diagnosis during which cervical neoplasia is asymptomatic but cytologically detectable, was ascertained from medical records. A total of 39 cases and 80 controls were eligible. The odds ratio of cervical cancer death associated with screening during the presumed detectable preclinical phase was 0.26 (95% confidence interval: 0.10, 0.63) after adjustment for matching characteristics, smoking, marital status, and race/ethnicity using logistic regression. We estimate that cervical cytology screening of all women aged 55-79 years in the United States could avert 630 deaths annually. These results provide a minimum estimate of the efficacy of human papillomavirus DNA screening-a more sensitive test-to reduce cervical cancer death among older women.

  20. Outcomes in cervical screening using various cytology technologies

    DEFF Research Database (Denmark)

    Barken, Sidsel S; Rebolj, Matejka; Lynge, Elsebeth;

    2013-01-01

    signed out as normal, (3) liquid-based cytology (LBC) with 50% automatically signed out as normal, (4) LBC with 25% automatically signed out as normal, and (5) LBC with 25% automatically signed out as normal and with 16 preselected areas for attention in manual reading. We calculated proportion......Unlike for human papillomavirus screening, little is known about the possible age-dependent variation in the outcomes of cervical cytology screening. The aim of our study was to describe age-related outcomes of five cytological technologies in a population-based screening program targeting women...... aged 23-59 years. All cervical cytology from women residing in Copenhagen has been analyzed in the laboratory of the Department of Pathology, Hvidovre University Hospital. We studied five technology phases: (1) conventional cytology with manual reading, (2) conventional cytology with 50% automatically...

  1. WELL WOMAN CLINIC - SCREENING PROGRAM FOR CERVICAL C ARCINOMAS

    Directory of Open Access Journals (Sweden)

    Vani Padmaja

    2014-02-01

    Full Text Available Cervical cancer is a common cancer occurring in women in the reproductive age group. It is also a cancer that can be easily prevented by taking Cervical Smears, staining them by the Papanicalou’s stain, diagnosing and treating them at an early stage . It is a very cost effective, sensitive, specific and easy method of early detection of cervical canc er and thereby helps in preventing the mortality and morbidity caused by invasive carcinomas. This screening program was conducted in the outpatient department of Gandhi hospital. All th e women between the age of 21 and 65years were included. The antenatal women were excluded. A total of 2864 women were screened and 2562 Pap smears were done. 228 High grade intraepithelial lesions [HSIL ] and 365 Low Grade intraepithelial lesions [LSIL] were diagnosed. Cervical biopsy was done. Curative treatment was offered to all those who had intraepithelial lesions on biopsy. Hence such screening programs are of great help in detecting early cancer and preventing invasive cancers. Thus reducing mortality and morbidity associated with invasive cancers

  2. Risk of invasive cervical cancer after atypical glandular cells in cervical screening: nationwide cohort study

    Science.gov (United States)

    Andrae, Bengt; Sundström, Karin; Ström, Peter; Ploner, Alexander; Elfström, K Miriam; Arnheim-Dahlström, Lisen; Dillner, Joakim; Sparén, Pär

    2016-01-01

    Objectives To investigate the risks of invasive cervical cancer after detection of atypical glandular cells (AGC) during cervical screening. Design Nationwide population based cohort study. Setting Cancer and population registries in Sweden. Participants 3 054 328 women living in Sweden at any time between 1 January 1980 and 1 July 2011 who had any record of cervical cytological testing at ages 23-59. Of these, 2 899 968 women had normal cytology results at the first screening record. The first recorded abnormal result was atypical glandular cells (AGC) in 14 625, high grade squamous intraepithelial lesion (HSIL) in 65 633, and low grade squamous intraepithelial lesions (LSIL) in 244 168. Main outcome measures Cumulative incidence of invasive cervical cancer over 15.5 years; proportion of invasive cervical cancer within six months of abnormality (prevalence); crude incidence rates for invasive cervical cancer over 0.5-15.5 years of follow-up; incidence rate ratios compared with women with normal cytology, estimated with Poisson regression adjusted for age and stratified by histopathology of cancer; distribution of clinical assessment within six months after the abnormality. Results The prevalence of cervical cancer was 1.4% for women with AGC, which was lower than for women with HSIL (2.5%) but higher than for women with LSIL (0.2%); adenocarcinoma accounted for 73.2% of the prevalent cases associated with AGC. The incidence rate of invasive cervical cancer after AGC was significantly higher than for women with normal results on cytology for up to 15.5 years and higher than HSIL and LSIL for up to 6.5 years. The incidence rate of adenocarcinoma was 61 times higher than for women with normal results on cytology in the first screening round after AGC, and remained nine times higher for up to 15.5 years. Incidence and prevalence of invasive cervical cancer was highest when AGC was found at ages 30-39. Only 54% of women with AGC underwent histology assessment

  3. Cervical pre-malignant lesions in HIV infected women attending Care and Treatment Centre in a tertiary hospital, Dar es Salaam, Tanzania.

    Science.gov (United States)

    Balandya, Belinda S; Pembe, Andrea B; Mwakyoma, Henry A

    2011-09-01

    The aims of this study was to determine proportion of HIV infected women with cervical pre-malignant lesions; and compare the use of Visual Inspection of the cervix after application of Acetic acid (VIA) and Papanicolau (Pap) smear in screening for cervical premalignant lesions in HIV positive women attending Care and Treatment Centre (CTC) at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania. A total of 316 women aged 18-70 years had a Pap smear taken for cytology, followed by spraying onto the cervix with 4% acetic acid and then inspecting it. Cytology was considered negative when there was no Cervical Intraepithelial Neoplasia (CIN) lesion reported from the Pap smear taken, and positive if CIN lesion 1, 2 or 3 was reported. Detection of a well-defined, opaque acetowhite lesion close to the squamocolumnar junction or close to the external cervical os constituted a positive VIA. Out of 316 women, 132 women had acetowhite lesions on VIA, making the proportion of abnormal cervical lesions to be 42.4%. One hundred and one out of 312 women (32.4%) had CIN lesions detected on Pap smear. The proportion of agreement between these two tests was 0.3. The proportion of agreement was moderate in women with advanced WHO HIV clinical stage of the disease and in women not on ART (Anti Retroviral Therapy). Women with CD-4 count less than 200 cells/mm3 had more abnormal cervical lesions. There is considerable proportion of HIV positive women with premalignant lesions of the cervix. Considering the proportion of HIV women with abnormal lesions and the difficulty in logistics of doing Pap smear in low resource settings, these results supports the recommendation to introduce screening of premalignant lesions of the cervix using VIA to all HIV infected women.

  4. Cervical cancer screening and adherence to follow-up among Hispanic women study protocol: a randomized controlled trial to increase the uptake of cervical cancer screening in Hispanic women

    Directory of Open Access Journals (Sweden)

    Duggan Catherine

    2012-05-01

    Full Text Available Abstract Background In the US, Hispanic women have a higher incidence of, and mortality from, cervical cancer than non-Hispanic white women. The reason for this disparity may be attributable to both low rates of screening and poor adherence to recommended diagnostic follow-up after an abnormal Pap test. The 'Cervical Cancer Screening and Adherence to Follow-up Among Hispanic Women' study is a collaboration between a research institution and community partners made up of members from community based organizations, the Yakima Valley Farm Workers Clinic and the Breast, Cervical, and Colon Health Program of the Yakima District . The study will assess the efficacy of two culturally-appropriate, tailored educational programs designed to increase cervical cancer screening among Hispanic women, based in the Yakima Valley, Washington, US. Methods/design A parallel randomized-controlled trial of 600 Hispanic women aged 21–64, who are non-compliant with Papanicolau (Pap test screening guidelines. Participants will be randomized using block randomization to (1 a control arm (usual care; (2 a low-intensity information program, consisting of a Spanish-language video that educates women on the importance of cervical cancer screening; or (3 a high-intensity program consisting of the video plus a ‘promotora’ or lay-community health educator-led, home based intervention to encourage cervical cancer screening. Participants who attend cervical cancer screening, and receive a diagnosis of an abnormal Pap test will be assigned to a patient navigator who will provide support and information to promote adherence to follow-up tests, and any necessary surgery or treatment. Primary endpoint: Participants will be tracked via medical record review at community-based clinics, to identify women who have had a Pap test within 7 months of baseline assessment. Medical record reviewers will be blinded to randomization arm. Secondary endpoint: An evaluation of the patient

  5. Cervical cancer screening coverage in a high-incidence region

    Directory of Open Access Journals (Sweden)

    Cibelli Navarro

    2015-01-01

    Full Text Available OBJECTIVE To analyze the coverage of a cervical cancer screening program in a city with a high incidence of the disease in addition to the factors associated with non-adherence to the current preventive program. METHODS A cross-sectional study based on household surveys was conducted. The sample was composed of women between 25 and 59 years of age of the city of Boa Vista, RR, Northern Brazil who were covered by the cervical cancer screening program. The cluster sampling method was used. The dependent variable was participation in a women’s health program, defined as undergoing at least one Pap smear in the 36 months prior to the interview; the explanatory variables were extracted from individual data. A generalized linear model was used. RESULTS 603 women were analyzed, with an mean age of 38.2 years (SD = 10.2. Five hundred and seventeen women underwent the screening test, and the prevalence of adherence in the last three years was up to 85.7% (95%CI 82.5;88.5. A high per capita household income and recent medical consultation were associated with the lower rate of not being tested in multivariate analysis. Disease ignorance, causes, and prevention methods were correlated with chances of non-adherence to the screening system; 20.0% of the women were reported to have undergone opportunistic and non-routine screening. CONCLUSIONS The informed level of coverage is high, exceeding the level recommended for the control of cervical cancer. The preventive program appears to be opportunistic in nature, particularly for the most vulnerable women (with low income and little information on the disease. Studies on the diagnostic quality of cervicovaginal cytology and therapeutic schedules for positive cases are necessary for understanding the barriers to the control of cervical cancer.

  6. Cervical cancer screening in Australia: modelled evaluation of the impact of changing the recommended interval from two to three years

    Directory of Open Access Journals (Sweden)

    Howard Kirsten

    2010-11-01

    Full Text Available Abstract Background The National Cervical Screening Program in Australia currently recommends that sexually active women between the ages of 18-70 years attend routine screening every 2 years. The publically funded National HPV Vaccination Program commenced in 2007, with catch-up in females aged 12-26 years conducted until 2009; and this may prompt consideration of whether the screening interval and other aspects of the organized screening program could be reviewed. The aim of the current evaluation was to assess the epidemiologic outcomes and cost implications of changing the recommended screening interval in Australia to 3 years. Methods We used a modelling approach to evaluate the effects of moving to a 3-yearly recommended screening interval. We used data from the Victorian Cervical Cytology Registry over the period 1997-2007 to model compliance with routine screening under current practice, and registry data from other countries with 3-yearly recommendations to inform assumptions about future screening behaviour under two alternative systems for screening organisation - retention of a reminder-based system (as in New Zealand, or a move to a call-and-recall system (as in England. Results A 3-yearly recommendation is predicted to be of similar effectiveness to the current 2-yearly recommendation, resulting in no substantial change to the total number of incident cervical cancer cases or cancer deaths, or to the estimated 0.68% average cumulative lifetime risk of cervical cancer in unvaccinated Australian women. However, a 3-yearly screening policy would be associated with decreases in the annual number of colposcopy and biopsy procedures performed (by 4-10% and decreases in the number of treatments for pre-invasive lesions (by 2-4%. The magnitude of the decrease in the number of diagnostic procedures and treatments would depend on the method of screening organization, with call-and-recall screening associated with the highest reductions. The

  7. Barriers to adoption of recent technology in cervical screening

    Directory of Open Access Journals (Sweden)

    Jhala Darshana

    2007-01-01

    Full Text Available Abstract The Pap smear is one of the modern success stories in the field of preventive medicine. Since its introduction as a screening test, there has been a dramatic reduction in the incidence of cervical cancer. However, the search for a better screening test continues. The new technologies, including liquid-based cytology (LBC, Human Papilloma Virus (HPV testing and automated or machine-assisted screening have been introduced. However, there is continuous debate about whether society's limited resources are better spent on reaching the underserved rather than on these technologies. Another question is whether these technologies create yet another kind of disparity in delivering preventive care. For example, despite the wide use of LBC (99% of tests submitted to our laboratory are LBC, conventional Pap smears are still used to screen/follow up some women. It is not clear why some providers continue to prefer conventional smear over LBC and what are the barriers for adopting LBC in cervical cancer screening. We hypothesize the lower cost of conventional compared to LBC Pap testing, patient's lower socio-economic indices, a patient's medical history and provider's subspecialty/training all appear to play a role in the choice of using conventional Pap testing rather than LBC. Unintentionally, this choice results in repeat testing, delayed treatment and potentially higher costs than intended. The ultimate goal of this review article is to understand and explore possible barriers and disparities to adopting new technology in cancer screening.

  8. Inadequate cervical cancer screening among mid-aged Australian women who have experienced partner violence

    NARCIS (Netherlands)

    Loxton, Deborah; Powers, Jennifer; Schofield, Margot; Hussain, Rafat; Hosking, Stacey

    2009-01-01

    Objectives. Partner violence is linked to cervical cancer and other gynaecological conditions. However, results of current research into associations between partner violence and cervical cancer screening have been inconclusive. Therefore, the current research investigates the association between pa

  9. ACOG Recommendations and Guidelines for Cervical Cancer Screening and Management

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about ACOG's recommendations for cervical cancer screening and management.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  10. Human papillomavirus prevalence in paired urine and cervical samples in women invited for cervical cancer screening.

    Science.gov (United States)

    Burroni, Elena; Bonanni, Paolo; Sani, Cristina; Lastrucci, Vieri; Carozzi, Francesca; Iossa, Anna; Andersson, Karin Louise; Brandigi, Livia; Di Pierro, Carmelina; Confortini, Massimo; Levi, Miriam; Boccalini, Sara; Indiani, Laura; Sala, Antonino; Tanini, Tommaso; Bechini, Angela; Azzari, Chiara

    2015-03-01

    With the introduction of Human papillomavirus (HPV) vaccination in young girls in 2007, it is important to monitor HPV infections and epidemiological changes in this target population. The present study has evaluated the detection of human papillomavirus DNA in paired cervical and urine samples to understand if HPV testing in urine could be used as non-invasive method to monitor HPV status in young women. The study enrolled 216 twenty five-year-old women, resident in Florence and invited for the first time to the cervical cancer Screening Program within a project evaluating the impact of HPV vaccination. HPV genotyping was performed on 216 paired urine and cervical samples. The overall concordance between cervix and urine samples, investigated by HPV genotyping (INNO-LiPA HPV Genotyping Extra), was: 85.6% (184/215), 84.6% (182/215), 80% (172/215) when the same HPV, at least the same HR HPV and all HR HPV, respectively, were detected. HPV type specific concordance in paired urine and cervical samples was observed in 85.8% (175/204) of women with normal cytology and in seven out of nine women with abnormal cytology. Urine seems to be a suitable and reliable biological material for HPV DNA detection as evidenced by the high concordance with HPV detected in cervical samples. These results suggest that urine could be a good noninvasive tool to monitor HPV infection in vaccinated women.

  11. Reaching women in the Peruvian Andes through cervical cancer screening campaigns: assessing attitudes of stakeholders and patients

    Science.gov (United States)

    Luque, John S; Maupin, Jonathan N; Ferris, Daron G; Guevara Condorhuaman, Wendy S

    2016-01-01

    Background Peru is characterized by high cervical cancer incidence and mortality rates. The country also experiences significant gaps in quality cervical cancer screening coverage for the population. Objective This descriptive mixed methods study conducted in Cusco, Peru, aimed to assess the attitudes and perceptions of medical staff, health care workers, and patients toward a cervical cancer screening program that included both clinic-based and community outreach services conducted by a nongovernmental organization clinic (CerviCusco). The study also explored patient knowledge and attitudes around cervical cancer and about the human papillomavirus (HPV) to inform patient education efforts. Methods The study employed structured interviews with key informants (n=16) primarily from CerviCusco, which provides cervical cancer prevention, screening, diagnosis and treatment services, and surveys with a sample of patients (n=30) receiving services at the clinic and at screening campaigns. Results The majority of key informant medical staff participants felt that the general public had a very negative view of government health services. One theme running throughout the interviews was the perception that the general population lacked a culture of preventive health care and would wait until symptoms were severe before seeking treatment. Regarding services that were received by patients at CerviCusco, the participants responded that the prices were reasonable and more affordable than some private clinics. Patients attending the rural health campaigns liked that the services were free and of good quality. Conclusion CerviCusco has demonstrated its capacity to provide screening outreach campaigns to populations who had not previously had access to liquid-based cytology services. The finding that patients had generally low levels of knowledge about cervical cancer and the HPV vaccine prompted the development of culturally and linguistically appropriate educational and

  12. Screening for cervical cancer in French Guiana: screening rates from 2006 to 2011.

    Science.gov (United States)

    Douine, M; Roué, T; Lelarge, C; Adenis, A; Thomas, N; Nacher, M

    2015-12-01

    In French Guiana, the age-standardized incidence rate of cervical cancer is four times higher than in France and the mortality rate 5.5 times higher. A survival study revealed that stage at diagnosis was the main factor influencing the prognosis, showing that early detection is crucial to increase cervical cancer survival. The present study aimed at evaluating the cervical cancer screening rate between 2006 and 2011 by age and for a 3-year period in French Guiana. All pap smears realised in French Guiana were analysed in two laboratories allowing exhaustive review of screening data. The screening rate was estimated at about 54% from 2006 to 2011, with a statistical difference between coastal and rural area (56.3% versus 18.7%). Although the methodological difference did not allow comparisons with metropolitan France, these results could be used to evaluate the impact of organised cervical cancer screening by the French Guiana Association for Organized Screening of Cancers which has been implemented in French Guiana since 2012.

  13. Process performance of cervical screening programmes in Europe

    DEFF Research Database (Denmark)

    Ronco, Guglielmo; Ballegooijen, Marjolein van; Becker, Nikolaus;

    2009-01-01

    to 4.4% in Romania-Cluj) and the Positive Predictive Value (PPV) of colposcopic attendance (ranging from 8% in Romania-Cluj to 52% in Lithuania) were strongly influenced by management protocols, in particular for atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous...... intraepithelial lesion (LSIL) cytology. However, cytology-specific PPV also showed remarkable variability. The detection rate of CIN2+ histology ranged from 1% in England and Denmark. Low attendance for colposcopy after referral was observed in some east-European countries...... the cytological and histological classifications used in screening, as well as data registration systems across Europe....

  14. HPV DNA testing in population-based cervical screening (VUSA-Screen study) : results and implications

    NARCIS (Netherlands)

    Rijkaart, D. C.; Berkhof, J.; van Kemenade, F. J.; Coupe, V. M. H.; Rozendaal, L.; Heideman, D. A. M.; Verheijen, R. H. M.; Bulk, S.; Verweij, W.; Snijders, P. J. F.; Meijer, C. J. L. M.

    2012-01-01

    BACKGROUND: Human papillomavirus (HPV) testing is more sensitive than cytology for detecting high-grade cervical intraepithelial neoplasia (CIN). We evaluated the performance of high-risk HPV (hrHPV) testing in routine screening. METHODS: In all, 25 871 women (29-61) enrolled in our population-based

  15. Cervical Cancer Knowledge, Perceptions and Screening Behaviour Among Female University Students in Ghana.

    Science.gov (United States)

    Binka, Charity; Nyarko, Samuel H; Doku, David T

    2016-06-01

    Cervical cancer is becoming a leading cause of death among women in developing countries. Nevertheless, little is known regarding knowledge and perception of cervical cancer and screening behaviour particularly among female tertiary students in Ghana. This study sought to examine the knowledge and perceptions of cervical cancer and screening behaviour among female students in the University of Cape Coast and Ghana Institute of Management and Public Administration in Ghana. A cross-sectional survey design was adopted for the study. Systematic and stratified random sampling techniques were used to select 410 participants for the study. The study found that the participants lacked knowledge on specific risk factors and symptoms of cervical cancer. Also, even though the participants had a fair perception of cervical cancer, they had a poor cervical cancer screening behaviour. Awareness of cervical cancer was significantly influenced by religious affiliation while cervical cancer screening was significantly determined by the working status of the participants. Specific knowledge on cervical cancer and its risk factors as well as regular screening behaviour is paramount to the prevention of cervical cancer. Consequently, the University Health Services should focus on promoting regular cervical cancer awareness campaigns and screening among the students particularly, females.

  16. The costs of reducing loss to follow-up in South African cervical cancer screening

    Directory of Open Access Journals (Sweden)

    Kuhn Louise

    2005-11-01

    Full Text Available Abstract Background This study was designed to quantify the resources used in reestablishing contact with women who missed their scheduled cervical cancer screening visits and to assess the success of this effort in reducing loss to follow-up in a developing country setting. Methods Women were enrolled in this Cape Town, South Africa-based screening study between 2000 and 2003, and all had scheduled follow-up visits in 2003. Community health worker (CHW time, vehicle use, maintenance, and depreciation were estimated from weekly logs and cost accounting systems. The percentage of women who attended their scheduled visit, those who attended after CHW contact(s, and those who never returned despite attempted contact(s were determined. The number of CHW visits per woman was also estimated. Results 3,711 visits were scheduled in 2003. Of these, 2,321 (62.5% occurred without CHW contact, 918 (24.8% occurred after contact(s, and 472 (12.7% did not occur despite contact(s. Loss to follow-up was reduced from 21% to 6%, 39% to 10%, and 50% to 24% for 6, 12, and 24-month visits. CHWs attempted 3,200 contacts in 530 trips. On average, 3 CHWs attempted to contact 6 participants over each 111 minute trip. The per-person cost (2003 Rand for these activities was 12.75, 24.92, and 40.50 for 6, 12, and 24-month visits. Conclusion CHW contact with women who missed scheduled visits increased their return rate. Cost-effectiveness analyses aimed at policy decisions about cervical cancer screening in developing countries should incorporate these findings.

  17. Primary human papillomavirus DNA screening for cervical cancer prevention: Can the screening interval be safely extended?

    Science.gov (United States)

    Vink, Margaretha A; Bogaards, Johannes A; Meijer, Chris J L M; Berkhof, Johannes

    2015-07-15

    Cytological screening has substantially decreased the cervical cancer incidence, but even better protection may be achieved by primary high-risk human papillomavirus (hrHPV) screening. In the Netherlands, five-yearly cytological screening for women aged 30-60 years will be replaced by primary hrHPV screening in 2016. The new screening guidelines involve an extension of the screening interval from 5 to 10 years for hrHPV-negative women aged 40 or 50 years. We investigated the impact of this program change on the lifetime cancer risks in women without an hrHPV infection at age 30, 35, 40, 45 or 50 years. The time to cancer was estimated using 14-year follow-up data from a population-based screening intervention trial and the nationwide database of histopathology reports. The new screening guidelines are expected to lead to a reduced cervical cancer risk for all age groups. The average risk reduction was 34% and was smallest (25%) among women aged 35 years. The impact of hrHPV screening on the cancer risk was sensitive to the duration from cervical intraepithelial neoplasia grade 2/3 (CIN2/3) to cancer; a small increase in the cancer risk was estimated for women aged 35 or 40 years in case a substantial proportion of CIN2/3 showed fast progression to cancer. Our results indicate that primary hrHPV screening with a ten-yearly interval for hrHPV-negative women of age 40 and beyond will lead to a further reduction in lifetime cancer risk compared to five-yearly cytology, provided that precancerous lesions progress slowly to cancer.

  18. Screening history of cervical cancers in Emilia-Romagna, Italy: defining priorities to improve cervical cancer screening.

    Science.gov (United States)

    Rossi, Paolo Giorgi; Caroli, Stefania; Mancini, Silvia; de' Bianchi, Priscilla Sassoli; Finarelli, Alba C; Naldoni, Carlo; Bucchi, Lauro; Falcini, Fabio

    2015-03-01

    Most invasive cervical cancers in industrialized countries are due to the lack of Pap test coverage, very few are due to screening failures. This study aimed at quantifying the proportion of invasive cancers occurring in nonscreened or underscreened women and that in women with a previous negative screening, that is, screening failure, during the first two screening rounds (1996-2002) and in the following rounds (2003-2008) in the Emilia-Romagna region. All cases of invasive cancers registered in the regional cancer registry between 1996 and 2008 were classified according to screening history through a record linkage with the screening programme registry. The incidence significantly decreased from 11.6/100 000 to 8.7/100 000; this decrease is due to a reduction in squamous cell cancers (annual percentage change -6.2; confidence interval: -7.8, -4.6) and advanced cancers (annual percentage change -6.6; confidence interval: -8.8, -4.3), whereas adenocarcinomas and microinvasive cancers were essentially stable. The proportion of cancers among women not yet invited and among nonresponders decreased over the two periods, from 45.5 to 33.3%. In contrast, the proportion of women with a previous negative Pap test less than 5 years and 5 years or more before cancer incidence increased from 5.7 to 13.3% and from 0.3 to 5.5%, respectively. Although nonattendance of the screening programme remains the main barrier to cervical cancer control, the introduction of a more sensitive test, such as the human papillomavirus DNA test, could significantly reduce the burden of disease.

  19. A randomised trial of the effect of postal reminders on attendance for breast screening

    Science.gov (United States)

    Allgood, Prue C; Maxwell, Anthony J; Hudson, Sue; Offman, Judith; Hutchison, Gillian; Beattie, Cathryn; Tuano-Donnelly, Raquel; Threlfall, Anthony; Summersgill, Tina; Bellis, Lesley; Robinson, Collette; Heaton, Samantha; Patnick, Julietta; Duffy, Stephen W

    2016-01-01

    Background: Some women make an informed choice not to attend breast screening, whereas others may have forgotten about the appointment. We report on a randomised trial that investigates whether a reminder letter affects attendance. Methods: Women scheduled for a breast screening appointment were randomised to either receive a reminder letter a few days before their breast screening appointment in addition to the standard invitation letter (intervention) or not (control). The primary outcome was attendance within 30 days of the first offered appointment. Secondary outcomes were attendance within 90 and 180 days. Results: In all, 11 383 (49.9%) women were randomised to the intervention and 11 445 (50.1%) to the control. In the intervention arm, 7759 (68.2%) attended within 30 days of the first offered appointment compared with 7349 (64.2%) in the control arm. This difference was significant (P<0.001). The odds ratio (OR) (95% confidence interval) for the primary end point was 1.19 (1.13–1.26). This was not significantly affected by age, socioeconomic status or type of screen (prevalent or incident). Secondary endpoint analyses supported these results. Results did differ, however, between the different centres studied. Conclusions: This study found that postal reminders increase breast screening uptake, and could be practicable to implement in the NHS Breast Screening Programme. PMID:26784123

  20. Perceived ethical acceptability of financial incentives to improve diabetic eye screening attendance

    Science.gov (United States)

    Wadge, Hester; Bicknell, Colin; Vlaev, Ivo

    2015-01-01

    Objective To test the ethical acceptability of using financial incentives to increase diabetic retinopathy screening attendance. Background Financial incentives could be an effective way to increase attendance at screening for diabetic retinopathy, although there can be ethical concerns about this approach. Design Survey of people with diabetes in North West London. Those who were due to attend a screening appointment were invited to complete a questionnaire. Key demographic variables included age, gender, and deprivation. Setting and participants A questionnaire was issued to those invited to attend screening in North West London and those who run the screening service. The questionnaire captured views on aspects of the ethical problem and different incentive types. Main variables studied It captured views on the different dimensions of the ethical problem and different types of incentive. In order to understand how views might vary within a population, demographic variables were used to analyze the results. Results and conclusions Vouchers were found to be the most acceptable form of incentive, significantly more so than cash payments. Most rejected the notion of targeting those who need incentivizing, preferring equality. Age was an important factor, with those aged between 40 and 64 the most optimistic about the potential benefits. Higher levels of deprivation were linked to increased acceptability scores. While some ethical concerns are strongly held among certain groups, there is also much support for the principle of incentivizing positive behaviors. This paves the way for future research into the effectiveness of incentivizing diabetic retinopathy screening attendance. PMID:26635964

  1. Cervical screening in HIV-positive women in the East of England: recent CD4 as the predictive risk factor.

    Science.gov (United States)

    Davies, Olubanke; Rajamanoharan, Sasikala; Balachandran, Thambiah

    2015-11-01

    This study examines the relationship between CD4 count and cervical cytological abnormality in HIV-positive women attending two district general hospital genitourinary medicine clinics in the East of England. It aims to determine whether the rate of cervical cytological abnormalities differs in HIV-positive women with CD4 count >350 cells/µl and those with CD4 count ≤350 cells/µl; and to compare the rates of abnormalities with that of the general population. We retrospectively reviewed data from a cross-sectional audit undertaken between December 2010 and December 2011 and analysed them using multivariable statistics. There was a significant association between recent CD4 count ≤350 cells/µl and cervical cytological abnormality (p 350 cells/µl had abnormal cervical smear results, compared with 6.6% of the general population in the screening period 2010-11 and 7.2% of the general population in the screening period 2009-10. In our study population of women with recent CD4 counts >350 cells/µl, the proportions of mild, moderate and severe dysplasia were also similar to national figures. This raises important questions about the cost effectiveness of blanket annual screening for HIV-positive women.

  2. A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women

    Directory of Open Access Journals (Sweden)

    Lu Mingshan

    2012-06-01

    Full Text Available Abstract Background The Asian population is one of the fastest growing ethnic minority groups in western countries. However, cancer screening uptake is consistently lower in this group than in the native-born populations. As a first step towards developing an effective cancer screening intervention program targeting Asian women, we conducted a comprehensive systematic review, without geographic, language or date limitations, to update current knowledge on the effectiveness of existing intervention strategies to enhance breast and cervical screening uptake in Asian women. Methods This study systematically reviewed studies published as of January 2010 to synthesize knowledge about effectiveness of cancer screening interventions targeting Asian women. Fifteen multidisciplinary peer-reviewed and grey literature databases were searched to identify relevant studies. Results The results of our systematic review were reported in accordance with the PRISMA Statement. Of 37 selected intervention studies, only 18 studies included valid outcome measures (i.e. self-reported or recorded receipt of mammograms or Pap smear. 11 of the 18 intervention studies with valid outcome measures used multiple intervention strategies to target individuals in a specific Asian ethnic group. This observed pattern of intervention design supports the hypothesis that employing a combination of multiple strategies is more likely to be successful than single interventions. The effectiveness of community-based or workplace-based group education programs increases when additional supports, such as assistance in scheduling/attending screening and mobile screening services are provided. Combining cultural awareness training for health care professionals with outreach workers who can help healthcare professionals overcome language and cultural barriers is likely to improve cancer screening uptake. Media campaigns and mailed culturally sensitive print materials alone may be ineffective

  3. A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women

    Science.gov (United States)

    2012-01-01

    Background The Asian population is one of the fastest growing ethnic minority groups in western countries. However, cancer screening uptake is consistently lower in this group than in the native-born populations. As a first step towards developing an effective cancer screening intervention program targeting Asian women, we conducted a comprehensive systematic review, without geographic, language or date limitations, to update current knowledge on the effectiveness of existing intervention strategies to enhance breast and cervical screening uptake in Asian women. Methods This study systematically reviewed studies published as of January 2010 to synthesize knowledge about effectiveness of cancer screening interventions targeting Asian women. Fifteen multidisciplinary peer-reviewed and grey literature databases were searched to identify relevant studies. Results The results of our systematic review were reported in accordance with the PRISMA Statement. Of 37 selected intervention studies, only 18 studies included valid outcome measures (i.e. self-reported or recorded receipt of mammograms or Pap smear). 11 of the 18 intervention studies with valid outcome measures used multiple intervention strategies to target individuals in a specific Asian ethnic group. This observed pattern of intervention design supports the hypothesis that employing a combination of multiple strategies is more likely to be successful than single interventions. The effectiveness of community-based or workplace-based group education programs increases when additional supports, such as assistance in scheduling/attending screening and mobile screening services are provided. Combining cultural awareness training for health care professionals with outreach workers who can help healthcare professionals overcome language and cultural barriers is likely to improve cancer screening uptake. Media campaigns and mailed culturally sensitive print materials alone may be ineffective in increasing screening

  4. Hysterectomy and its impact on the calculated incidence of cervical cancer and screening coverage in Denmark

    DEFF Research Database (Denmark)

    Lam, Janni Uyen Hoa; Lynge, Elsebeth; Njor, Sisse Helle;

    2015-01-01

    BACKGROUND: The incidence rates of cervical cancer and the coverage in cervical cancer screening are usually reported by including in the denominator all women from the general population. However, after hysterectomy women are not at risk anymore of developing cervical cancer. Therefore, it makes...

  5. Cervical Cancer Screening Interventions for U.S. Latinas: A Systematic Review

    Science.gov (United States)

    Corcoran, Jacqueline; Dattalo, Patrick; Crowley, Meghan

    2012-01-01

    The high cervical cancer mortality rate among Latinas compared with other ethnic groups in the United States is of major concern. Latina women are almost twice as likely to die from cervical cancer as non-Hispanic white women. To improve Latina cervical cancer screening rates, interventions have been developed and tested. This systematic review…

  6. Mapping HPV Vaccination and Cervical Cancer Screening Practice in the Pacific Region-Strengthening National and Regional Cervical Cancer Prevention

    DEFF Research Database (Denmark)

    Obel, J; McKenzie, J; Buenconsejo-Lum, L E

    2015-01-01

    OBJECTIVE: To provide background information for strengthening cervical cancer prevention in the Pacific by mapping current human papillomavirus (HPV) vaccination and cervical cancer screening practices, as well as intent and barriers to the introduction and maintenance of national HPV vaccination...... guidelines and policies for HPV vaccination. CONCLUSION: Current practices to prevent cervical cancer in the Pacific Region do not match the high burden of disease from cervical cancer. A regional approach, including reducing vaccine prices by bulk purchase of vaccine, technical support for implementation...

  7. Clinical significance of colposcopy on screening cervical intraepithelial neoplasia in cytological negative and smooth cervices

    Institute of Scientific and Technical Information of China (English)

    Dianyun Shi; Saiying Chen; Yan Sun

    2014-01-01

    Objective:The aim of the study was to evaluate the clinical value of the video colposcopy in screening cervical intraepithelial neoplasia (CIN) in cytological negative and smooth cervices by optical y gynecological examination. Methods:The 1050 women, whose cervices had been shown smooth and cytological negative by optical examine, were examined with electronic colposcopy in gynecological clinic, and biopsy was taken when the double abnormality of aceto-white epithelium and iodine negative, and other abnormal images were shown. A retrospective analysis of these cases was performed. Re-sults:(1) The 514 samples from 458 cases, including 458 samples of abnormal tissues under colposcopy and 56 samples of polyp or polypoid tumors by optical y, were examined by biopsy. Among them, 68 samples were found to be CIN, including 11 cases of CINII/CINIII;(2) The 72 of 1050 cases showed the double-abnormality of aceto-white epithelium and iodine nega-tive. Among them, 64 cases were CIN determined by biopsy. And the positive predictive value of the double-abnormality of aceto-white epithelium and iodine negative under colposcopy was 88.9%, with a false negative rate of 3.3%;(3) Among 458 women examined by biopsy, only one of 350 samples from cervical polyp tissue was CIN (0.3%), while 67 of 164 samples from the tissues with abnormal colposcopic images were found to be CIN (40.9%), indicating the close relation between abnormal colposcopic findings and CIN;(4) The results of age-distribution analysis showed that, in the 164 cases with abnormal features under colposcopy, the incidence of double abnormality of aceto-white epithelium and iodine negative was higher in the age of sexual activity, just the same as the age distribution feature of CIN;while single abnormality of iodine negative appeared more in the age of over 50 years. Conclusion:Abnormal features displayed by colposcopy, especial y the double abnormality of aceto-white epithelium and iodine negative, has an important

  8. Frequency of Human Papillumavirus among Women with High-Grade Squamous Intraepithelial Lesions and Invasive Cervical Cancer Attending Shahid Beheshti University of Medical Sciences Clinics, Tehran, Iran.

    Directory of Open Access Journals (Sweden)

    Nahid Khodakarami

    2014-11-01

    Full Text Available The previous studies reported some information about prevalence release of high-risk HPV types in HSIL or cervical cancer globally and in Iran, however, this information is not enough for final judgment about vaccination against HPV or any screening program. The aim of the present study was to assess the HPV type distribution in HSIL and ICC specimens of women attending Shahid Beheshti University of Medical Sciences teaching hospitals, Tehran, Iran for treatment during 10 years.This retrospective- descriptive study evaluated the HPV type distribution of pathologic specimens of Iranian women with invasive cervical cancer (ICC and high-grade squamous cell intraepithelial lesions (HSIL. Formalin-fixed tumor biopsies that were retrieved from women presenting with histological confirmation for ICC and 17 pathologic confirmation for HSIL specimens.The most frequently identified HPV type 16 among both groups, women with invasive cervical cancer (4-2.18% and women with High Grade Squamous Intraepithelial Lesion (29.41%, followed by HPV18, HPV31 and 26. HPV16 and / or 18 accounted for 82.2% of all infected samples.The dominance of HPV16 over other high-risk types might be even higher than in a region with low HPV exposure. However, there was no strong evidence for any judgment that show to the policy makers; which one is cost-effectiveness and feasibility for cervical cancer prevention in Iran, vaccination, screening or both? More population based study and national meta-analysis needed for better understanding of HPV prevalence and HPV DNA patterns in Iran.

  9. Differences in coverage patterns in cervical cytology screening

    Science.gov (United States)

    Smith, Amy; Gale, Alastair G.; Wooding, David S.; Purdy, Kevin J.

    2003-05-01

    The visual screening of cervical smears is a complex process requiring appropriate slide coverage to detect any unusual appearances without making any omission errors. In examining a smear the observer has both to move the microscope stage appropriately to bring different slide areas into view, plus visually search the information presented within the binocular visual field. This study examined the patterns of slide coverage by different individuals when they inspected liquid based cervical smears. A binocular microscope was first adapted in order to record both the physical movement of the stage by the observer and also to access the microscope"s visual field. An image of the area of the smear under the microscope was displayed on a PC monitor and observers" eye movements were recorded as they searched this. By manually adjusting the microscope controls they also moved the stage and all stage movements and focussing were also recorded. The behaviour was examined of both novices and an expert screener as they searched a number of test cervical smears. It was found that novices adopted a regular examination pattern, which maximized slide coverage, albeit slowly. In contrast, the experienced screener covered the slides faster and more effectively ensuring more overlap between microscope fields.

  10. Issues and challenges in implementing cervical cancer screenings in the emergence of HPV vaccination in Thailand.

    Science.gov (United States)

    Juntasopeepun, Phanida; Davidson, Patricia M; Srisomboon, Jatupol

    2012-01-01

    The discovery of the HPV vaccine has been a major breakthrough in preventing cervical cancer and other HPV-related diseases around the globe. Cervical cancer is a significant public health problem in Thailand. Despite the long-time availability of cervical cancer screening programs in Thailand, the uptake among the target female population remains low. HPV vaccines were approved by the Food and Drug Administration of Thailand in 2007. As of March 2011, due to financial limitations, HPV vaccines have still not been included in the national immunization program under the public health benefit plans although individuals has the option to pay privately for the vaccine. This paper discusses the issues and challenges in implementing cervical cancer screening programs in the era of HPV vaccination in Thailand. Recommendations to increase the uptake of cervical cancer screening and further research to inform a policy regarding the cervical cancer screening measures are proposed.

  11. Estimating the cost of cervical cancer screening in five developing countries

    Directory of Open Access Journals (Sweden)

    Goldie Sue J

    2006-08-01

    purchasing power parity. Results Cervical cytology laboratory processing costs were I$1.57–3.37 using the quantity and price method compared to I$1.58–3.02 from the face validation method. HPV DNA processing costs were I$6.07–6.59. Rural laboratory transport costs for cytology were I$0.12–0.64 and I$0.14–0.74 for HPV DNA laboratories. Under assumptions of lower resource efficiency, these estimates increased to I$0.42–0.83 and I$0.54–1.06. Estimates of the value of an hour of patient time using only formal sector participation were I$0.07–4.16, increasing to I$0.30–4.80 when informal and unpaid labor was also included. The value of patient time for traveling, waiting, and attending a screening visit was I$0.68–17.74. With the total cost of screening for cytology and HPV DNA testing ranging from I$4.85–40.54 and I$11.30–48.77 respectively, the cost of the laboratory transport, processing, and patient time accounted for 26–66% and 33–65% of the total costs. From a payer perspective, laboratory transport and processing accounted for 18–48% and 25–60% of total direct medical costs of I$4.11–19.96 and I$10.57–28.18 respectively. Conclusion Cost estimates of laboratory processing, sample transport, and patient time account for a significant proportion of total cervical cancer screening costs in five developing countries and provide important inputs for CEAs of alternative screening modalities.

  12. Socioecological perspectives on cervical cancer and cervical cancer screening among Asian American women.

    Science.gov (United States)

    Lee, Jongwon; Carvallo, Mauricio

    2014-10-01

    Although cervical cancer is one of the most commonly diagnosed cancers among Vietnamese American women (VAW) and Korean American women (KAW), both groups consistently report much lower rates of cervical cancer screening compared with other Asian ethnic subgroups and non-Hispanic Whites. This study aimed to explore multilevel factors that may underlie low screening rates among VAW and KAW living in a city where their ethnic communities are relatively small. The socioecological model was used as a conceptual framework. Thirty participants were conveniently recruited from ethnic beauty salons run by VA and KA cosmetologists in Albuquerque, New Mexico. The participants' average age was 44.6 years (SD = .50; range = 21-60). Most participants were married (80 %) and employed (73.3 %), and had health insurance (83.3 %). A qualitative interview was conducted in Vietnamese or Korean and transcribed verbatim. A thematic content analysis was used to identify major codes, categories, and patterns across the transcripts. The study identified several factors at the individual (e.g., pregnancy, poverty, personality), interpersonal (e.g., family responsibility, mother as influential referent), and community (e.g., lack of availability, community size) levels. The study sheds light on four major areas that must be taken into consideration in the development of culturally appropriate, community-based interventions aimed to reduce disparities in cervical cancer screening among ethnic minority women in the United States: (1) ethnic community size and geographic location; (2) cross-cultural similarities and dissimilarities; (3) targeting of not only unmarried young women, but also close referents; and (4) utilization of trusted resources within social networks.

  13. Using the Theory of Planned Behavior to Understand Cervical Cancer Screening among Latinas

    Science.gov (United States)

    Roncancio, Angelica M.; Ward, Kristy K.; Sanchez, Ingrid A.; Cano, Miguel A.; Byrd, Theresa L.; Vernon, Sally W.; Fernandez-Esquer, Maria Eugenia; Fernandez, Maria E.

    2015-01-01

    To reduce the high incidence of cervical cancer among Latinas in the United States it is important to understand factors that predict screening behavior. The aim of this study was to test the utility of theory of planned behavior in predicting cervical cancer screening among a group of Latinas. A sample of Latinas (N = 614) completed a baseline…

  14. Cervical cancer risk factors and feasibility of visual inspection with acetic acid screening in Sudan

    DEFF Research Database (Denmark)

    Ibrahim, Ahmed; Rasch, Vibeke; Pukkala, Eero;

    2011-01-01

    To assess the risk factors of cervical cancer and the feasibility and acceptability of a visual inspection with acetic acid (VIA) screening method in a primary health center in Khartoum, Sudan.......To assess the risk factors of cervical cancer and the feasibility and acceptability of a visual inspection with acetic acid (VIA) screening method in a primary health center in Khartoum, Sudan....

  15. Do general practices adhere to organizational guidelines for effective cervical cancer screening?

    NARCIS (Netherlands)

    Hermens, R P; Hak, E; Hulscher, M E; Mulder, J; Braspenning, J C; Grol, R P

    1998-01-01

    BACKGROUND: Well-organized cervical screening has been shown to be effective in the reduction of both morbidity and mortality from cancer of the uterine cervix. In The Netherlands, the GP plays an important role in the cervical screening. The question is whether the general practices are able to org

  16. Personality and Gastric Cancer Screening Attendance: 
A Cross-Sectional Analysis from the Miyagi Cohort Study

    Science.gov (United States)

    Arai, Shizuha; Nakaya, Naoki; Kakizaki, Masako; Ohmori-Matsuda, Kaori; Shimazu, Taichi; Kuriyama, Shinichi; Fukao, Akira; Tsuji, Ichiro

    2009-01-01

    Objective To determine the associations between personality subscales and attendance at gastric cancer screenings in Japan. Methods A total of 21,911 residents in rural Japan who completed a short form of the Eysenck Personality Questionnaire-Revised (EPQ-R) and a questionnaire on various health habits including the number of gastric cancer screenings attended were included in the primary analysis. We defined gastric cancer screening compliance as attendance at gastric cancer screening every year for the previous 5 years; all other patterns of attendance were defined as non-compliance. We defined gastric cancer screening visiting as attendance at 1 or more screenings during the previous 5 years; lack of attendance was defined as non-visiting. We used logistic regression to estimate the odds ratios (ORs) of gastric cancer screening compliance and visiting according to 4 score levels that corresponded to the 4 EPQ-R subscales (extraversion, neuroticism, psychoticism, and lie). Result Extraversion had a significant linear, positive association with both compliance and visiting (trend, P Lie had no association with either compliance or visiting. Conclusion The personality traits of extraversion, neuroticism, and psychoticism were significantly associated with gastric cancer screening attendance. A better understanding of the association between personality and attendance could lead to the establishment of effective campaigns to motivate people to attend cancer screenings. PMID:19164872

  17. Adherence to cervical cancer screening in an Italian SLE cohort

    Directory of Open Access Journals (Sweden)

    R. Talarico

    2011-06-01

    Full Text Available Objective: Papanicolau (Pap smear abnormalities are more frequently observed in systemic lupus erythematosus (SLE respect to the general population. The primary objective of the present study was to evaluate the adherence to cervical cancer (CC screening in an Italian cohort of SLE patients and, secondly, to evaluate the disease-related factors possibly influencing the patients’ behavior. Methods: Consecutive 25 to 64 year old SLE patients and aged- matched healthy women were enrolled for the study. All patients were interviewed during ambulatory visits, at admission to the clinic or by a telephone contact; disease related variables were also collected from the clinical charts. Results: 140 SLE patients (mean age 48.3±12 years and 70 controls matched for demographic and sociocultural characteristics were enrolled. Ninety-three SLE patients (66.4% declared to perform the Pap test at least every three years (23.6% yearly and 42.8% when asked by the screening programs while 47 (33.6% did not perform regular CC screening (16.4% never did the test and 17.1% only occasionally. No significant differences were observed between patients and controls in cancer screening adherence. No significant associations were observed between the screening program behaviours and disease-related variables. Conclusions: Despite the growing evidence of an increased risk of CC in SLE, and regardless of the broad availability of screening programs and official recommendations, our results show insufficient CC surveillance among SLE patients and emphasize to rheumatologists and/or general practitioners the importance to discuss with patients this aspect during routine evaluations in order to encourage compliance to the recommended preventive measures.

  18. Cost-effectiveness of HIV screening of patients attending clinics for sexually transmitted diseases in Amsterdam

    NARCIS (Netherlands)

    Bos, JM; Fennema, JSA; Postma, MJ

    2001-01-01

    Objective: To estimate the cost-effectiveness of universal HIV screening of patients attending a clinic for sexually transmitted diseases (STD) in Amsterdam. Design: Cost effectiveness analysis. Methods: A Bernoulli model for the secondary transmission of HIV was linked with epidemiological data on

  19. Psychological Impact of Primary Screening (PIPS) for HPV: a protocol for a cross-sectional evaluation within the NHS cervical screening programme

    Science.gov (United States)

    McBride, Emily; Marlow, Laura; Forster, Alice S; Moss, Sue; Myles, Jonathan; Kitchener, Henry; Patnick, Julietta; Waller, Jo

    2016-01-01

    Introduction The NHS Cervical Screening Programme is now using human papillomavirus (HPV) testing as the primary test in six sentinel sites in England, with the intention of rolling this out across the whole of England. Previous research evaluating HPV testing in the cervical screening context suggests that an HPV-positive result may increase anxiety beyond that associated with abnormal cytology, but this has not been explored in the context of primary HPV testing. The main aim of this study is to explore the impact of the HPV primary screening programme on anxiety and distress. Methods and analysis A cross-sectional between-groups design (total N ∼ 673) will be employed to assess the psychological impact of different HPV and cytology results at three time points: shortly after receiving the results, and 6 and 12 months later. Women will fall into one of six groups based on their screening results. The primary outcomes will be anxiety and general distress. Secondary outcomes will include understanding of screening results, perceived risk of cervical cancer, psychosexual functioning, intention to attend future screening and knowledge of HPV. General linear modelling will be used to test for differences between groups and changes over the three time points. Ethics and dissemination Health Research Authority approval was received on 26 September 2016. Ethical approval was received from London- Surrey Borders NHS Research Ethics Committee on 30 August 2016. Section 251 approval was received from the Confidentiality Advisory Group on 24 August 2016. Results will be disseminated via peer-reviewed publication and presentation at national and international conferences. PMID:28011816

  20. Trichomonas, Candida , and Gardnerella in cervical smears of Iranian women for cancer screening

    Directory of Open Access Journals (Sweden)

    Narges Kalantari

    2014-01-01

    Full Text Available Background: Trichomonas vaginalis, Gardrenella vaginalis, and Candida sp are responsible for 90% of vaginitis which has been reported as important risk factors for cervical cancer. Aim: This study aimed to find the prevalence of T. vaginalis, Candida sp, and G. vaginalis in women attended the cancer clinic charity, Babol, Iran and to identify the associated risk factors. Materials and Methods: This retrospective study carried out from 1996 to July 2012 on women who attended to a cancer screening program at the cancer clinics charity, Babol, Iran. Papanicolaou test and clinical examinations were performed for each woman. In addition to Papanicolaou test results, demographic data were collected. The data were analyzed with X 2 test using SPSS software, version 18. Results: In total, 2511 out of 33600 (7.5% cases had vaginal infections. A total of 71 (0.2%, 2248 (6.7%, and 192 (0.6% of subjects were infected by T. vaginalis, Candida sp, and Gardnerella, respectively. The highest rate of infection was seen in 20-30 and 30-40 years age group. The frequency of vaginal ulcers was higher in trichomoniasis (14.1%. Conclusion: This study demonstrated that the prevalence of T. vaginalis, Candida sp, and Gardnerella was low among the studied population. Moreover, malignant cytological alternations were not seen in any infected women.

  1. CERVICAL CYTOLOGICAL SCREENING AND MANAGEMENT IN PREGNANT AND POSTPARTUM WOMEN

    Institute of Scientific and Technical Information of China (English)

    Gui-fang He; Mei-lu Bian; Ying Wang; Xiao-yan Liu

    2005-01-01

    Objective To examine and follow up cervical cytology of pregnant and postpartum women and study their cytopathologic characteristics, so as to determine screening and managing programs for abnormal cervical cytology.Methods Totally 5296 patients in pregnancy and postpartum, in which 3729 by computer-assisted cytology test and 1567 by liquid-based monolayers cytology test, were examined and diagnosed by the Bethesda System made in 2001. Those proven epithelial abnormalities patients were followed up until the lesions regressed to normal. The remaining patients,who exhibited persistent abnormalities or progression, were given further examinations.Results The positive rate of cervical cytological test was 8.72% (462/5296), including squamous carcinoma (SCA) 1case (0.02%), high grade squamous intraepithelial lesion (HSIL) 34 cases (0.64%), low grade squamous intraepithelial lesion (LSIL) 145 cases (2.74%), atypical glandular cells (AGC) 5 cases (0.09%), atypical squamous cells cannot exclude HSIL (ASC-H) 14 cases (0.26%), atypical squamous cells of undetermined significance (ASC-US) 263 cases (4.97%). The 419 proven cytological abnormality cases were followed up successfully. The total transnegative rate in three months was 73.74% (309/419), in which 303 cases (72.32%) persisted normal status for more than six months after regression. And the transnegative rate of ASC-US, ASC-H, AGC, LSIL, and HSIL were 79.56%, 64.29%, 100%,72.14% and 44.12%, respectively. Forty-six cases received biopsy directed by colposcopy. The distribution of coincidence of cytopathologic and histopathologic diagnosis was: SCA 1 case (100%), HSIL 10 cases (76.92%), LSIL 13 cases (65%), ASC-H 2 cases (50%), ASC-US 3 cases (37.50%), total 29 cases (63.04%).Conclusions We should cast more attention to screening cervix lesions in pregnant and postpartum women. Their cytopathologic characteristics are liable to make the clinician give a false positive diagnosis. So we propose to follow up them closely

  2. Cervical cytological changes in HIV-infected patients attending care and treatment clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania

    Directory of Open Access Journals (Sweden)

    Mwakigonja Amos R

    2012-02-01

    Full Text Available Abstract Background Tanzania is among Sub-Saharan countries mostly affected by the HIV and AIDS pandemic, females being more vulnerable than males. HIV infected women appear to have a higher rate of persistent infection by high risk types of human papillomavirus (HPV strongly associated with high-grade squamous intraepithelial lesions (HSIL and invasive cervical carcinoma. Furthermore, although HIV infection and cervical cancer are major public health problems, the frequency and HIV/HPV association of cervical cancer and HSIL is not well documented in Tanzania, thus limiting the development of preventive and therapeutic strategies. Methods A prospective unmatched, case-control study of HIV-seropositive, ≥ 18 years of age and consenting non-pregnant patients attending the care and treatment center (CTC at Muhimbili National Hoospital (MNH as cases was done between 2005 and 2006. HIV seronegative, non-pregnant and consenting women recruited from the Cervical Cancer Screening unit (CCSU at ORCI were used as controls while those who did not consent to study participation and/or individuals under Results A total of 170 participants from the two centers were recruited including 50 HIV-seronegative controls were from the CCSU. Ages ranged from 20-66 years (mean 40.5 years for cases and 20-69 years (mean 41.6 years for controls. The age group 36-45 years was the most affected by HIV (39.2%, n = 47. Cervicitis, squamous intraepithelial lesions (SIL and carcinoma constituted 28.3% (n = 34, 38.3% (n = 46 and 5.8% (n = 7 respectively among cases, and 28% (n = 14, 34% (n = 17 and 2% (n = 1 for controls, although this was not statistically significant (P-value = 0.61. IHC showed that p53 was not detectable in HPV + Pap smears and cell blocks indicating possible degradation. Conclusions The frequency of SIL and carcinoma appeared to be higher among HIV-infected women on HAART compared to seronegative controls and as expected increased with age. HIV

  3. Challenges to cervical screening in a developing country: The case of Malaysia

    DEFF Research Database (Denmark)

    Othman, Nor Hayati; Rebolj, Matejka

    2009-01-01

    OBJECTIVES: Many developing countries, including Malaysia, will need to continue relying on cervical screening because they will not be able to cover their entire female adolescent populations with HPV vaccination. The aim of this paper was to establish the extent of the health care, informational......, financial and psychosocial barriers to cervical screening in Malaysia. METHODS: A literature search was made for reports on implementation, perceptions and reception of cervical screening in Malaysia published between January 2000 and September 2008. RESULTS: Despite offering Pap smears for free since 1995......: Improving screening coverage will remain an important strategy for combating cervical cancer in Malaysia. The focus should be on the policy-making context, improving awareness and the screening infrastructure, and making the service better accessible to women....

  4. Feasibility of Utilizing Ethnic Beauty Salons for Cervical Cancer Screening Education.

    Science.gov (United States)

    Lee, Jongwon; Carvallo, Mauricio; Lee, Eunice

    2015-11-01

    The purpose of this study was to assess the feasibility of using ethnic beauty salons to reach out to Vietnamese and Korean American women for cervical cancer screening education. Participants (N = 62) were conveniently recruited from ethnic beauty salons located in Albuquerque, New Mexico. Two feasibility questionnaires were separately administered to cosmetologists and their customers. Findings support the view that ethnic beauty salons can be used as a gateway to reach out to these populations, and cosmetologists have the potential to operate as community lay health workers to deliver cervical cancer screening education aimed at reducing disparities in cervical cancer and screening to their ethnic customers.

  5. Routine HIV screening of sexually transmitted disease clinic attenders has favourable cost-effectiveness ratio in low HIV prevalence settings

    NARCIS (Netherlands)

    Bos, JM; van der Meijden, WI; Swart, W; Postma, MJ

    2002-01-01

    HIV screening for attenders of clinics for sexually transmitted disease (STD) may identify individuals with high-risk sexual behaviour and avert HIV infections in partners. Extending our previous analysis in AIDS, we performed an economic evaluation of HIV screening of STD-clinic attenders in Rotter

  6. Extended duration of the detectable stage by adding HPV test in cervical cancer screening.

    NARCIS (Netherlands)

    Marie, ME van den Akker-v; Ballegooijen, van M.; Rozendaal, L.; Meijer, C.J.L.M.; Habbema, J.D.

    2003-01-01

    The human papillomavirus test (HPV) test could improve the (cost-) effectiveness of cervical screening by selecting women with a very low risk for cervical cancer during a long period. An analysis of a longitudinal study suggests that women with a negative Pap smear and a negative HPV test have a st

  7. Extended duration of the detectable stage by adding HPV test in cervical cancer screening

    NARCIS (Netherlands)

    M.E. Van Den Akker-van Marie (M.); M. van Ballegooijen (Marjolein); L. Rozendaal (Lawrence); C.J.L.M. Meijer (Chris); J.D.F. Habbema (Dik)

    2003-01-01

    textabstractThe human papillomavirus test (HPV) test could improve the (cost-) effectiveness of cervical screening by selecting women with a very low risk for cervical cancer during a long period. An analysis of a longitudinal study suggests that women with a negative Pap smear and a negative HPV te

  8. Positive diagnostic values and histological detection ratios from the Rotterdam cervical cancer screening programme

    NARCIS (Netherlands)

    F.A. Kreuger; H. Beerman (Henk); H.G. Nijs (Huub); M. van Ballegooijen (Marjolein)

    1998-01-01

    textabstractBACKGROUND: In organized screening programmes for cervical cancer, pre-cancerous lesions are detected by cervical smears. However, during follow-up after a positive smear these pre-cancerous lesions are not always found. The purpose of the study is to analys

  9. Restriction of human papillomavirus DNA testing in primary cervical screening to women above age 30

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Njor, Sisse H; Lynge, Elsebeth

    2012-01-01

    Cervical screening with human papillomavirus (HPV) testing is less specific for high-grade cervical intraepithelial neoplasia (=CIN3) than cytology. The aim of this systematic review was to determine whether a restriction of HPV testing to women aged at least 30 years would eliminate the problem....

  10. Performance of Implementing Guideline Driven Cervical Cancer Screening Measures in an Inner City Hospital System

    Science.gov (United States)

    Wieland, Daryl L.; Reimers, Laura L.; Wu, Eijean; Nathan, Lisa M.; Gruenberg, Tammy; Abadi, Maria; Einstein, Mark H.

    2013-01-01

    Objective In 2006, the American Society for Colposcopy and Cervical Pathology (ASCCP) updated evidence based guidelines recommending screening intervals for women with abnormal cervical cytology. In our low-income inner city population, we sought to improve performance by uniformly applying the guidelines to all patients. We report the prospective performance of a comprehensive tracking, evidence-based algorithmically driven call-back and appointment scheduling system for cervical cancer screening in a resource-limited inner city population. Materials and Methods Outreach efforts were formalized with algorithm-based protocols for triage to colposcopy, with universal adherence to evidence-based guidelines. During implementation from August 2006 through July 2008, we prospectively tracked performance using the electronic medical record with administrative and pathology reports to determine performance variables such as the total number of Pap tests, colposcopy visits, and the distribution of abnormal cytology and histology results, including all CIN 2,3 diagnoses. Results 86,257 gynecologic visits and 41,527 Pap tests were performed system-wide during this period of widespread and uniform implementation of standard cervical cancer screening guidelines. The number of Pap tests performed per month varied little. The incidence of CIN 1 significantly decreased from 117/171 (68.4%) the first tracked month to 52/95 (54.7%) the last tracked month (p=0.04). The monthly incidence rate of CIN 2,3, including incident cervical cancers did not change. The total number of colposcopy visits declined, resulting in a 50% decrease in costs related to colposcopy services and approximately a 12% decrease in costs related to excisional biopsies. Conclusions Adherence to cervical cancer screening guidelines reduced the number of unnecessary colposcopies without increasing numbers of potentially missed CIN 2,3 lesions, including cervical cancer. Uniform implementation of administrative

  11. Improving population-based cervical cancer screening in general practice : effects of a national strategy

    NARCIS (Netherlands)

    Hermens, R P; Hak, E; Hulscher, M E; Mulder, J; Tacken, M A; Braspenning, J C; Grol, R P

    1999-01-01

    OBJECTIVE: To assess the effects of a Dutch national prevention programme, aimed at general practitioners (GPs), on the adherence to organizational guidelines for effective cervical cancer screening in general practice. To identify the characteristics of general practices determining success. DESIGN

  12. Development of a self-administered questionnaire to screen patients for cervical myelopathy

    Directory of Open Access Journals (Sweden)

    Sekiguchi Yasufumi

    2010-11-01

    Full Text Available Abstract Background In primary care, it is often difficult to diagnose cervical myelopathy. However, a delay in treatment could cause irreversible aftereffects. With a brief and effective self-administered questionnaire for cervical myelopathy, cervical myelopathy may be screened more easily and oversight may be avoided. As there is presently no screening tool for cervical myelopathy, the aim of this study was to develop a self-administered questionnaire for the screening of cervical myelopathy. Methods A case-control study was performed with the following two groups at our university hospital from February 2006 to September 2008. Sixty-two patients (48 men, 14 women with cervical myelopathy who underwent operative treatment were included in the myelopathy group. In the control group, 49 patients (20 men, 29 women with symptoms that could be distinguished from those of cervical myelopathy, such as numbness, pain in the upper extremities, and manual clumsiness, were included. The underlying conditions were diagnosed as carpal tunnel syndrome, cubital tunnel syndrome, thoracic outlet syndrome, tarsal tunnel syndrome, diabetes mellitus neuropathy, cervical radiculopathy, and neuralgic amyotrophy. Twenty items for a questionnaire in this study were chosen from the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire, which is a new self-administered questionnaire, as an outcome measure for patients with cervical myelopathy. Data were analyzed by univariate analysis using the chi-square test and by multiple logistic regression analysis. According to the resulting odds ratio, β-coefficients, and p value, items were chosen and assigned a score. Results Eight items were chosen by univariate and multiple logistic regression analyses and assigned a score. The Hosmer-Lemeshow statistic showed p = 0.805. The area under the receiver operation characteristic curve was 0.86. The developed questionnaire had a sensitivity of 93.5% and a

  13. Socio-economic inequalities in breast and cervical cancer screening practices in Europe: influence of the type of screening program

    NARCIS (Netherlands)

    L. Palència; A. Espelt; M. Rodríguez-Sanz; R. Puigpinós; M. Pons-Vigués; M.I. Pasarín; T. Spadea; A.E. Kunst; C. Borrell

    2010-01-01

    Methods A cross-sectional study was performed using individual-level data from the WHO World Health Survey (2002) and data regarding the implementation of cancer screening programmes. The study population consisted of women from 22 European countries, aged 25-69 years for cervical cancer screening (

  14. Low-cost technology for screening uterine cervical cancer.

    Science.gov (United States)

    Parashari, A; Singh, V; Sehgal, A; Satyanarayana, L; Sodhani, P; Gupta, M M

    2000-01-01

    We report on an illuminated, low-cost (Rs 1500 (US$ 36)) magnifying device (Magnivisualizer) for detecting precancerous lesions of the uterine cervix. A total of 403 women attending a maternal and child health care clinic who had abnormal vaginal discharge and related symptoms were referred for detailed pelvic examination and visual inspection by means of the device after the application of 5% (v/v) acetic acid. Pap smears were obtained at the same time. The results were compared with those obtained using colposcopy and/or histology. The Magnivisualizer improved the detection rate of early cancerous lesions from 60%, for unaided visual inspection, to 95%. It also permitted detection of 58% of cases of low-grade dysplasia and 83% of cases of high-grade dysplasia; none of these cases were detectable by unaided visual inspection. For low-grade dysplasia the sensitivity of detection by means of the Magnivisualizer was 57.5%, in contrast with 75.3% for cytological examination. However, the two methodologies had similar sensitivities for higher grades of lesions. The specificity of screening with the Magnivisualizer was 94.3%, while that of cytology was 99%. The cost per screening was approximately US$ 0.55 for the Magnivisualizer and US$ 1.10 for cytology.

  15. Barriers to cervical cancer screening in Mulanje, Malawi: a qualitative study

    Directory of Open Access Journals (Sweden)

    Victoria K Fort

    2011-03-01

    Full Text Available Victoria K Fort1, Mary Sue Makin2, Aaron J Siegler1, Kevin Ault3, Roger Rochat11Rollins School of Public Health, Atlanta, Georgia, USA; 2Mulanje Mission Hospital, Mulanje, Malawi; 3Emory University Medical School, Atlanta, Georgia, USABackground: In Malawi, cervical cancer is the most prevalent form of cancer among women, with an 80% mortality rate. The Mulanje Mission Hospital has offered free cervical cancer screening for eight years; however, patients primarily seek medical help for gynecologic complaints after the disease is inoperable.Methods: We investigated how women in rural Malawi make health-seeking decisions regarding cervical cancer screening using qualitative research methods. The study was conducted between May and August of 2009 in Mulanje, Malawi.Results: This study found that the primary cue to action for cervical cancer screening was symptoms of cervical cancer. Major barriers to seeking preventative screening included low knowledge levels, low perceived susceptibility and low perceived benefits from the service. Study participants did not view cervical cancer screening as critical health care. Interviews suggested that use of the service could increase if women are recruited while visiting the hospital for a different service.Conclusion: This study recommends that health care providers and health educators target aspects of perceived susceptibility among their patients, including knowledge levels and personal risk assessment. We believe that continued support and advertisement of cervical cancer screening programs along with innovative recruitment strategies will increase usage density and decrease unnecessary deaths from cervical cancer in Malawi.Keywords: cervical cancer, interviews, health care, Mulanje Mission Hospital

  16. Oral health screening of elderly people attending a community care centre.

    Science.gov (United States)

    Diu, S; Gelbier, S

    1989-08-01

    A socio-dental survey was carried out to determine the level of dental disease and treatment requirement among elderly people attending a Community Care Centre. A screening programme involving 293 elderly people demonstrated a normative need of 82% and a felt need of 53%. Seventy-six per cent would have benefited from dental care. Many individuals who both needed and wanted dental care were not receiving it because they were discouraged from doing so predominantly because of poor mobility. It is recommended, therefore, that dentists be included in multi-disciplinary teams caring for elderly people so that they can be screened and given the opportunity to obtain dental care.

  17. Cervical Cancer Screening after Perimenopause: How Is Human Papillomavirus Test Performed?

    Science.gov (United States)

    Chung, Soo-Ho

    2016-08-01

    Cervical cancer is the third most prevalent cancer in women around the world. Recently in Korea, the incidence of cervical cancer has decreased, but in all stages of cervical intraepithelial neoplasia (CIN), CIN has shown a 91% increase from 1999 to 2008. Persistent human papillomavirus (HPV) infection has been found to be the main cause of cervical cancer. HPV types 16 and 18 have been found in 70% of cervical cancer patients around the world. Cervical cancer screening such as cytology has limitations in terms of sensitivity and specificity. A discussion about the need for the HPV test is becoming active in order to compensate for the limitation of cytology. After the role of HPV in cervical cancer was identified, the importance of HPV detection test as a screening was emphasized. Several tests have been developed and each test has its own advantages and disadvantages, and new test method to overcome the disadvantages is still being developed. Today's guidelines and tests are those you would choose from among the large number of cervical cancer screening guidelines and tests, based on the consideration that the selected guidelines and the test are effective.

  18. Cervical cancer screening and treatment of cervical intraepithelial neoplasia in female sex workers using “screen and treat” approach

    Directory of Open Access Journals (Sweden)

    Joshi S

    2015-05-01

    Full Text Available Smita Joshi,1 Vinay Kulkarni,2 Trupti Darak,2 Uma Mahajan,1 Yogesh Srivastava,3 Sanjay Gupta,3 Sumitra Krishnan,1 Mahesh Mandolkar,2 Alok Chandra Bharti31Hirabai Cowasji Jehangir Medical Research Institute (HCJMRI, Jehangir Hospital Premises, Pune, Maharashtra, India; 2Prayas Health Group, Amrita Clinic, Pune, India; 3Institute for Cytology and Preventive Oncology, Indian Council of Medical Research, New Delhi, IndiaObjective: Female sex workers (FSWs are at an increased risk of human immunodeficiency virus (HIV as well as human papillomavirus (HPV infections and thus have an increased risk of cervical intraepithelial neoplasia (CIN and cervical cancer. We evaluated the feasibility of “screen and treat approach” for cervical cancer prevention and the performance of different screening tests among FSWs.Methods: Women were screened using cytology, VIA (visual inspection with acetic acid, and VILI (visual inspection with Lugol’s iodine and underwent colposcopy, biopsy, and immediate treatment using cold coagulation, if indicated, at the same visit.Results: We screened 300 FSWs of whom 200 (66.67% were HIV uninfected and 100 (33.34% were HIV infected. The overall prevalence of CIN 2–3 lesions was 4.7%. But all women with CIN 2–3 lesions were HIV infected, and thus the prevalence of CIN 2–3 lesions in HIV-infected FSWs was 14/100 (14%, 95% confidence interval: 7.2–20.8. All of them screened positive by all three screening tests. Cold coagulation was well tolerated, with no appreciable side effects.Conclusion: Cervical cancer prevention by “screen and treat” approach using VIA, followed by ablative treatment, in this high-risk group of women is feasible and can be implemented through various targeted intervention programs. Keywords: cytology, VIA, VILI, CIN, cold coagulation, cervical cancer, HPV, FSWs

  19. Cervical Screening within HIV Care: Findings from an HIV-Positive Cohort in Ukraine

    Science.gov (United States)

    Bailey, Heather; Thorne, Claire; Semenenko, Igor; Malyuta, Ruslan; Tereschenko, Rostislav; Adeyanova, Irina; Kulakovskaya, Elena; Ostrovskaya, Lyudmila; Kvasha, Liliana; Cortina-Borja, Mario; Townsend, Claire L.

    2012-01-01

    Introduction HIV-positive women have an increased risk of invasive cervical cancer but cytologic screening is effective in reducing incidence. Little is known about cervical screening coverage or the prevalence of abnormal cytology among HIV-positive women in Ukraine, which has the most severe HIV epidemic in Europe. Methods Poisson regression models were fitted to data from 1120 women enrolled at three sites of the Ukraine Cohort Study of HIV-infected Childbearing Women to investigate factors associated with receiving cervical screening as part of HIV care. All women had been diagnosed as HIV-positive before or during their most recent pregnancy. Prevalence of cervical abnormalities (high/low grade squamous intraepithelial lesions) among women who had been screened was estimated, and associated factors explored. Results Overall, 30% (337/1120) of women had received a cervical screening test as part of HIV care at study enrolment (median 10 months postpartum), a third (115/334) of whom had been tested >12 months previously. In adjusted analyses, women diagnosed as HIV-positive during (vs before) their most recent pregnancy were significantly less likely to have a screening test reported, on adjusting for other potential risk factors (adjusted prevalence ratio (APR) 0.62, 95% CI 0.51–0.75 p<0.01 for 1st/2nd trimester diagnosis and APR 0.42, 95% CI 0.28–0.63 p<0.01 for 3rd trimester/intrapartum diagnosis). Among those with a cervical screening result reported at any time (including follow-up), 21% (68/325) had a finding of cervical abnormality. In adjusted analyses, Herpes simplex virus 2 seropositivity and a recent diagnosis of bacterial vaginosis were associated with an increased risk of abnormal cervical cytology (APR 1.83 95% CI 1.07–3.11 and APR 3.49 95% CI 2.11–5.76 respectively). Conclusions In this high risk population, cervical screening coverage as part of HIV care was low and could be improved by an organised cervical screening programme for HIV

  20. Cervical screening within HIV care: findings from an HIV-positive cohort in Ukraine.

    Directory of Open Access Journals (Sweden)

    Heather Bailey

    Full Text Available INTRODUCTION: HIV-positive women have an increased risk of invasive cervical cancer but cytologic screening is effective in reducing incidence. Little is known about cervical screening coverage or the prevalence of abnormal cytology among HIV-positive women in Ukraine, which has the most severe HIV epidemic in Europe. METHODS: Poisson regression models were fitted to data from 1120 women enrolled at three sites of the Ukraine Cohort Study of HIV-infected Childbearing Women to investigate factors associated with receiving cervical screening as part of HIV care. All women had been diagnosed as HIV-positive before or during their most recent pregnancy. Prevalence of cervical abnormalities (high/low grade squamous intraepithelial lesions among women who had been screened was estimated, and associated factors explored. RESULTS: Overall, 30% (337/1120 of women had received a cervical screening test as part of HIV care at study enrolment (median 10 months postpartum, a third (115/334 of whom had been tested >12 months previously. In adjusted analyses, women diagnosed as HIV-positive during (vs before their most recent pregnancy were significantly less likely to have a screening test reported, on adjusting for other potential risk factors (adjusted prevalence ratio (APR 0.62, 95% CI 0.51-0.75 p<0.01 for 1(st/2(nd trimester diagnosis and APR 0.42, 95% CI 0.28-0.63 p<0.01 for 3(rd trimester/intrapartum diagnosis. Among those with a cervical screening result reported at any time (including follow-up, 21% (68/325 had a finding of cervical abnormality. In adjusted analyses, Herpes simplex virus 2 seropositivity and a recent diagnosis of bacterial vaginosis were associated with an increased risk of abnormal cervical cytology (APR 1.83 95% CI 1.07-3.11 and APR 3.49 95% CI 2.11-5.76 respectively. CONCLUSIONS: In this high risk population, cervical screening coverage as part of HIV care was low and could be improved by an organised cervical screening programme

  1. Effects of numerical information on intention to participate in cervical screening among women offered HPV vaccination

    DEFF Research Database (Denmark)

    Hestbech, Mie Sara; Gyrd-Hansen, Dorte; Kragstrup, Jakob;

    2016-01-01

    Objectives: To investigate the effects of different types of information about benefits and harms of cervical screening on intention to participate in screening among women in the first cohorts offered human papilloma virus (HPV) vaccination. Design: Randomised survey study. Setting: Denmark...... of cervical screening: no information; non-numerical information; and two numerical information modules. Moreover, we provided HPV-vaccinated women in one of the arms with numerical information about benefits and harms in two steps: firstly, information without consideration of HPV vaccination...... and subsequently information conditional on HPV vaccination. Main outcome measure: Self-reported intention to participate in cervical screening. Results: A significantly lower proportion intended to participate in screening in the two groups of women receiving numerical information compared to controls...

  2. Perceptions of cervical cancer risk and screening among transmasculine individuals: patient and provider perspectives.

    Science.gov (United States)

    Agénor, Madina; Peitzmeier, Sarah M; Bernstein, Ida M; McDowell, Michal; Alizaga, Natalie M; Reisner, Sari L; Pardee, Dana J; Potter, Jennifer

    2016-10-01

    Transmasculine people (individuals assigned a female sex at birth who identify as male or masculine) are at risk of cervical cancer. Despite low rates of Pap test use in this population, research examining the determinants of cervical cancer screening among transmasculine individuals is scarce. We conducted in-depth interviews and focus groups with 49 participants (32 transmasculine patients and 17 healthcare providers) in order to examine transmasculine individuals' and healthcare providers' perceptions of cervical cancer risk and screening among individuals on the transmasculine continuum. Overall, patients believed that transmasculine individuals should receive regular Pap tests, especially in the event of gynaecological concerns. While healthcare providers' views varied, many perceived transmasculine individuals to be at low risk of cervical cancer. Contrary to existing screening guidelines, several providers believed that transmasculine individuals who did not engage in penile-vaginal intercourse with cisgender men, expressed discomfort about Pap testing or intended to obtain a hysterectomy might not need to be screened regularly or at all. Our findings underscore the importance of educating patients and providers about cervical cancer risk among transmasculine individuals and establishing evidence-based guidelines for cervical cancer screening in this underserved population.

  3. The Effect of a Universal Cervical Length Screening Program on Antepartum Management and Birth Outcomes

    Science.gov (United States)

    Shainker, Scott A.; Modest, Anna M.; Hacker, Michele R.; Ralston, Steven J.

    2016-01-01

    Objective The objective of this study was to evaluate the effect of a universal cervical length screening program on the incidence of antepartum interventions. Study Design This retrospective cohort study included women delivering ≥ 20 weeks of gestation with singleton pregnancies before and after implementing universal cervical length screening. Antepartum interventions included admission for threatened preterm birth, ≥ 2 cervical length measurements, cervical cerclage, neonatology consultation, betamethasone, antibiotic administration for preterm premature rupture of membranes, and tocolysis. Results There were 1,131 women—506 before the screening program (unexposed) and 625 afterward (exposed). The screening program resulted in significantly more women screened (3.0 vs. 69.9%, p gestation length was significantly longer in the exposed (39.6 weeks [interquartile, IQR: 38.6–40.4] vs. 39.0 weeks [IQR: 38.0–40.0, p < 0.001]); however, preterm delivery incidence was unaffected (9.4 vs. 10.9%, p = 0.43). Remaining neonatal outcomes were similar (all p ≥ 0.14). Conclusion Implementing universal cervical length screening significantly increased the proportion of women undergoing ≥ 1 antepartum intervention. With the exception of a modestly prolonged gestation, other outcomes were unaffected. PMID:27280063

  4. The Association of Social Support and Education with Breast and Cervical Cancer Screening

    Science.gov (United States)

    Documet, Patricia; Bear, Todd M.; Flatt, Jason D.; Macia, Laura; Trauth, Jeanette; Ricci, Edmund M.

    2015-01-01

    Background: Disparities in breast and cervical cancer screening by socioeconomic status persist in the United States. It has been suggested that social support may facilitate screening, especially among women of low socioeconomic status. However, at present, it is unclear whether social support enables mammogram and Pap test compliance. Purpose:…

  5. Determinants of acceptance of cervical cancer screening in Dar es Salaam, Tanzania

    DEFF Research Database (Denmark)

    Kahesa, Crispin; Kjaer, Susanne; Mwaiselage, Julius;

    2012-01-01

    ABSTRACT: OBJECTIVE: To describe how demographic characteristics and knowledge of cervical cancer influence screening acceptance among women living in Dar es Salaam, Tanzania. METHODS: Multistage cluster sampling was carried out in 45 randomly selected streets in Dar es Salaam. Women between...... cervical cancer screening can be increased in Dar es Salaam. Special attention should be paid to women of low education and women of high parity. In addition, knowledge and awareness raising campaigns that goes hand in hand with culturally acceptable screening services will likely lead to an increased...

  6. Use of thermo-coagulation as an alternative treatment modality in a 'screen-and-treat' programme of cervical screening in rural Malawi.

    Science.gov (United States)

    Campbell, Christine; Kafwafwa, Savel; Brown, Hilary; Walker, Graeme; Madetsa, Belito; Deeny, Miriam; Kabota, Beatrice; Morton, David; Ter Haar, Reynier; Grant, Liz; Cubie, Heather A

    2016-08-15

    The incidence of cervical cancer in Malawi is the highest in the world and projected to increase in the absence of interventions. Although government policy supports screening using visual inspection with acetic acid (VIA), screening provision is limited due to lack of infrastructure, trained personnel, and the cost and availability of gas for cryotherapy. Recently, thermo-coagulation has been acknowledged as a safe and acceptable procedure suitable for low-resource settings. We introduced thermo-coagulation for treatment of VIA-positive lesions as an alternative to cryotherapy within a cervical screening service based on VIA, coupled with appropriate, sustainable pathways of care for women with high-grade lesions and cancers. Detailed planning was undertaken for VIA clinics, and approvals were obtained from the Ministry of Health, Regional and Village Chiefs. Educational resources were developed. Thermo-coagulators were introduced into hospital and health centre settings, with theoretical and practical training in safe use and maintenance of equipment. A total of 7,088 previously unscreened women attended VIA clinics between October 2013 and March 2015. Screening clinics were held daily in the hospital and weekly in the health centres. Overall, VIA positivity was 6.1%. Almost 90% received same day treatment in the hospital setting, and 3- to 6-month cure rates of more than 90% are observed. Thermo-coagulation proved feasible and acceptable in this setting. Effective implementation requires comprehensive training and provider support, ongoing competency assessment, quality assurance and improvement audit. Thermo-coagulation offers an effective alternative to cryotherapy and encouraged VIA screening of many more women.

  7. Human papillomavirus type-specific prevalence in the cervical cancer screening population of Czech women.

    Directory of Open Access Journals (Sweden)

    Ruth Tachezy

    Full Text Available BACKGROUND: Infection with high-risk human papillomavirus (HPVtypes has been recognized as a causal factor for the development of cervical cancer and a number of other malignancies. Today, vaccines against HPV, highly effective in the prevention of persistent infection and precancerous lesions, are available for the routine clinical practice. OBJECTIVES: The data on the prevalence and type-specific HPV distribution in the population of each country are crucial for the surveillance of HPV type-specific prevalence at the onset of vaccination against HPV. METHODS: Women attending a preventive gynecological examination who had no history of abnormal cytological finding and/or surgery for cervical lesions were enrolled. All samples were tested for the presence of HPV by High-Risk Hybrid Capture 2 (HR HC2 and by a modified PCR-reverse line blot assay with broad spectrum primers (BS-RLB. RESULTS: Cervical smears of 1393 women were analyzed. In 6.5% of women, atypical cytological findings were detected. Altogether, 28.3% (394/1393 of women were positive for any HPV type by BS-RLB, 18.2% (254/1393 by HR HC2, and 22.3% (310/1393 by BS-RLB for HR HPV types. In women with atypical findings the prevalence for HR and any HPV types were significantly higher than in women with normal cytological findings. Overall, 36 different HPV types were detected, with HPV 16 being the most prevalent (4.8%. HPV positivity decreased with age; the highest prevalence was 31.5% in the age group 21-25 years. CONCLUSIONS: Our study subjects represent the real screening population. HPV prevalence in this population in the Czech Republic is higher than in other countries of Eastern Europe. Also the spectrum of the most prevalent HPV types differs from those reported by others but HPV 16 is, concordantly, the most prevalent type. Country-specific HPV type-specific prevalences provide baseline information which will enable to measure the impact of HPV vaccination in the future.

  8. Cervical cancer screening among women aged 18-30 years - United States, 2000-2010.

    Science.gov (United States)

    2013-01-01

    Screening women for cervical cancer can save lives. However, among young women, cervical cancer is relatively rare, and too-frequent screening can lead to high costs and adverse events associated with overtreatment. Before 2012, cervical cancer screening guidelines of the American College of Obstetricians and Gynecologists (ACOG), American Cancer Society (ACS), and U.S. Preventive Services Task Force (USPSTF) differed on age to start and how often to get screened for cervical cancer. In 2012, however, all three organizations recommended that 1) screening by Papanicolau (Pap) test should not be used for women aged <21 years, regardless of initiation of sexual activity, and 2) a screening interval of 3 years should be maintained for women aged 21-30 years. ACS and ACOG explicitly recommend against yearly screening. To assess trends in Pap testing before the new guidelines were introduced, CDC analyzed 2000-2010 data from the Behavioral Risk Factor Surveillance System (BRFSS) for women aged 18-30 years. CDC found that, among women aged 18-21 years, the percentage reporting never having been screened increased from 26.3% in 2000 to 47.5% in 2010, and the proportion reporting having had a Pap test in the past 12 months decreased from 65.0% to 41.5%. Among those aged 22-30 years, the proportion reporting having had a Pap test within the preceding 12 months decreased from 78.1% to 67.0%. These findings showed that Pap testing practices for young women have been moving toward the latest guidelines. However, the data also showed a concerning trend: among women aged 22-30 years, who should be screened every 3 years, the proportion who reported never having had a Pap test increased from 6.6% to 9.0%. More effort is needed to promote acceptance of the latest evidence-based recommendations so that all women receive the maximal benefits of cervical cancer screening.

  9. Knowledge and acceptability of human papillomavirus vaccination and cervical cancer screening among women in Karnataka, India.

    Science.gov (United States)

    Montgomery, Martha P; Dune, Tanaka; Shetty, Prasanna K; Shetty, Avinash K

    2015-03-01

    Cervical cancer is the leading cause of cancer-related mortality among women in India; however, participation in prevention and screening is low and the reasons for this are not well understood. In a cross-sectional survey in August 2008, 202 healthy women in Karnataka, India completed a questionnaire regarding knowledge, attitudes, and practices related to human papillomavirus (HPV) and cervical cancer. Factors associated with vaccination and Papanicolau (Pap) smear screening acceptance were explored. Thirty-six percent of women had heard of HPV while 15% had heard of cervical cancer. Five percent of women reported ever having a Pap smear, and 4% of women felt at risk of HPV infection. Forty-six percent of women were accepting of vaccination, but fewer (21%) were willing to have a Pap smear. Overall, knowledge related to HPV and cervical cancer topics was low. Women with negative attitudes toward HPV infection were 5.3 (95% confidence interval (CI) 2.8-10) times more likely to accept vaccination but were not significantly more likely to accept Pap smear (odds ratio 1.5, 95% CI 0.7-3.0). Cost and a low level of perceived risk were the most frequent factors cited as potential barriers. Improving awareness of HPV and cervical cancer through health care providers in addition to increasing access to vaccination and screening through government-sponsored programs may be feasible and effective methods to reduce cervical cancer burden in India.

  10. Structural and sociocultural factors associated with cervical cancer screening among HIV-infected African American women in Alabama.

    Science.gov (United States)

    Williams, Michelle; Moneyham, Linda; Kempf, Mirjam-Colette; Chamot, Eric; Scarinci, Isabel

    2015-01-01

    African American women have disproportionately high prevalence rates of HIV and cervical cancer. HIV-infected women are significantly less likely to obtain recommended cervical cancer screenings than HIV-uninfected women. The purpose of this study was to examine sociocultural and structural factors associated with cervical cancer screening among HIV-infected African American in Alabama. The PEN-3 Model and the Health Belief Model were used as theoretical frameworks. In-depth interviews were conducted with twenty HIV-infected African American women to identify perceptions, enablers, and nurturers, perceived susceptibility, perceived severity, and perceived benefits related to cervical cancer and screening. The most common positive perceptions, enablers, and nurturers that contributed to cervical cancer screening included internal motivation and awareness of the importance of HIV-infected women getting Pap tests due to their weakened immune system. Negative perceptions, enablers, and nurturers included lack of knowledge about cervical cancer and screening, and lack of perceived susceptibility to cervical cancer. The results of this study can be used to guide the development of culturally relevant cervical cancer and screening education interventions aimed at increasing cervical cancer screening adherence among HIV-infected African American women.

  11. A fall-off in cervical screening coverage of younger women in developed countries

    DEFF Research Database (Denmark)

    Lancucki, L; Fender, M; Koukari, A;

    2010-01-01

    OBJECTIVES: To analyse cervical screening coverage data by age over time in a number of developed countries throughout the world, with specific emphasis on trends for younger women and on age differentials between younger and older women. METHODS: Routinely collected cervical screening statistics...... that generally the gap between coverage of younger women and coverage of older women increased, sometimes dramatically, between the mid-1990s and the mid-2000s. CONCLUSIONS: There is a general trend in developed countries towards lower coverage in young women (25-29 years old). No common underlying cause has...... and survey data were collected on the proportion of women who have undergone cervical screening with cytology in seven countries in the period 1995 to 2005. RESULTS: Data for the 25-29 age group were examined. Coverage fell in most countries, in three by more than 5 percentage points. In two countries while...

  12. Screening for Chlamydial Infections in Women Attending Family Planning Clinics—Evaluation of Presumptive Indicators for Therapy

    OpenAIRE

    Schachter, Julius; Stoner, Eileen; Moncada, Jeanne

    1983-01-01

    Chlamydia trachomatis was recovered from the cervices of 9.8 percent (268/2,729) of women attending seven family planning clinics. The infection rate varied from 5.5 percent to 22.5 percent in different clinics. Chlamydial infection could be associated with younger age, nulliparity, being black and use of oral contraceptives. Most (70 percent) of the chlamydial infections were inapparent and presumptive indicators for antichlamydial therapy that are useful for symptomatic women will not make ...

  13. Scaling up cervical cancer screening in the midst of human papillomavirus vaccination advocacy in Thailand

    Directory of Open Access Journals (Sweden)

    Teerawattananon Yot

    2010-07-01

    Full Text Available Abstract Background Screening tests for cervical cancer are effective in reducing the disease burden. In Thailand, a Pap smear program has been implemented throughout the country for 40 years. In 2008 the Ministry of Public Health (MoPH unexpectedly decided to scale up the coverage of free cervical cancer screening services, to meet an ambitious target. This study analyzes the processes and factors that drove this policy innovation in the area of cervical cancer control in Thailand. Methods In-depth interviews with key policy actors and review of relevant documents were conducted in 2009. Data analysis was guided by a framework, developed on public policy models and existing literature on scaling-up health care interventions. Results Between 2006 and 2008 international organizations and the vaccine industry advocated the introduction of Human Papillomavirus (HPV vaccine for the primary prevention of cervical cancer. Meanwhile, a local study suggested that the vaccine was considerably less cost-effective than cervical cancer screening in the Thai context. Then, from August to December 2008, the MoPH carried out a campaign to expand the coverage of its cervical cancer screening program, targeting one million women. The study reveals that several factors were influential in focusing the attention of policymakers on strengthening the screening services. These included the high burden of cervical cancer in Thailand, the launch of the HPV vaccine onto the global and domestic markets, the country’s political instability, and the dissemination of scientific evidence regarding the appropriateness of different options for cervical cancer prevention. Influenced by the country’s political crisis, the MoPH’s campaign was devised in a very short time. In the view of the responsible health officials, the campaign was not successful and indeed, did not achieve its ambitious target. Conclusion The Thai case study suggests that the political crisis was a

  14. Improving the Utilization of Human Papillomavirus and Cervical Cytology Co-testing for Cervical Cancer Screening in an Obstetrics and Gynecology Resident Clinic.

    Science.gov (United States)

    Yoshino, Kurt; Karimoto, Maxine; Marzo, Christina; Kaneshiro, Bliss; Hiraoka, Mark

    2015-08-01

    Human Papillomavirus (HPV) testing in combination with cervical cytology (HPV co-testing) has been recommended for cervical cancer screening for women 30 to 65 years of age. In several studies, HPV co-testing increased sensitivity for detecting high grade dysplasia and resulted in cost-savings. This retrospective cohort study assessed the prevalence of HPV co-testing in an obstetrics and gynecology resident clinic before and after a brief educational intervention which was designed to reinforce current cervical cancer screening recommendations. The intervention consisted of a short presentation that was given to all residents and medical assistants in October 2011. The proportion of women age 30-65 years of age who had cervical cancer screening with HPV co-testing as compared to cervical cytology alone was compared before and after the intervention using chi-square tests. The goal of the intervention was to increase the percentage of patients receiving co-testing from 0.5% to 7.8%. Each arm (pre- and post-intervention) required 130 subjects to achieve 80% power with a significance of P = .05. No significant differences in demographics including age, insurance type, and cytology were noted. HPV co-testing increased from 0% to 55% (P cervical cancer screening for another 5 years. HPV co-testing represents an underutilized cervical cancer screening modality for women 30 years and older. This brief educational intervention, adaptable to any clinical setting, significatnly increased co-testing at the clinical site.

  15. The clinical utility of HPV DNA testing in cervical cancer screening strategies.

    Science.gov (United States)

    Bhatla, Neerja; Moda, Nidhi

    2009-09-01

    Cervical cancer continues to be the commonest cause of death among women in developing countries, largely due to the failure to the inability to sustain effective cytology-based screening programs. While this burden may come down following implementation of the human papillomavirus (HPV) vaccine, screening will still be required. HPV DNA testing is a promising new technology for cervical cancer prevention and is the most reproducible of all cervical cancer screening tests. Presently, the two assays most widely used for the detection of genital types are the polymerase chain reaction (PCR) and Hybrid Capture 2 assays (hc2). Rapid, affordable tests are expected to be available soon. HPV DNA testing can be used in a variety of clinical scenarios that include primary screening in women older than 30 yr; as an adjunctive test to cytology; in the triage of women with an equivocal cytologic report, e.g., ASC-US; or for follow-up post-treatment for cervical intraepithelial neoplasia (CIN). HPV DNA testing can also be performed on self-collected samples, which allows screening in remote areas and also in women who refuse gynecologic examination.

  16. Improvements in the Dutch Cervical Cancer Screening Programme since 1995

    NARCIS (Netherlands)

    A.B. Bos (Anita)

    2006-01-01

    markdownabstract__Abstract__ Worldwide, cervical cancer is the second most common cancer in women, and therefore an important public health problem (1 ). In developing countries, the age standardised incidence rate varies between 16 - 40 per 100,000 women in 1988- 1992 (2). In the same period, in d

  17. Recent Developments in the Dutch Cervical Cancer Screening Programme

    NARCIS (Netherlands)

    M. Rebolj (Matejka)

    2008-01-01

    textabstractWorldwide, cervical cancer is the second most common female malignancy, diagnosed in 500,000 women each year, while 275,000 die from it. Without prevention, the peak incidence occurs at a relatively young age, between 40-55 years, when women are still active on the labour market and have

  18. Meta-analysis of type-specific human papillomavirus prevalence in Iranian women with normal cytology, precancerous cervical lesions and invasive cervical cancer: Implications for screening and vaccination.

    Science.gov (United States)

    Jalilvand, Somayeh; Shoja, Zabihollah; Nourijelyani, Keramat; Tohidi, Hamid Reza; Hamkar, Rasool

    2015-02-01

    To predict the impact of current vaccines on cervical cancer and for the improvement of screening programs, regional data on distribution of human papillomavirus (HPV) types in women with or without cervical cancer is crucial. The present meta-analysis intend to comprehensively evaluate the HPV burden in women with invasive cervical cancer, high-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 2 and 3), low-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 1), atypical squamous cells of undetermined significance and normal cytology, as these data will help decision making in regards with screening programs and HPV vaccination in Iran. To determine the HPV prevalence and type distribution in Iranian women with or without cervical cancer, 20 published studies were included in this meta-analysis. In total, 713, 124, 104, 60, and 2577 women invasive cervical cancer, high-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 2 and 3), low-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 1), atypical squamous cells of undetermined significance and normal were reviewed, respectively. Overall HPV prevalence in women with invasive cervical cancer, high-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 2 and 3), low-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 1), atypical squamous cells of undetermined significance and normal cytology were 77.4%, 71.8%, 65.3%, 61.7%, and 8.4%, respectively. The six most common types were HPV 16, 18, 6/11, 31, and 33; among them HPV 16 was the most frequent type in all five different groups. According to this study, it was estimated that HPV vaccines could have a great impact on prevention of cervical cancer in Iran. In conclusion, this meta-analysis highlights the necessity of introducing vaccination program in Iran.

  19. A comparative study of cervical cancer screening methods in a rural community setting of North India

    Directory of Open Access Journals (Sweden)

    L Satyanarayana

    2014-01-01

    Full Text Available Context: Pap smear testing as a conventional cervical screening approach has limitations for implementation and aided visual cervical testing has varying results in different regions. Aims: The aim of this study is to demonstrate the performance of aided visual cervical screening tests as against conventional Pap smear testing in a rural community setting of North India. Settings and Design: This was a rural community based cross-sectional study. Materials and Methods: All 7603 ever married women of age 30-59 years surveyed in a pocket of Dadri Tehsil, Uttar Pradesh, India were targeted for screening by Pap, visual inspection of cervix using acetic acid (VIA and visual inspection of cervix using Lugol′s iodine (VILI methods. Screen positives were referred to colposcopy and confirmation by histology. Statistical Analysis Used: Detection of histological cervical intraepithelial neoplasia (CIN II + and CIN III + assessed separately by sensitivity, specificity and likelihood ratio′s and predictive values. Analysis of data was performed by using IBM SPSS statstics software version 16.0. Results: A total of 65.6%(4988/7604 eligible women of 30-59 years age group in the target population were screened. Out of 4988, further analysis was performed on 4148 after excluding those who did not complete all screenings, who lost to follow-up and had missing histology results. Screen positivity rates by Pap (ASCUS and above, VIA and VILI were 2.6%, 9.7% and 13.5% respectively. Sensitivity and specificity of detecting the CIN III+ lesions were 87.5 and 98.8% for Pap, 50.0% and 96.7% for VIA and 50.0% and 95.7% for VILI respectively. Conclusions: VIA screening demonstrated as a feasible primary screening test for detecting high grade CIN and as to perform better when the Pap test is not feasible.

  20. Cost of the Cervical Cancer Screening Program at the Mexican Social Security Institute

    Directory of Open Access Journals (Sweden)

    Víctor Granados-García

    2014-09-01

    Full Text Available Objective. To estimate the annual cost of the National Cervical Cancer Screening Program (CCSP of the Mexican Institute of Social Security (IMSS. Materials and methods. This cost analysis examined regional coverage rates reported by IMSS. We estimated the number of cytology, colposcopy, biopsy and pathology evaluations, as well as the diagnostic test and treatment costs for cervical intraepithelial neoplasia grade II and III (CIN 2/3 and cervical cancer. Diagnostic test costs were estimated using a micro-costing technique. Sensitivity analyses were performed. Results. The cost to perform 2.7 million cytology tests was nearly 38 million dollars, which represents 26.1% of the total program cost (145.4 million. False negatives account for nearly 43% of the program costs. Conclusion. The low sensitivity of the cytology test generates high rates of false negatives, which results in high institutional costs from the treatment of undetected cervical cancer cases.

  1. Factors associated with breast and cervical cancer screening behavior among African immigrant women in Minnesota.

    Science.gov (United States)

    Harcourt, Nonyelum; Ghebre, Rahel G; Whembolua, Guy-Lucien; Zhang, Yan; Warfa Osman, S; Okuyemi, Kolawole S

    2014-06-01

    Immigrant populations in the United States (US) have lower cancer screening rates compared to none immigrant populations. The purpose of this study was to assess the rates of cancer screening and examine factors associated with cancer screening behavior among African immigrant women in Minnesota. A cross sectional survey of a community based sample was conducted among African immigrants in the Twin Cities. Cancer screening outcome measures were mammography and Papanicolau smear test. The revised theoretical model of health care access and utilization and the behavioral model for vulnerable populations were utilized to assess factors associated with cancer screening. Only 61 and 52% of the age eligible women in the sample had ever been screened for breast and cervical cancer respectively. Among these women, duration of residence in the US and ethnicity were significant determinants associated with non-screening. Programs to enhance screening rates among this population must begin to address barriers identified by the community.

  2. Early Screening of Cervical Cancer%宫颈癌的早期筛查

    Institute of Scientific and Technical Information of China (English)

    李春凤

    2012-01-01

    Ideal early screening of cervical cancer should have the advantages of simple operating, economical and practical, convenient, and high diagnostic accuracy. Early cervical cancer screening methods were various, and different screening methods have their own advantages and limitations, although the diagnosis accuracy rate of early screening improved greatly with the development of clinical diagnosis technology, there was not a single method that can be popularized effectively. We took a variety of combined examinations of early screening to reduce the rate of misdiagnosis, improve the diagnostic accuracy rate, reduce the risk of cervical cancer on women maximally and protect women health. Ideal early screening of cervical cancer should have the advantages of simple operating, economical and practical, convenient, and high diagnostic accuracy. Early cervical cancer screening methods were various, and different screening methods have their own advantages and limitations, although the diagnosis accuracy rate of early screening improved greatly with the development of clinical diagnosis technology, there was not a single method that can be popularized effectively. We took a variety of combined examinations of early screening to reduce the rate of misdiagnosis, improve the diagnostic accuracy rate, reduce the risk of cervical cancer on women maximally and protect women health.%宫颈癌理想的早期筛查方法 应具有操作简单、经济实用、便于普及、诊断准确率高等优点.宫颈癌早期筛查的方法 有多种,不同的筛查方法 均有其自身的优点和局限性,虽然随着临床诊断技术的发展,早期筛查诊断的准确率得到很大提高,但目前尚无单一的方法 来真正得到广泛、有效的推广和普及.现多采取多种方法 联合检查的早期筛查方式,以降低漏诊率、提高诊断的准确率,最大限度地降低宫颈癌对妇女生命的威胁,保障妇女身体健康.

  3. Validation of cervical cancer screening methods in HIV positive women from Johannesburg South Africa.

    Directory of Open Access Journals (Sweden)

    Cynthia Firnhaber

    Full Text Available BACKGROUND: HIV-infected women are at increased risk for developing cervical cancer. Women living in resource-limited countries are especially at risk due to poor access to cervical cancer screening and treatment. We evaluated three cervical cancer screening methods to detect cervical intraepithelial neoplasia grade 2 and above (CIN 2+ in HIV-infected women in South Africa; Pap smear, visual inspection with 5% acetic acid (VIA and human papillomavirus detection (HPV. METHODS: HIV-infected women aged 18-65 were recruited in Johannesburg. A cross-sectional study evaluating three screening methods for the detection of the histologically-defined gold standard CIN-2 + was performed. Women were screened for cervical abnormalities with the Digene HC2 assay (HPV, Pap smear and VIA. VIA was performed by clinic nurses, digital photographs taken and then later reviewed by specialist physicians. The sensitivity, specificity and predictive valves for CIN-2 + were calculated using maximum likelihood estimators. RESULTS: 1,202 HIV-infected women participated, with a median age of 38 years and CD4 counts of 394 cells/mm(3. One third of women had a high grade lesion on cytology. VIA and HPV were positive in 45% and 61% of women respectively. Estimated sensitivity/specificity for HPV, Pap smear and VIA for CIN 2+ was 92%/51.4%, 75.8%/83.4% and 65.4/68.5% (nurse reading, respectively. Sensitivities were similar, and specificities appeared significantly lower for the HPV test, cytology and VIA among women with CD4 counts ≤200 cells/mm(3 as compared to CD4 counts >350 cells/mm(3. CONCLUSIONS: Although HPV was the most sensitive screening method for detecting CIN 2+, it was less specific than conventional cytology and VIA with digital imaging review. Screening programs may need to be individualized in context of the resources and capacity in each area.

  4. Cervical cancer screening in women referred to healthcare centres in Tabriz, Iran

    Directory of Open Access Journals (Sweden)

    Azizeh Farshbaf-Khalili

    2015-01-01

    Full Text Available Background: Cervical cancer is the second most common cancer among Iranian women and among the few cancers that could be easily diagnosed in the pre-malignant stage. We aimed to assess the status of cervical cancer screening in women referred to health care centres in Tabriz, northwest Iran. Materials and Methods: This descriptive-analytical study was done on 441 women referred to health care centres of Tabriz, northwest Iran. The centres were selected using the multi-stage cluster sampling method. The participants were selected from the active records of those centres. A questionnaire regarding the socio-demographic characteristics and cervical cancer screening and reasons for referring or not referring for screening was completed by the participants A P < 0.05 was considered as significant. Results: Out of the participants 49.4% of women had done the Pap smear test while 50.6% had never done this test. The main reason why women had not performed cervical cancer screening was being unaware of the importance of it (46.1%. Logistic regression analysis with adjustment showed a significant relationship between screening and awareness scores (OR = 1.17, CI = 95%:1.12-1.23, when the effect of other confounding factors [total awareness scores, risk factors (marriage or having sexual intercourse at a young age, history of obvious cervical infection, cautery, cryotherapy or repeated curettage, age and type of family planning] in screening was controlled. Conclusion: Suitable and continuous educational programmes especially for high risk women should be implemented through the health care services. Preparing educational brochures and pamphlets and providing adequate training on the necessity of early referral and marriage counseling could also be effective in improving woman′s awareness and performance.

  5. From cancer screening to treatment: service delivery and referral in the National Breast and Cervical Cancer Early Detection Program.

    Science.gov (United States)

    Miller, Jacqueline W; Hanson, Vivien; Johnson, Gale D; Royalty, Janet E; Richardson, Lisa C

    2014-08-15

    The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screening and diagnostic services to low-income and underserved women through a network of providers and health care organizations. Although the program serves women 40-64 years old for breast cancer screening and 21-64 years old for cervical cancer screening, the priority populations are women 50-64 years old for breast cancer and women who have never or rarely been screened for cervical cancer. From 1991 through 2011, the NBCCEDP provided screening and diagnostic services to more than 4.3 million women, diagnosing 54,276 breast cancers, 2554 cervical cancers, and 123,563 precancerous cervical lesions. A critical component of providing screening services is to ensure that all women with abnormal screening results receive appropriate and timely diagnostic evaluations. Case management is provided to assist women with overcoming barriers that would delay or prevent follow-up care. Women diagnosed with cancer receive treatment through the states' Breast and Cervical Cancer Treatment Programs (a special waiver for Medicaid) if they are eligible. The NBCCEDP has performance measures that serve as benchmarks to monitor the completeness and timeliness of care. More than 90% of the women receive complete diagnostic care and initiate treatment less than 30 days from the time of their diagnosis. Provision of effective screening and diagnostic services depends on effective program management, networks of providers throughout the community, and the use of evidence-based knowledge, procedures, and technologies.

  6. Effect of organized screening on incidence and mortality of cervical cancer in Denmark

    DEFF Research Database (Denmark)

    Lynge, E; Madsen, Mette; Engholm, G

    1989-01-01

    multiplicative Poisson models on county-based incidence and mortality data for women aged 30-59 years in 1963-1982 showed a statistically significant effect of organized screening in reducing both the incidence (RR = 0.67; 95% CI, 0.61-0.73), and the mortality (RR = 0.68; 95% CI, 0.59-0.78) of cervical cancer...

  7. Cost-effectiveness of cervical cancer screening: Cytology versus human papillomavirus DNA testing

    NARCIS (Netherlands)

    J.M. van Rosmalen (Joost); I.M.C.M. de Kok (Inge); M. van Ballegooijen (Marjolein)

    2012-01-01

    textabstractObjective To determine the most cost-effective screening programme for cervical cancer. Design Cost-effectiveness analysis from a societal perspective. Setting The Netherlands. Population Dutch women who have not been invited for human papillomavirus (HPV) vaccination. Methods We calibra

  8. Frequency of cervical intraepithelial neoplasia treatment in a well-screened population

    DEFF Research Database (Denmark)

    Barken, Sidsel Svennekjaer; Rebolj, Matejka; Andersen, Erik Søgaard

    2012-01-01

    a nationwide population-based estimate of the frequency of CIN treatment per prevented cervical cancer case in a well-screened population. We retrieved the data from the Danish National Population, Patient, Health Insurance, Pathology, and Cancer Registers, and calculated annual age-standardized CIN treatment...

  9. Effects of HPV detection in population-based screening programmes for cervical cancer; a Dutch moment.

    NARCIS (Netherlands)

    Bekkers, R.L.M.; Meijer, C.J.M.; Massuger, L.F.A.G.; Snijders, P.J.L.M.; Melchers, W.J.G.

    2006-01-01

    Presently, large randomised studies are investigating the value of incorporating HPV detection in population-based cervical screening programmes to improve the effectiveness of these programmes. None of these studies, however, has assessed the effect of HPV detection on the participation rate of wom

  10. Handheld multispectral dual-axis confocal microscope for cervical cancer screening

    Science.gov (United States)

    Sarapukdee, Pongsak; Rattanavarin, Santi; Jarujareet, Ungkarn; Khemthongcharoen, Numfon; Jolivot, Romuald; Jung, Il Woong; López, Daniel; Mandella, Michael J.; Piyawattanametha, Wibool

    2013-03-01

    Our work demonstrates a MEMS based handheld dual-axis confocal microscope for cervical cancer screening. Imaging demonstration is performed with plant and animal tissue biopsies. The data is collected and displayed in real time with 2-5 Hz frame rates.

  11. Mass screening programmes and trends in cervical cancer in Finland and the Netherlands

    NARCIS (Netherlands)

    Aa, van der Maaike A.; Pukkala, Eero; Coebergh, Jan Willem W.; Anttila, Ahti; Siesling, Sabine

    2008-01-01

    With respect to cervical cancer management, Finland and the Netherlands are comparable in relevant characteristics, e.g., fertility rate, age-of-mother at first birth and a national screening programme for several years. The aim of this study is to compare trends in incidence of and mortality from c

  12. Optimal Management Strategies for Primary HPV Testing for Cervical Screening: Cost-Effectiveness Evaluation for the National Cervical Screening Program in Australia

    Science.gov (United States)

    Hall, Michaela; Lew, Jie-Bin; Hughes, Suzanne; Yuill, Susan; Hammond, Ian; Saville, Marion; Canfell, Karen

    2017-01-01

    Background Several countries are implementing a transition to HPV testing for cervical screening in response to the introduction of HPV vaccination and evidence indicating that HPV screening is more effective than cytology. In Australia, a 2017 transition from 2-yearly conventional cytology in 18–20 to 69 years to 5-yearly primary HPV screening in 25 to 74 years will involve partial genotyping for HPV 16/18 with direct referral to colposcopy for this higher risk group. The objective of this study was to determine the optimal management of women positive for other high-risk HPV types (not 16/18) ('OHR HPV'). Methods We used a dynamic model of HPV transmission, vaccination, natural history and cervical screening to determine the optimal management of women positive for OHR HPV. We assumed cytology triage testing was used to inform management in this group and that those with high-grade cytology would be referred to colposcopy and those with negative cytology would receive 12-month surveillance. For those with OHR HPV and low-grade cytology (considered to be a single low-grade category in Australia incorporating ASC-US and LSIL), we evaluated (1) the 20-year risk of invasive cervical cancer assuming this group are referred for 12-month follow-up vs. colposcopy, and compared this to the risk in women with low-grade cytology under the current program (i.e. an accepted benchmark risk for 12-month follow-up in Australia); (2) the population-level impact of the whole program, assuming this group are referred to 12-month surveillance vs. colposcopy; and (3) the cost-effectiveness of immediate colposcopy compared to 12-month follow-up. Evaluation was performed both for HPV-unvaccinated cohorts and cohorts offered vaccination (coverage ~72%). Findings The estimated 20-year risk of cervical cancer is ≤1.0% at all ages if this group are referred to colposcopy vs. ≤1.2% if followed-up in 12 months, both of which are lower than the ≤2.6% benchmark risk in women with low

  13. An opto-electronic joint detection system based on DSP aiming at early cervical cancer screening

    Science.gov (United States)

    Wang, Weiya; Jia, Mengyu; Gao, Feng; Yang, Lihong; Qu, Pengpeng; Zou, Changping; Liu, Pengxi; Zhao, Huijuan

    2015-02-01

    The cervical cancer screening at a pre-cancer stage is beneficial to reduce the mortality of women. An opto-electronic joint detection system based on DSP aiming at early cervical cancer screening is introduced in this paper. In this system, three electrodes alternately discharge to the cervical tissue and three light emitting diodes in different wavelengths alternately irradiate the cervical tissue. Then the relative optical reflectance and electrical voltage attenuation curve are obtained by optical and electrical detection, respectively. The system is based on DSP to attain the portable and cheap instrument. By adopting the relative reflectance and the voltage attenuation constant, the classification algorithm based on Support Vector Machine (SVM) discriminates abnormal cervical tissue from normal. We use particle swarm optimization to optimize the two key parameters of SVM, i.e. nuclear factor and cost factor. The clinical data were collected on 313 patients to build a clinical database of tissue responses under optical and electrical stimulations with the histopathologic examination as the gold standard. The classification result shows that the opto-electronic joint detection has higher total coincidence rate than separate optical detection or separate electrical detection. The sensitivity, specificity, and total coincidence rate increase with the increasing of sample numbers in the training set. The average total coincidence rate of the system can reach 85.1% compared with the histopathologic examination.

  14. Comparison Between Pap Smear and Via As Screening For Cervical Lesions

    Directory of Open Access Journals (Sweden)

    Harshini V 1, Amritha Bhandary 2, Suchithra Thunga 3

    2013-09-01

    Full Text Available Introduction: An important reason for higher cervical cancer incidence in developing countries is lack of effectivescreening programs like pap smear, aimed at detecting precancerous conditions before they progress to invasivecancer. The potential difficulties in implementing cervical cytology based screening in low-resource settings haveprompted the investigation of accuracy of alternative low technology tests such as Visual inspection with acetic acidapplication [VIA], Visual inspection with acetic acid application with magnification [VIAM], visual inspection onLugol’s Iodine application [VILI] in early detection of cervical neoplasia .In our study we compared pap smear withVIA to study the accurarcy of VIA as it is simpler and easier technique to be used as screening in low resourcesettings. Aim: This is a hospital based descriptive, prospective study to evaluate validity of pap smear and VIAtechniques as screening tests in identifying cervical lesions. Materials And Methods: After general and systemicexamination as a routine,visual local pelvic examination including visualisation of cervix and vagina per speculumand the findings are documented in the proforma .Then VIA and pap smear are done in that order, if any of thesetests are positive then cervical biopsy will be taken and further advise to the subject is given. Results: A total of 313women were involved in the study. The sensitivity of pap smear is 54.5% specificity is 98.9% while that of VIA95.4% and 97.9%respectively. We found that VIA accuracy was comparatively more than that of pap smear.Conclusion: In low resource settings, usefulness of VIA is more than that of pap smear. We suggest to perform VIAin all the women inspite of having pap smear facility to improve detection rate of cervical lesions and provide betterpatient councelling and treatment.

  15. Factors associated with cervical cancer screening amongst women of reproductive age from Yucatan, Mexico.

    Science.gov (United States)

    Conde-Ferraez, Laura; Suarez Allen, Rosa Etelvina; Carrillo Martinez, Jorge Ramiro; Ayora-Talavera, Guadalupe; Gonzalez-Losa, Maria Del Refugio

    2012-01-01

    This study aimed to analyse the participation of women of reproductive age in a cancer screening program, and survey reasons for non-screening in a region from Mexico with high cervical cancer mortality. A total of 281 obstetric patients from a previous HPV study in a social security hospital during 2008-2009 were included. Reasons for not participating in the screening were directly asked. HPV positive patients were invited to participate in an informative workshop, and they filled in a knowledge questionnaire. The women ranged in age from 14-47 years; 123 (43.8%) had never participated in screening, of which 97 (78.9%) had their first sexual intercourse 2 to 10 years ago, resulting in 25% HPV positive. Screening history was strongly associated with 2 or more gestations (OR= 10.07, p=0.00) and older age (OR=6.69 p=0.00). When 197 women were contacted and interviewed, reasons referred for non-screening were ignorance, lack of interest or time, recent sexual onset, shame and fear. More than 50% of the workshop participants showed knowledge of HPV, while 38.9% and 25% knew about Pap smear and cervical cancer. A high percentage of women of reproductive age have never had a Pap smear. Promoting the screening program in medical facilities seems to be important in this population. New approaches to inform vulnerable individuals on the benefits of screening need to be implemented, especially for young women.

  16. Why worry about awareness in choice problems? Econometric analysis of screening for cervical cancer.

    Science.gov (United States)

    Belkar, Rochelle; Fiebig, Denzil G; Haas, Marion; Viney, Rosalie

    2006-01-01

    The decision to undertake a screening test is conditional upon awareness of screening. From an econometric perspective there is a potential selection problem, if no distinction is made between aware and unaware non-screeners. This paper explores this problem through analysis of the determinants of cervical screening in Australia. Cervical cancer is one of the most preventable and curable forms of cancer. Since 1991 there has been a concerted effort in Australia to recommend and encourage women to have Pap smears every two years. The success of this program can be partly gauged by exploring the determinants of screening for cervical cancer. Using unit record data from the 1995 National Health Survey, an econometric model is developed for whether women have ever screened or not. A proportion of women in the sample contend that they have never heard of a Pap test. The analysis characterizes this group of women and accounts for their presence in the modelling. The paper demonstrates failing to model awareness can result in inconsistent parameter estimates even when the degree of censoring in the sample is relatively small.

  17. A study of the impact of adding HPV types to cervical cancer screening and triage tests.

    Science.gov (United States)

    Schiffman, Mark; Khan, Michelle J; Solomon, Diane; Herrero, Rolando; Wacholder, Sholom; Hildesheim, Allan; Rodriguez, Ana Cecilia; Bratti, Maria C; Wheeler, Cosette M; Burk, Robert D

    2005-01-19

    Use of human papillomavirus (HPV) testing in cervical cancer prevention is increasing rapidly. A DNA test for 13 HPV types that can cause cervical cancer is approved in the United States for co-screening with cytology of women >or=30 years old and for triage of women of all ages with equivocal cytology. However, most infections with HPV are benign. We evaluated trade-offs between specificity and sensitivity for approximately 40 HPV types in predicting cervical intraepithelial neoplasia 3 and cancer in two prospective studies: a population-based screening study that followed 6196 women aged 30-94 years from Costa Rica for 7 years and a triage study that followed 3363 women aged 18-90 years with equivocal cytology in four U.S. centers for 2 years. For both screening and triage, testing for more than about 10 HPV types decreased specificity more than it increased sensitivity. The minimal increases in sensitivity and in negative predictive value achieved by adding HPV types to DNA tests must be weighed against the projected burden to thousands of women falsely labeled as being at high risk of cervical cancer.

  18. Congenital spine deformities: a new screening indication for blunt cerebrovascular injuries after cervical trauma?

    Science.gov (United States)

    Capone, Christine; Burjonrappa, Sathyaprasad

    2010-12-01

    Blunt cerebrovascular injuries (BCVI) carry significant morbidity if not diagnosed and treated early. A high index of clinical suspicion is needed to recognize the injury patterns associated with this condition and to order the requisite imaging studies needed to diagnose it accurately. We report of BCVI associated with a congenital cervical spine malformation after blunt trauma. We recommend inclusion of cervical spine malformations to the current Eastern Association for the Surgery of Trauma screening criteria for BCVI and explain our rationale for the same.

  19. Cervical pap smear study and its utility in cancer screening to specify the strategy for cervical cancer control

    Directory of Open Access Journals (Sweden)

    Mandakini M Patel, Amrish N Pandya, Jigna Modi

    2011-01-01

    Full Text Available The study was conducted to explore various lesions of Uterine cervix [inflammatory and growth], to find out target age group in which screening efforts can be concentrated for early detection as well as reduction of the incidence of cervical cancer, in our set up. Patients in the age group 15-50 and 50-78 years with various complaints were screened during June 2006 to December 2007. Total 995 patients were studied. Slides were fixed in 95% ethyl alcohol and stained with Pap stain. Slides were reported according to The 2001 Bethesda System, by cytopathologists. Out of 995 patients studied, 940 showed inflammation and other benign lesions. 55 patients showed premalignant and malignant lesions. Premalignant lesions were present in 30-50 year of age group.

  20. Integrating cervical cancer screening with HIV care in a district hospital in Abuja, Nigeria

    Directory of Open Access Journals (Sweden)

    Solomon Odafe

    2013-01-01

    Full Text Available Background: Human immunodeficiency virus positive (HIV+ women have a higher risk of developing invasive cervical cancer compared with uninfected women. This study aims to document programmatic experience of integrating cervical cancer screening using Visual Inspection and Acetic Acid (VIA into HIV care as well as to describe patients′ characteristics associated with positive VIA findings amongst HIV+ women. Materials and Methods: A cross-sectional study analysed routine service data collected at the antiretroviral therapy (ART and cervical cancer screening services. Our program integrated screening for cervical cancer using VIA technique to HIV care and treatment services through a combination of stakeholder engagement, capacity building for health workers, creating a bi-directional referral between HIV and reproductive health (RH services and provider initiated counselling and screening for cervical cancer. Information on patients′ baseline and clinical characteristics were captured using an electronic medical records system and then exported to Statistical Package for the Social Sciences (SPSS. Logistic regression model was used to estimate factors that influence VIA results. Results: A total of 834 HIV+ women were offered VIA screening between April 2010 and April 2011, and 805 (96.5% accepted it. Complete data was available for 802 (96.2% women. The mean age at screening and first sexual contact were 32.0 (SD 6.6 and 18.8 (SD 3.5 years, respectively. VIA was positive in 52 (6.5% women while 199 (24.8% had a sexually transmitted infection (STI. Of the 199 who had a STI, eight (4.0% had genital ulcer syndrome, 30 (15.1% had lower abdominal pain syndrome and 161 (80.9% had vaginal discharge syndrome. Presence of lower abdominal pain syndrome was found to be a significant predictor of a positive VIA result ( P = 0.001. Women with lower abdominal pain syndrome appeared to be more likely (OR 47.9, 95% CI: 4.8-480.4, P = 0.001 to have a

  1. Implementation of cervical cancer screening: A demonstration in a rural community of North India

    Directory of Open Access Journals (Sweden)

    Satyanarayana Labani

    2014-01-01

    Full Text Available Context: S trategies for implementation of cervical screening are the need of the hour while effective screening tests for early detection exist. Aim: To demonstrate the implementation of cervical cancer screening by aided visual tests in a North Indian rural community. Setting and Design: Cross-sectional study in a rural setting. Subjects and Methods: Baseline survey of community perspectives of screening and identification of eligible women of age 30-59 years was performed by Accredited Social Health Activists (ASHAs. Screening was targeted on 7604 women by the methods of visual inspection of cervix using acetic acid (VIA, by using lugol′s iodine (VILI tests and by Pap test. Screen positives were referred to colposcopy and further management. Data on evaluation parameters was collected. Statistical Analysis: Screening test performances were assessed by sensitivity, specificity and positive/negative predictive values (PPV/NPV for detection of histological CIN II+. Results: Study showed coverage of 65.6% of total eligible women (7604. Extent of agreement of visual testes (VIA/VILI between nurses and doctor was 77.3-100%. Screen positivity rates by VIA, VILI and Pap were 9.7%, 13.5% and 2.6%, respectively. Screen positives turned up for confirmatory diagnosis were 78%. Acceptance of treatment was 76%. Screen positivity of VIA and VILI declined (P < 0.001 with increase in age. Sensitivity, specificity, and PPV of VIA were 59.0%, 92.3% and 3.6% and of VILI were72.7%, 89.6% and 3.3% respectively. NPV was 99% in all the tests. Conclusion: Implementation of screening by aided visual tests was successfully demonstrated through utilization of ASHAs for motivation, achievement of good coverage and good response in clinical management of screen positives.

  2. Knowledge and attitudes about Human Papilloma Virus (HPV) vaccination and cervical cancer screening among women in rural Uganda (POSTPRINT)

    Science.gov (United States)

    2016-01-01

    about Human Papilloma Virus (HPV) vaccination and cervical cancer screening among women in rural Uganda NKONWA INNOCENT H 1,2,3* , MICHAEL J...Human Papilloma virus (HPV) strains 16 and 18. While cervical cancer is widely understood as a fatal disease, knowledge and awareness of cervical...capture assay of self – collected virginal swabs in rural Uganda for detection of human papilloma virus . J Infect Disease, 1999 1999.180; p. 1316.1319. 19

  3. Screening Response to Hepatitis C Virus Antibodies among Diabetic Patients Attending UITH Nigeria

    Directory of Open Access Journals (Sweden)

    J.A. Ndako

    2011-11-01

    Full Text Available Epidemiological studies have suggested that hepatitis C virus (HCV infection is a risk factor for the development of diabetes mellitus (DM type 2; hence this study was carried out to investigate the prevalence of hepatitis C Virus (HCV among diabetic patients attending University of Ilorin Teaching Hospital (UITH. A total number of one hundred and eighty diabetic patients made up of seventy five males (41.7% and one hundred and five females (58.3% were recruited for the study. Structured questionnaire on demographic data and risk factors for HCV was administered to the participants. The sera of all the subjects were assayed for antibodies to HCV using a fourth generation enzyme linked immunosorbent Assay [Forte Diagnostic Limited], All the sera were tested for antibodies to Hepatitis C virus by ELISA method. The overall prevalence of HCV infection among diabetic patients was 5.0%. Of the nine participants’ positive for anti-HCV antibodies, three were males (1.7% while six were females (3.3%. Although more female attended the diabetic clinic, there was no significant difference between HCV infection and sex (p = 0.603; p>0.05. The prevalence of HCV infection was highest in the 40-60 age categories. Two of the seropositive individuals had elevated transaminases, with one of the two being an alcoholic consumer. Type 2 diabetes is a debilitating disease condition especially in individuals above 30 years of age, with these scenario it has become very vital for screening exercise to be carried out so as to determine the prevalence rate of HCV among diabetic patient.

  4. High grade squamous intraepithelial lesion in inmates from Ohio: cervical screening and biopsy follow-up

    Directory of Open Access Journals (Sweden)

    Rofagha Soraya

    2006-01-01

    Full Text Available Abstract Background Cervical carcinoma remains the second leading cause of cancer death in women worldwide and sexual behavior is regarded as the main contributing factor. We studied cervical cytology screening with surgical biopsy follow-up in women prisoners and compared the findings to those in the general population. Methods We reviewed 1024 conventional cervical smears, 73 cervical biopsies and 2 loop electrosurgical excision procedure (LEEP specimens referred to us from the Correctional Center in Columbus, Ohio during a 12-month period. The results were compared to 40,993 Pap smears from the general population for the same 12-month period. Results High grade squamous intraepithelial lesion (HGSIL was diagnosed in 1.3% of the cervical smears from the inmate population versus 0.6% in the general population (p < 0.01. The unsatisfactory rate was 1.6% compared to 0.3% in the general population (p < 0.01. Among the study population, follow-up tissue diagnosis was obtained in 24.3% of the abnormal cytology results (ASCUS, LGSIL, and HGSIL. Of the HGSIL Pap smears, 61.5% had a subsequent tissue diagnosis. Thirty-nine biopsies (52% of the all inmate biopsies and LEEP showed CIN II/III (cervical intraepithelial neoplasia II/III. Eight of these thirty-nine follow-up biopsies diagnosed as CIN II/III had a previous cervical cytology diagnosis of ASCUS. The average age for HGSIL was 30.5 years (S.D. = 5.7 and for low grade squamous intraepithelial lesion (LGSIL was 27.2 years (S.D. = 6.1. Conclusion A significantly higher prevalence of HGSIL cervical cytology and unsatisfactory smears was encountered in female inmates, with tissue follow-up performed in less than two thirds of the patients with HGSIL. These results are in keeping with data available in the literature suggesting that the inmate population is high-risk and may be subject to less screening and tissue follow-up than the general population. Clinicians should proceed with urgency to improve

  5. Use of HPV testing for cervical screening in vaccinated women--Insights from the SHEVa (Scottish HPV Prevalence in Vaccinated Women) study.

    Science.gov (United States)

    Bhatia, Ramya; Kavanagh, Kimberley; Cubie, Heather Ann; Serrano, Itziar; Wennington, Holli; Hopkins, Mark; Pan, Jiafeng; Pollock, Kevin G; Palmer, Tim J; Cuschieri, Kate

    2016-06-15

    The management of cervical disease is changing worldwide as a result of HPV vaccination and the increasing use of HPV testing for cervical screening. However, the impact of vaccination on the performance of HPV based screening strategies is unknown. The SHEVa (Scottish HPV Prevalence in Vaccinated women) projects are designed to gain insight into the impact of vaccination on the performance of clinically validated HPV assays. Samples collated from women attending for first cervical smear who had been vaccinated as part of a national "catch-up" programme were tested with three clinically validated HPV assays (2 DNA and 1 RNA). Overall HR-HPV and type specific positivity was assessed in total population and according to underlying cytology and compared to a demographically equivalent group of unvaccinated women. HPV prevalence was significantly lower in vaccinated women and was influenced by assay-type, reducing by 23-25% for the DNA based assays and 32% for the RNA assay (p = 0.0008). All assays showed over 75% reduction of HPV16 and/or 18 (p HPV was not significantly different in vaccinated vs unvaccinated women. In women with low grade abnormalities, the proportion associated with non 16/18 HR-HPV was significantly higher in vaccinated women (p HPV assays are affected differentially when applied to vaccinated women, dependent on assay chemistry. The increased proportion of non HPV16/18 infections may have implications for clinical performance, consequently, longitudinal studies linking HPV status to disease outcomes in vaccinated women are warranted.

  6. Modeling human papillomavirus and cervical cancer in the United States for analyses of screening and vaccination

    Directory of Open Access Journals (Sweden)

    Ortendahl Jesse

    2007-10-01

    Full Text Available Abstract Background To provide quantitative insight into current U.S. policy choices for cervical cancer prevention, we developed a model of human papillomavirus (HPV and cervical cancer, explicitly incorporating uncertainty about the natural history of disease. Methods We developed a stochastic microsimulation of cervical cancer that distinguishes different HPV types by their incidence, clearance, persistence, and progression. Input parameter sets were sampled randomly from uniform distributions, and simulations undertaken with each set. Through systematic reviews and formal data synthesis, we established multiple epidemiologic targets for model calibration, including age-specific prevalence of HPV by type, age-specific prevalence of cervical intraepithelial neoplasia (CIN, HPV type distribution within CIN and cancer, and age-specific cancer incidence. For each set of sampled input parameters, likelihood-based goodness-of-fit (GOF scores were computed based on comparisons between model-predicted outcomes and calibration targets. Using 50 randomly resampled, good-fitting parameter sets, we assessed the external consistency and face validity of the model, comparing predicted screening outcomes to independent data. To illustrate the advantage of this approach in reflecting parameter uncertainty, we used the 50 sets to project the distribution of health outcomes in U.S. women under different cervical cancer prevention strategies. Results Approximately 200 good-fitting parameter sets were identified from 1,000,000 simulated sets. Modeled screening outcomes were externally consistent with results from multiple independent data sources. Based on 50 good-fitting parameter sets, the expected reductions in lifetime risk of cancer with annual or biennial screening were 76% (range across 50 sets: 69–82% and 69% (60–77%, respectively. The reduction from vaccination alone was 75%, although it ranged from 60% to 88%, reflecting considerable parameter

  7. Salud es Vida: a Cervical Cancer Screening Intervention for Rural Latina Immigrant Women.

    Science.gov (United States)

    Luque, John S; Tarasenko, Yelena N; Reyes-Garcia, Claudia; Alfonso, Moya L; Suazo, Norma; Rebing, Laura; Ferris, Daron G

    2016-01-12

    This study examined the feasibility and efficacy of Salud es Vida-a promotora-led, Spanish language educational group session on cervical cancer screening (Pap tests)-self-efficacy (belief in ability to schedule and complete a Pap test), and knowledge among immigrant Hispanic/Latina women from farmworker backgrounds. These women are disproportionately burdened with cervical cancer, with mortality rates significantly higher than non-Hispanic whites. The two-arm, quasi-experimental study was conducted in four rural counties of Southeast Georgia in 2014-2015. Hispanic/Latina immigrant women aged 21-65 years and overdue for a Pap test were included as intervention (N = 38) and control (N = 52) group participants. The intervention was developed in partnership with a group of promotoras to create the toolkit of materials which includes a curriculum guide, a brochure, a flipchart, a short animated video, and in-class activities. Twelve (32 %) intervention group participants received the Pap test compared to 10 (19 %) control group participants (p = 0.178). The intervention group scored significantly higher on both cervical cancer knowledge recall and retention than the control group (p < 0.001). While there was no statistically significant difference in cervical cancer screening self-efficacy scores between the group participants, both groups scored higher at follow-up, adjusting for the baseline scores. The group intervention approach was associated with increased cervical cancer knowledge but not uptake of Pap test. More intensive interventions using patient navigation approaches or promotoras who actively follow participants or conducting one-on-one rather than group sessions may be needed to achieve improved screening outcomes with this population.

  8. A Suggested Approach to Simplify and Improve Cervical Screening in the United States.

    Science.gov (United States)

    Schiffman, Mark; Wentzensen, Nicolas

    2016-01-01

    Cervical cancer prevention strategies in the United States have become complicated and even controversial, despite advanced understanding of carcinogenic human papillomavirus (HPV) infection as the necessary causal agent. Twenty years ago, etiologic and methodologic studies had already yielded 2 powerful preventive approaches. There are excellent vaccines to prevent the most carcinogenic types of HPV infection; reduced HPV endemicity will ultimately prevent a large fraction of cervical precancer and cancers. For prevention of cervical cancer in the interim, sensitive HPV tests that target women at risk of cancer, by detection of the DNA/RNA of approximately a dozen carcinogenic HPV types, permit early diagnosis and treatment of precancers.Although HPV vaccines and tests have continued to improve, implementation of these new HPV-based prevention methods has been relatively slow in the United States and in most places worldwide. Increasing vaccination rates is the clearest and most vital long-term priority. But, for decades to come, screening will also be important. To promote useful discussion, this commentary will raise some current critical issues in simplifying and speeding the rational introduction of HPV molecular methods into US cervical screening.

  9. Quantitative Detection of Screening for Cervical Lesions with ThinPrep Cytology Test

    Institute of Scientific and Technical Information of China (English)

    Hong-xin ZHANG; Yi-min SONG; Su-hong LI; Yu-hui YIN; Dong-ling GAO; Kui-sheng CHEN

    2010-01-01

    OBJECTIVE To investigate the available parameters in gynecological screening for cervical lesions by liquid-based cytology technology (ThinPrep Cytology Test, TCT) and The Bethesda System (TBS), also with computer image analysis. METHODS With application of the image analysis system, all grades of cervical lesion cells were detected quantitatively and sorted in atypical squamous cells of undetermined significance (ASCUS), atypical squamous cells-cannot exclude HSIL (ASC-H), low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL) and cervical squamous cell carcinoma (SCC) with the mean optical density (MOD), average grey (AG), positive units (PU), and nucleus to cytoplasmic ratio (N:C). Differences between each group of cells were compared and analyzed statistically.RESULTS Apart from four stereologic parameters in LSIL and HSIL groups there were no differences among them, in the other groups, there was statistically significant in differences between MOD, AG and PU values. Differences between them in the ratio of nucleus to cytoplasm were highly statistically signifi cant. CONCLUSION Stereological indexes may serve as a screening tool for cervical lesions. The image analysis system is expected to become a new means of cytological assisted diagnosis.

  10. Cervical cancer risk factors and feasibility of visual inspection with acetic acid screening in Sudan

    Directory of Open Access Journals (Sweden)

    Ibrahim A

    2011-04-01

    Full Text Available Ahmed Ibrahim1, Vibeke Rasch2, Eero Pukkala3, Arja R Aro11Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark; 2Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark; 3Institute for Statistical and Epidemiological Cancer Research, Finnish Cancer Registry, Helsinki, FinlandObjectives: To assess the risk factors of cervical cancer and the feasibility and acceptability of a visual inspection with acetic acid (VIA screening method in a primary health center in Khartoum, Sudan.Methods: A cross-sectional prospective pilot study of 100 asymptomatic women living in Khartoum State in Sudan was carried out from December 2008 to January 2009. The study was performed at the screening center in Khartoum. Six nurses and two physicians were trained by a gynecologic oncologist. The patients underwent a complete gynecological examination and filled in a questionnaire on risk factors and feasibility and acceptability. They were screened for cervical cancer by application of 3%–5% VIA. Women with a positive test were referred for colposcopy and treatment.Results: Sixteen percent of screened women were tested positive. Statistically significant associations were observed between being positive with VIA test and the following variables: uterine cervix laceration (odds ratio [OR] 18.6; 95% confidence interval [CI]: 4.64–74.8, assisted vaginal delivery (OR 13.2; 95% CI: 2.95–54.9, parity (OR 5.78; 95% CI: 1.41–23.7, female genital mutilation (OR 4.78; 95% CI: 1.13–20.1, and episiotomy (OR 5.25; 95% CI: 1.15–23.8. All these associations remained statistically significant after adjusting for age, educational level, employment, and potential confounding factors such as smoking, number of sexual partners, and use of contraceptive method. Furthermore, the VIA screening method was found to be feasible and acceptable to participants.Conclusion: This pilot study showed that women who have uterine

  11. Awareness and Practice of Cervical Smear as A Screening Procedure for Cervical Cancer among Female Nurses in A Tertiary Hospital in South-South Nigeria

    Directory of Open Access Journals (Sweden)

    Imoh Unang

    2011-12-01

    Full Text Available AIM: Carcinoma of the cervix, the second most common cancer among women remains a public health problem. Though this preventable cancer occurs more commonly in the developing world, it is almost non-existent in developed countries where there are well established screening programs. The aim of this study is to determine the degree of awareness and practice of cervical smear as a screening procedure for cervical cancer among female nurses in a tertiary health facility in south-south Nigeria. METHOD: Semi-structured questionnaires were distributed to all the female nurses at the University of Uyo Teaching Hospital. RESULTS: The ages of the respondents were between 21 - 60 years with the modal age group being 31- 40 years (48.9%. Majority of the respondents were married (59.7% and 36.4% of them had practiced nursing for over 10 years. Majority of the respondents (94.3% had heard of the cervical smear and 79.5% of the nurses knew that cervical smears were used to detect premalignant diseases of the cervix. Only 7.4% of the nurses had undergone screening for cervical cancer. Common reasons given by the respondents who had not screened were not being a candidate for cervical cancer (31.9% and ignorance as to where screening is done (28.8%. The most common sources of information about cervical smear were the hospital (87.5% and textbooks (13.6%. CONCLUSION: The level of awareness of the cervical smear as a preventive tool for cervical cancer was high but utilization of the test was disappointingly low. Modern concepts of cancer prevention and control should be included in the curriculum of the school of nursing and nurses should be involved in the organisation of health talks to members of the community on cervical cancer and its prevention. The print and electronic media should be made to participate in the dissemination of information on the prevention of cervical cancer in our environment. [TAF Prev Med Bull 2011; 10(6.000: 675-680

  12. [Customer satisfaction analysis in women attending an organized mammographic screening. Pilot study at Trento].

    Science.gov (United States)

    Della Sala, W; Tognotti, F; Pellegrini, M; Bernardi, D; Gentilini, M; Piffer, S

    2005-01-01

    Present paper reports on the results of a pilot customer satisfaction study carried out on 1.720 consecutive women (18.7 with spontaneous access) attended senology department (Trento and Borgo) in the context of a organized mammography screening programme, started in October 2000. Data were collected by a questionnarie filled by the women after mammography. 4.3% of the invited women reported the receiving the letter late, 0.9% considered it inaccurate, 7.2% had some problems for getting a new date for test, 1.8% of the whole sample reported some problems for external access and 2.2% for internal access to health facilities; 1.9% perceived waiting room as not friendly. The welcoming by the personnel is judged quite well, only 0.6% complained about it. Trento centre, is more efficient than Borgo. In 21.7% of the cases the mammography has been performed within next 30 minutes of the fixed time and in 7.9% besides that. 36.8% of the whole sample perceived mammography as tiresome and 4.1% as painful. The percentage of women reporting mammography disconforting increase, in Trento sample, according the education level as previously reported. The data about perceived quality are satisfactory, on the whole. Anyway it would be opportune to contain the waiting time.

  13. Cancer screening in the United States, 2013: a review of current American Cancer Society guidelines, current issues in cancer screening, and new guidance on cervical cancer screening and lung cancer screening.

    Science.gov (United States)

    Smith, Robert A; Brooks, Durado; Cokkinides, Vilma; Saslow, Debbie; Brawley, Otis W

    2013-01-01

    Each year the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, a report on data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, current ACS cancer screening guidelines are summarized, as are updated guidelines on cervical cancer screening and lung cancer screening with low-dose helical computed tomography. The latest data on the use of cancer screening from the National Health Interview Survey also are described, as are several issues related to screening coverage under the Patient Protection and Affordable Care Act of 2010.

  14. Primary HPV screening for cervical cancer prevention: results from European trials

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Rebolj, Matejka

    2009-01-01

    for each extra detected CIN2+ case; although, in another trial, this number was 49 in women > or =35 years of age. The outcome of HPV testing versus cytological testing depends not only on the relative accuracy of the primary test but also on how radical the different triage procedures are. In two trials......Six European, randomized, controlled trials that will compare human papillomavirus (HPV) testing with cytological testing for cervical screening are under way. We reviewed the results published so far to compare the benefits and costs for participating women. At baseline screening, use of HPV...... testing increased the detection of cervical intraepithelial neoplasia (CIN) grade 2+. Detection of CIN3+ was significantly increased in two trials (relative risks [RRs] 1.70 and 2.26), but not in three other trials (RRs 1.03, 1.09 and 1.31). In three trials, seven extra women had a false-positive test...

  15. How well do the theory of reasoned action and theory of planned behaviour predict intentions and attendance at screening programmes? A meta-analysis.

    Science.gov (United States)

    Cooke, Richard; French, David P

    2008-01-01

    Meta-analysis was used to quantify how well the Theories of Reasoned Action and Planned Behaviour have predicted intentions to attend screening programmes and actual attendance behaviour. Systematic literature searches identified 33 studies that were included in the review. Across the studies as a whole, attitudes had a large-sized relationship with intention, while subjective norms and perceived behavioural control (PBC) possessed medium-sized relationships with intention. Intention had a medium-sized relationship with attendance, whereas the PBC-attendance relationship was small sized. Due to heterogeneity in results between studies, moderator analyses were conducted. The moderator variables were (a) type of screening test, (b) location of recruitment, (c) screening cost and (d) invitation to screen. All moderators affected theory of planned behaviour relationships. Suggestions for future research emerging from these results include targeting attitudes to promote intention to screen, a greater use of implementation intentions in screening information and examining the credibility of different screening providers.

  16. Risk of cervical cancer in women with autoimmune diseases, in relation with their use of immunosuppressants and screening

    DEFF Research Database (Denmark)

    Dugué, Pierre-Antoine; Rebolj, Matejka; Hallas, Jesper;

    2015-01-01

    Severely immunosuppressed individuals have a strongly increased risk of cervical cancer. In patients with autoimmune diseases (AID), who have defects in their immune system and receive immunosuppressants, the risk of cervical cancer is less clear. We conducted a cohort study, using Danish....... Hazard ratios (HR) from time-dependent Cox models stratified by AID were used to explore the effect of the most frequently used immunosuppressants, taking into account potential dose-response relationships and lag times between drug exposure and cervical cancer development. Cervical screening coverage...

  17. Visual inspection with acetic acid for cervical cancer screening in a tertiary health care centre

    Directory of Open Access Journals (Sweden)

    Shaily Agarwal

    2016-03-01

    Conclusions: VIA is useful for detection of precursor lesions of cervical cancer not only in low-resource settings but also in well-equipped health centers and cancer centers. In these non low-resource settings, VIA has a positive predictive value comparable to the conventional Pap smear, but it is more likely to achieve earlier diagnosis, follow-up, and treatment than cytology based screening. [Int J Reprod Contracept Obstet Gynecol 2016; 5(3.000: 752-756

  18. Screening cervical and oesophageal tissues using optical coherence tomography

    Science.gov (United States)

    Erry, Gavin R. G.; Bazant-Hegemark, Florian; Read, Mike D.; Stone, Nicholas

    2011-06-01

    Optical Coherence Tomography (OCT) is a technique that allows imaging tissue in three spatial dimensions. Such a technique makes it possible to examine the subsurface of the tissue. The depth of penetration into the tissue can be tailored by tuning the wavelength of the light source. While in some cases it is desirable to obtain deep penetration of the sample, when scanning for cancerous changes, it may only be necessary to penetrate the first few hundred micrometres. The use of a shorter wavelength, while decreasing the penetration depth, will improve the resolution of the instrument. While images from OCT systems contain speckle and other artefacts, there are methods of evaluating the information by using image processing techniques. Of particular interest is the scattering coefficient that can be derived from the OCT data. Using discriminant techniques on the scattering data (such as principal components analysis), gives a sensitive way of differentiating between changes in structure in the tissue. An extensive data collection was performed on cervical tissue using samples that ranged from normal to invasive cancer. The histopathology of each sample was gathered and was classified from normal to cancer. The scattering profiles of the data were averaged and gradient analysis was performed, showing that for small distances into the sample there is a significant difference between scattering profiles between cancerous and normal tissue. PCA was also performed on the data showing grouping into various stages of cancer.

  19. [Changes in genotype prevalence of human papillomavirus over 10-year follow-up of a cervical cancer screening cohort].

    Science.gov (United States)

    Dong, L; Hu, S Y; Zhang, Q; Feng, R M; Zhang, L; Zhao, X L; Ma, J F; Shi, S D; Zhang, X; Pan, Q J; Zhang, W H; Qiao, Y L; Zhao, F H

    2017-01-10

    Objective: To evaluate the dynamic variation of genotypes distribution of human papillomavirus (HPV) over 10-year follow-up in a cervical cancer screening cohort. Methods: Based on the Shanxi Province Cervical Cancer Screening Study Ⅰ cohort, we detected HPV genotypes on the well-preserved exfoliated cervical cells from women who were tested HPV positive from year 2005 to year 2014 using reverse linear probe hybridization assay. The changes of prevalence of type-specific HPV over time among the overall population were estimated using linear mixed models. The association between the type-specific HPV and cervical intraepithelial neoplasia grade 2 or worse (CIN2 +) was calculated by linear Chi-square test. Finally, the trends of multiple infections of HPV with the increase of the age were analyzed. Results: During the cervical cancer screening of the overall population from 2005 to 2014, the most common genotypes among the population were HPV16 and 52. The prevalence of HPV16 decreased over time from 4.6% in 2005 to 2.2% in 2010 and 2014 (F=8.125, Pcervical cancer screening in the context of regular screening combining with immediate treatment for those CIN2 + women. HPV16 prevalence significantly decreased over time, which indicated that the variation of type-specific HPV prevalence should be considered when regular cervical cancer screening was organized using HPV technique.

  20. Effective interventions to facilitate the uptake of breast, cervical and colorectal cancer screening: an implementation guideline

    Directory of Open Access Journals (Sweden)

    Brouwers Melissa C

    2011-09-01

    Full Text Available Abstract Background Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. Several high-quality systematic reviews and practice guidelines exist to inform the most effective screening options. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. We developed an implementation guideline to answer the question: What interventions have been shown to increase the uptake of cancer screening by individuals, specifically for breast, cervical, and colorectal cancers? Methods A guideline panel was established as part of Cancer Care Ontario's Program in Evidence-based Care, and a systematic review of the published literature was conducted. It yielded three foundational systematic reviews and an existing guidance document. We conducted updates of these reviews and searched the literature published between 2004 and 2010. A draft guideline was written that went through two rounds of review. Revisions were made resulting in a final set of guideline recommendations. Results Sixty-six new studies reflecting 74 comparisons met eligibility criteria. They were generally of poor to moderate quality. Using these and the foundational documents, the panel developed a draft guideline. The draft report was well received in the two rounds of review with mean quality scores above four (on a five-point scale for each of the items. For most of the interventions considered, there was insufficient evidence to support or refute their effectiveness. However, client reminders, reduction of structural barriers, and provision of provider assessment and feedback were recommended interventions to increase screening for at least two of three cancer sites studied. The final guidelines also provide advice on how the recommendations can be used and future areas for research. Conclusion Using established guideline development methodologies and the AGREE II as our methodological

  1. Effective interventions to facilitate the uptake of breast, cervical and colorectal cancer screening: an implementation guideline

    Science.gov (United States)

    2011-01-01

    Background Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. Several high-quality systematic reviews and practice guidelines exist to inform the most effective screening options. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. We developed an implementation guideline to answer the question: What interventions have been shown to increase the uptake of cancer screening by individuals, specifically for breast, cervical, and colorectal cancers? Methods A guideline panel was established as part of Cancer Care Ontario's Program in Evidence-based Care, and a systematic review of the published literature was conducted. It yielded three foundational systematic reviews and an existing guidance document. We conducted updates of these reviews and searched the literature published between 2004 and 2010. A draft guideline was written that went through two rounds of review. Revisions were made resulting in a final set of guideline recommendations. Results Sixty-six new studies reflecting 74 comparisons met eligibility criteria. They were generally of poor to moderate quality. Using these and the foundational documents, the panel developed a draft guideline. The draft report was well received in the two rounds of review with mean quality scores above four (on a five-point scale) for each of the items. For most of the interventions considered, there was insufficient evidence to support or refute their effectiveness. However, client reminders, reduction of structural barriers, and provision of provider assessment and feedback were recommended interventions to increase screening for at least two of three cancer sites studied. The final guidelines also provide advice on how the recommendations can be used and future areas for research. Conclusion Using established guideline development methodologies and the AGREE II as our methodological frameworks, we developed an

  2. A Markov Decision Process Model for Cervical Cancer Screening Policies in Colombia.

    Science.gov (United States)

    Akhavan-Tabatabaei, Raha; Sánchez, Diana Marcela; Yeung, Thomas G

    2017-02-01

    Cervical cancer is the second most common cancer in women around the world, and the human papillomavirus (HPV) is universally known as the necessary agent for developing this disease. Through early detection of abnormal cells and HPV virus types, cervical cancer incidents can be reduced and disease progression prevented. We propose a finite-horizon Markov decision process model to determine the optimal screening policies for cervical cancer prevention. The optimal decision is given in terms of when and what type of screening test to be performed on a patient based on her current diagnosis, age, HPV contraction risk, and screening test results. The cost function considers the tradeoff between the cost of prevention and treatment procedures and the risk of taking no action while taking into account a cost assigned to loss of life quality in each state. We apply the model to data collected from a representative sample of 1141 affiliates at a health care provider located in Bogotá, Colombia. To track the disease incidence more effectively and avoid higher cancer rates and future costs, the optimal policies recommend more frequent colposcopies and Pap tests for women with riskier profiles.

  3. Cervical Cancer Screening in Partly HPV Vaccinated Cohorts - A Cost-Effectiveness Analysis.

    Directory of Open Access Journals (Sweden)

    Steffie K Naber

    Full Text Available Vaccination against the oncogenic human papillomavirus (HPV types 16 and 18 will reduce the prevalence of these types, thereby also reducing cervical cancer risk in unvaccinated women. This (measurable herd effect will be limited at first, but is expected to increase over time. At a certain herd immunity level, tailoring screening to vaccination status may no longer be worth the additional effort. Moreover, uniform screening may be the only viable option. We therefore investigated at what level of herd immunity it is cost-effective to also reduce screening intensity in unvaccinated women.We used the MISCAN-Cervix model to determine the optimal screening strategy for a pre-vaccination population and for vaccinated women (~80% decreased risk, assuming a willingness-to-pay of €50,000 per quality-adjusted life year gained. We considered HPV testing, cytology testing and co-testing and varied the start age of screening, the screening interval and the number of lifetime screens. We then calculated the incremental cost-effectiveness ratio (ICER of screening unvaccinated women with the strategy optimized to the pre-vaccination population as compared to with the strategy optimized to vaccinated women, assuming different herd immunity levels.Primary HPV screening with cytology triage was the optimal strategy, with 8 lifetime screens for the pre-vaccination population and 3 for vaccinated women. The ICER of screening unvaccinated women 8 times instead of 3 was €28,085 in the absence of herd immunity. At around 50% herd immunity, the ICER reached €50,000.From a herd immunity level of 50% onwards, screening intensity based on the pre-vaccination risk level becomes cost-ineffective for unvaccinated women. Reducing the screening intensity of uniform screening may then be considered.

  4. What's next? Perspectives and future needs of cervical screening in Europe in the era of molecular testing and vaccination

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Antilla, Ahti; Arbyn, Marc;

    2009-01-01

    AIM: To outline the perspectives for future control of cervical cancer in Europe. METHODS: Review of current status for major cervical cancer control tools. The review was based on PubMed searches for cervical cancer prevention, Human Papillomavirus, HPV-test, HPV-vaccination, and treatment...... with large loop excision of the transformation zone, LLETZ. RESULTS: Recent studies suggest that condom use offers some but not complete protection against HPV-infection. High quality cytology screening with good population coverage reduces the incidence and mortality of cervical cancer. Randomised...... controlled trials have found HPV-testing to increase the detection rate of cervical intraepithelial neoplasia grade 2+, CIN2+, compared with cytology. Two studies found a decreased detection rate of CIN3+ in the HPV-testing arm at the subsequent screening. Randomised controlled trials found that women...

  5. [The impact of natural history and genital tract distribution of human papillomavirus on technology for cervical cancer screening].

    Science.gov (United States)

    Wu, Z N; Chen, W

    2016-04-01

    Human papillomavirus (HPV) infection is the necessary cause of cervical cancer. There is a close relationship between the amount of DNA, mRNA and protein expression in the natural history of virus and the cervical lesion. This article is aimed to elaborate the natural history and genital tract distribution of high risk HPV, and also evaluate the HPV based cervical cancer screening technology from the perspective of the natural history of HPV, which is meaningful for screening and clinical practice in devising and utilizing different detection technology.

  6. Follow-up of abnormal or inadequate test results in the Danish Cervical Cancer Screening Program

    DEFF Research Database (Denmark)

    Kristiansen, Bettina Kjær

    2014-01-01

    -up recommendation. However problems with delayed follow-up may threaten the effectiveness of the Danish Cervical Cancer Screening Program, as 20% of women are delayed and dysplasia potentially can progress into cancer. Delayed follow-up is found in situations where women either consciously or unconsciously postpone...... follow-up, or because of organizational aspects of the screening program, where communication regarding test results can fail either in content or with delay.This study will evaluate two interventions designed to increase follow-up: 1) A letter with the test result and potential recommendation for follow...

  7. An special epithelial staining agents: folic acid receptor-mediated diagnosis (FRD) effectively and conveniently screen patients with cervical cancer.

    Science.gov (United States)

    Lu, Meng-Han; Hu, Ling-Yun; Du, Xin-Xin; Yang, Min; Zhang, Wei-Yi; Huang, Ke; Li, Li-An; Jiang, Shu-Fang; Li, Ya-Li

    2015-01-01

    High-quality screening with cytology has markedly reduced mortality from cervical cancer. However, it needs experienced pathologists to review and make the final decisions. We have developed folic acid receptor-mediated diagnosis (FRD) kits to effectively and conveniently screen patients with cervical cancer. We conduct present study aim to assess clinical significances of FRD in screening cervical cancer. A total of 169 patients were enrolled at Chinese People's liberation Army (PLA) general hospital. We compared diagnostic significances of FRD with thinprep cytology test (TCT). Meanwhile, colposcopy was also performed to confirm any lesion suspicious for cervical cancer. The sensitivity and specificity of FRD were 71.93% and 66.07% in diagnosis cervical cancer, respectively. Meanwhile, the positive predictive values (PPV), negative predictive values (NPV), Youden index were 51.90%, 82.22%, 0.38, respectively. On the other hand, the sensitivity and specificity of TCT in diagnosis cervical cancer were 73.68% and 61.61% respectively. PPV, NPV and Youden index for TCT were 49.41%, 82.14% and 0.35 respectively. Overall, FRD have high values of sensitivity, specificity and Youden index. However, this difference failed to statistical significance. FRD have comparable diagnostic significance with TCT. Therefore, FRD might serve as one effective method to screen cervical cancer. Especially for those patients living in remote regions of China, where cytology was unavailable.

  8. Current Technologies and Recent Developments for Screening of HPV-Associated Cervical and Oropharyngeal Cancers

    Science.gov (United States)

    Shah, Sunny S.; Senapati, Satyajyoti; Klacsmann, Flora; Miller, Daniel L.; Johnson, Jeff J.; Chang, Hsueh-Chia; Stack, M. Sharon

    2016-01-01

    Mucosal infection by the human papillomavirus (HPV) is responsible for a growing number of malignancies, predominantly represented by cervical cancer and oropharyngeal squamous cell carcinoma. Because of the prevalence of the virus, persistence of infection, and long latency period, novel and low-cost methods are needed for effective population level screening and monitoring. We review established methods for screening of cervical and oral cancer as well as commercially-available techniques for detection of HPV DNA. We then describe the ongoing development of microfluidic nucleic acid-based biosensors to evaluate circulating host microRNAs that are produced in response to an oncogenic HPV infection. The goal is to develop an ideal screening platform that is low-cost, portable, and easy to use, with appropriate signal stability, sensitivity and specificity. Advances in technologies for sample lysis, pre-treatment and concentration, and multiplexed nucleic acid detection are provided. Continued development of these devices provides opportunities for cancer screening in low resource settings, for point-of-care diagnostics and self-screening, and for monitoring response to vaccination or surgical treatment. PMID:27618102

  9. Current Technologies and Recent Developments for Screening of HPV-Associated Cervical and Oropharyngeal Cancers

    Directory of Open Access Journals (Sweden)

    Sunny S. Shah

    2016-09-01

    Full Text Available Mucosal infection by the human papillomavirus (HPV is responsible for a growing number of malignancies, predominantly represented by cervical cancer and oropharyngeal squamous cell carcinoma. Because of the prevalence of the virus, persistence of infection, and long latency period, novel and low-cost methods are needed for effective population level screening and monitoring. We review established methods for screening of cervical and oral cancer as well as commercially-available techniques for detection of HPV DNA. We then describe the ongoing development of microfluidic nucleic acid-based biosensors to evaluate circulating host microRNAs that are produced in response to an oncogenic HPV infection. The goal is to develop an ideal screening platform that is low-cost, portable, and easy to use, with appropriate signal stability, sensitivity and specificity. Advances in technologies for sample lysis, pre-treatment and concentration, and multiplexed nucleic acid detection are provided. Continued development of these devices provides opportunities for cancer screening in low resource settings, for point-of-care diagnostics and self-screening, and for monitoring response to vaccination or surgical treatment.

  10. A closer look at cervical smear uptake and results pre- and post- introduction of the national screening programme.

    LENUS (Irish Health Repository)

    Gallagher, F

    2012-02-01

    Prior to the introduction of a national cervical screening programme, death rates from cervical cancer in the Republic of Ireland were greater than the death rates in all other regions in Britain and Northern Ireland. The following audit compares the impact of the national cervical screening programme, established on 1 September \\'08, on uptake and results per age group screened before and after its implementation. This retrospective audit was carried out in a four-doctor practice with approximately 1554 GMS and 5000 private patients. Data over a ten month period in \\'08\\/\\'09 was collected from the practice record of cervical smears and compared to the same period in \\'07\\/\\'08. A cohort of 534 Irish urban women was included. A total number of 148 women were screened between October 2007 and July 2008 compared with 386 women screened over the same months in 2008\\/2009. Increase in uptake was most marked in the 25-44 years age group, 100 (\\'07-\\'08) vs. 303 (\\'08-\\'09). The majority of results for both time periods were negative (85% 07\\/08, 81% 08\\/09). There was a higher number of HSIL in \\'08-\\'09 (an increase from 1% to 3.37% of the total screened). This audit clearly supports the introduction of the national cervical screening programme showing both an increase in uptake and a increased pick-up of high grade lesions.

  11. Quality appraisal of documents producing recommendations for breast, colorectal and cervical cancer screening

    Directory of Open Access Journals (Sweden)

    Paolo Giorgi Rossi

    2014-01-01

    Full Text Available Background: Breast, cervical, and colorectal cancer screening are evidence-based interventions recommended by most governmental agencies and scientific societies. The aim of this review is to assess the quality of guidelines on screening and to describe differences according to the context in which they were produced.Methods: A literature search of the main databases, websites on health care, and guidelines, as well as the websites of several scientific societies was carried out in order to identify the most recent guidelines (since 2000 on cervical, breast, and colorectal cancer screening. Only documents written in Italian or English were included. Two investigators independently assessed quality by using the AGREE (Appraisal of Guidelines, Research and Evaluation in Europe instrument.Results: Thirty-three, 32, and 18 relevant documents for cervical, breast, and colorectal cancer, respectively, were identified. Only some documents (19, 12 and 13 for cervical, breast, and colorectal cancer, respectively could be evaluated with AGREE. Items included in the domain “scope and purpose” obtained the highest scores, followed by “clarity of presentation” domain, while “applicability”, “patient involvement,” and “conflict of interest disclosure” domains obtained the lowest scores. The quality did not improve in more recent documents. Documents produced by governmental agencies, on average, had higher scores than documents by scientific societies, particularly for “stakeholder involvement” and “applicability”.Conclusions: Documents from different countries and health systems differ in terms of the main recommendations given and in the quality of the documents. Those produced by governmental agencies have a more multidisciplinary authorship and pay more attention to applicability than do those produced by scientific societies. societies.

  12. Examining the Cervical Screening Behaviour of Women Aged 50 or above and Its Predicting Factors: A Population-Based Survey

    Directory of Open Access Journals (Sweden)

    Carmen W. H. Chan

    2016-12-01

    Full Text Available Under-screening may increase the risk of cervical cancer in middle-aged women. This study aimed to investigate cervical cancer screening behaviour and its predictors among women aged 50 years or above. A population-based sample of 959 women was recruited by telephone from domestic households in Hong Kong, using random methods, and a structured questionnaire developed to survey participants. Multivariable logistic regressions were performed to examine the factors independently associated with cervical screening behaviour. Nearly half the sample (48% had never had a cervical smear test. Multivariable analyses showed that age, educational level, marital status, family history of cancer, smoking status, use of complementary therapy, recommendation from health professionals, and believing that regular visits to a doctor or a Chinese herbalist were good for their health were predictors of cervical screening behaviour. Misconceptions concerned with menopause may reduce women’s perceived susceptibility to cervical cancer, especially if they are 50 or above, and exert a negative effect on their screening behaviour. Healthcare professionals should actively approach these high-risk groups–older unmarried women, smokers, those less educated and who are generally not much concerned with their health.

  13. Uptake of Cervical Cancer Screening and Associated Factors among Women in Rural Uganda: A Cross Sectional Study.

    Directory of Open Access Journals (Sweden)

    Rawlance Ndejjo

    Full Text Available In developing countries, inadequate access to effective screening for cervical cancer often contributes to the high morbidity and mortality caused by the disease. The largest burden of this falls mostly on underserved populations in rural areas, where health care access is characterized by transport challenges, ill equipped health facilities, and lack of information access. This study assessed uptake of cervical cancer screening and associated factors among women in rural Uganda.This descriptive cross sectional study was carried out in Bugiri and Mayuge districts in eastern Uganda and utilised quantitative data collection methods. Data were collected using a semi-structured questionnaire on cervical cancer screening among females aged between 25 and 49 years who had spent six or more months in the area. Data were entered in Epidata 3.02 and analysed in STATA 12.0 statistical software. Univariate, bivariate and multivariate analyses were performed.Of the 900 women, only 43 (4.8% had ever been screened for cervical cancer. Among respondents who were screened, 21 (48.8% did so because they had been requested by a health worker, 17 (39.5% had certain signs and symptoms they associated with cervical cancer while 16 (37.2% did it voluntarily to know their status. Barriers to cervical cancer screening were negative individual perceptions 553 (64.5% and health facility related challenges 142 (16.6%. Other respondents said they were not aware of the screening service 416 (48.5%. The independent predictors of cervical cancer screening were: being recommended by a health worker [AOR = 87.85, p<0.001], knowing where screening services were offered [AOR = 6.24, p = 0.004], and knowing someone who had ever been screened [AOR = 9.48, p = 0.001].The prevalence of cervical cancer screening is very low in rural Uganda. Interventions to increase uptake of cervical cancer screening should be implemented so as to improve access to the service in rural areas.

  14. Incidence of cervical dysplasia and cervical cancer in women living with HIV in Denmark

    DEFF Research Database (Denmark)

    Thorsteinsson, Kristina; Ladelund, Steen; Jensen-Fangel, Søren;

    2014-01-01

    INTRODUCTION: Women living with HIV (WLWH) are reportedly at increased risk of invasive cervical cancer (ICC). WLWH in Denmark attend the National ICC screening program less often than women in the general population. We aimed to estimate the incidence of cervical dysplasia and ICC in WLWH...... and hazard ratios (HRs) for time from inclusion to first cervical intraepithelial neoplasia (CIN)/ICC and time from first normal cervical cytology to first CIN/ICC were estimated. Sensitivity analyses were performed to include prior screening outcome, screening intensity and treatment of CIN...... with normal baseline cytology, incidences of CIN1+ and CIN2+ were higher in WLWH. However, incidences were comparable between WLWH and controls adherent to the National ICC screening program. CONCLUSIONS: Overall, WLWH develop more cervical disease than controls. However, incidences of CIN are comparable...

  15. Cervical cancer screening and Chinese women: Insights from focus groups

    Directory of Open Access Journals (Sweden)

    Sabrina Chia Hsuan Chang

    2013-02-01

    Full Text Available Objective: Despite extensive efforts to raise awareness, Papanicolaou (Pap testing rates among Chinese women living in North America remain low compared with Euro-American women. Although the lower Pap testing rate and ensuing health repercussions among Chinese women are well characterized, mechanisms underlying such health disparities are not. The aim of this study was to use a qualitative approach to delineate such mechanisms. Qualitative approaches to understand constructs within the domain of sexual and reproductive health have been shown to be particularly appropriate, and offer a nuanced view of sexuality that is not afforded by traditional quantitative methods.Method: We carried out two focus groups aimed at exploring how Mandarin-speaking and English-speaking Chinese women experience Pap testing (N = 12. The women were invited to partake in the focus groups from having participated in a large-scale quantitative study. We used content analyses to analyze transcripts and extract themes. Results: The women heavily endorsed Chinese medicine philosophy, conceptualizing physical health holistically, and valuing preventative measures over screening and interceptive measures. Pap testing was described as qualitatively different from other screening procedures, such that women assigned a sexually charged meaning to Pap testing, often discussing it in relation to sexual activity and promiscuity. Women expressed their preference for the compulsory and depersonalized manner that Pap tests are performed in their home country of China, as this lessens the embarrassment associated with undergoing Pap testing. Conclusion: Three mechanisms may contribute to lower Pap testing among Chinese women: preference for Chinese medicine philosophy, perceived sexualization of Pap testing, and the institutionalization of medical care. Implications for improving the reproductive health of Chinese women are discussed.

  16. Cervical cancer screening: attitudes and behaviors of young Asian American women.

    Science.gov (United States)

    Yoo, Grace J; Le, Mai Nhung; Vong, Stephen; Lagman, Regina; Lam, Amy G

    2011-12-01

    Compared to other racial/ethnic groups, Korean, Filipino, and Vietnamese American women experience high incidence rates of cervical cancer but low rates of cervical cancer screenings. This study examines the behaviors and attitudes towards screening in young Korean, Filipino, and Vietnamese American women (n = 304) in the San Francisco Bay Area. Results indicated Vietnamese American (OR = 2.51) and Filipino American (OR = 2.31) women had greater odds of ever having a Pap test than Korean American women. Those older (OR = 1.55), born in the USA (OR = 2.64), and those comfortable with the test (OR = 3.41) also had greater odds of ever having a Pap test. Correct knowledge of cervical cancer and the human papillomavirus did not significantly affect the odds of having a Pap test. Interventions to increase Pap testing in these populations should focus on increasing levels of comfort and should target those younger and foreign born.

  17. HPV detection methods and genotyping techniques in screening for cervical cancer.

    Science.gov (United States)

    Eide, Maj Liv; Debaque, Hervé

    2012-12-01

    Human papillomaviruses (HPV), double-stranded DNA viruses, are causing many mucocutaneous diseases, benign or malignant, ranging from common warts to malignancies involving the upper aerodigestive tract and the anogenital sphere. The diagnosis of HPV infection is based primarily on the viral genome detection by molecular biological methods, given the difficulty in routine cultivation of these viruses. The current trend in screening against cervical cancer is to improve the sensitivity of screening with new methods and to propose new algorithms for diagnostic and therapeutic decisions. The development of liquid-based cytology facilitates the cytologic diagnosis and molecular assays from the same sample. There are two main types of HPV detection methods used on uterine cervical samples: signal amplification methods (hybridization techniques in liquid phase) and target amplification methods (the techniques of gene amplification or Polymerase Chain Reaction [PCR]). Genotyping techniques are also developed: they are based on an amplification technique followed by hybridization with probe specific types. In addition to the detection, genotyping techniques allow quantitative detection of viral DNA of HPV genotype and so monitor changes in viral load over time. Another approach relies on the detection of messenger RNA (mRNA) of HPV proteins E6 and E7 oncogenes, which would appear to be a relevant marker to identify and monitor women at risk of progression to a precancerous lesion or cervical cancer.

  18. Recommendations for cervical cancer screening programs in developing countries: the need for equity and technological development

    Directory of Open Access Journals (Sweden)

    Lazcano-Ponce Eduardo

    2003-01-01

    Full Text Available The cervical cancer screening programs (CCSP have not been very efficient in the developing countries. This explains the need to foster changes on policies, standards, quality control mechanisms, evaluation and integration of new screening alternatives considered as low and high cost, as well as to regulate colposcopy practices and the foundation of HPV laboratories. Cervical cancer (CC is a disease most frequently found in poverty-stricken communities and reflecting a problem of equity at both levels gender and regional, and this, is not only due to social and economic development inequalities, but to the infrastructure and human resources necessary for primary care. For this reason, the CCSP program must be restructured, a to primarily address unprivileged rural and urban areas; b to foster actions aimed at ensuring extensive coverage as well as a similar quality of that coverage in every region; c to use screening strategies in keeping with the availability of health care services. In countries with a great regional heterogeneity, a variety of screening procedures must be regulated and standardized, including a combination of assisted visual inspection, cervical cytology and HPV detection; d regional community intervention must be set up to assess the effectiveness of using HPV detection as an strategy in addition to cervical cytology (pap smear; e the practice of colposcopy must be regulated to prevent the use of it in healthy women at a population level, thus preventing unnecessary diagnosis and treatment which not only are expensive but also causes unnecessary anxiety to women at risk; f the operation of those clinical laboratories using HPV as a detection strategy must likewise be accredited and regulated and g the CCSP program for assuring health care quality should meet the expectations of its beneficiaries, and increase the knowledge in cervical cancer related matters. Finally, though a variety of clinical tests on prophylactic and

  19. Detention of HPV L1 Capsid Protein and hTERC Gene in Screening of Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Huang Bin

    2013-06-01

    Full Text Available   Objective(s: To investigate the expression of human papilloma virus (HPV L1 capsid protein, and human telomerase RNA component (hTERC in cervical cancer and the role of detection of both genes in screening of cervical cancer.   Materials and Methods: A total of 309 patients were recruited and cervical exfoliated cells were collected. Immunocytochemistry was employed to detect HPV L1 capsid protein, and fluorescent in situ hybridization (FISH was performed to detect the hTERC. Results: The expression of HPV L1 capsid protein reduced with the increase of the histological grade of cervical cells and was negatively related to the grade of cervical lesions. However, the expression of hTERC increased with the increase of the histological grade and positively associated with the grade of cervical lesions. The proportion of patients with L1(-/hTERC(+ was higher in patients with histological grade of CIN2 or higher than that in those with histological grade of CIN1. The L1(+/hTERC(- and L1(-/hTERC(- were negatively related to the grade of cervical lesions. L1(-/hTERC(+ was positively associated with the grade of cervical lesions. The L1/hTERC ratio increased. The negative predictive value of both HPV L1 and hTERC was higher than that of HPV L1 or hTERC, but there was no marked difference in the screening efficacy of cervical cancer among HPV L1, hTERC and HPV L1+hTERC. Conclusion: HPV L1 capsid protein and hTERC gene may serve as markers for the early diagnosis and prediction of cervical lesions. The increase in L1/hTERC ratio reflects the progression of cervical lesions to a certain extent.

  20. Cervicitis

    Science.gov (United States)

    ... much growth of normal bacteria in the vagina (bacterial vaginosis) can also cause cervicitis. ... under a microscope (may show candidiasis , trichomoniasis , or bacterial vaginosis) Pap test Tests for gonorrhea or chlamydia Rarely, ...

  1. Comprehensive evaluation of cervical cancer screening programs: the case of Colombia

    Directory of Open Access Journals (Sweden)

    Raúl Murillo

    2011-12-01

    Full Text Available OBJECTIVE: To identify critical screening program factors for reducing cervical cancer mortality in Colombia. MATERIAL AND METHODS: Coverage, quality, and screening follow-up were evaluated in four Colombian states with different mortality rates. A case-control study (invasive cancer and healthy controls evaluating screening history was performed. RESULTS: 3-year cytology coverage was 72.7%, false negative rate 49%, positive cytology follow-up 64.2%. There was no association between screening history and invasive cancer in two states having high cytology coverage but high false negative rates. Two states revealed association between deficient screening history and invasive cancer as well as lower positive-cytology follow-up. CONCLUSIONS: Reduced number of visits between screening and treatment is more relevant when low access to health care is present. Improved quality is a priority if access to screening is available. Suitable interventions for specific scenarios and proper appraisal of new technologies are compulsory to improve cervical cancer screening. Comprehensive process-failure audits among invasive cancer cases could improve program evaluation since mortality is a late outcome.OBJETIVO: Identificar factores críticos para reducir la mortalidad por cáncer cervical en Colombia. MATERIAL Y MÉTODOS: Se evaluó cobertura, calidad y seguimiento del tamizaje en cuatro departamentos con tasas de mortalidad diferenciales. Un estudio de casos (cáncer invasor y controles (sanos evaluó historia de tamizaje. RESULTADOS: Cobertura 72,7%; falsos negativos 49%; acceso a diagnóstico-tratamiento de HSIL 64,2%. La historia de tamizaje no se asoció con cáncer invasor en dos departamentos con elevada cobertura pero elevada proporción de falsos negativos. Dos departamentos con asociación entre historia de tamizaje deficiente y cáncer invasor tuvieron cobertura aceptable pero bajo acceso a diagnóstico-tratamiento. No hubo relación entre mortalidad

  2. The challenges of organising cervical screening programmes in the 15 old member states of the European Union

    DEFF Research Database (Denmark)

    Arbyn, Marc; Rebolj, Matejka; De Kok, Inge M C M;

    2009-01-01

    Cervical cancer incidence and mortality can be reduced substantially by organised cytological screening at 3 to 5 year intervals, as was demonstrated in the Nordic countries, the United Kingdom, the Netherlands and parts of Italy. Opportunistic screening, often proposed at yearly schedules, has a...

  3. A Community Capacity-Enhancement Approach to Breast and Cervical Cancer Screening among Older Women of Color

    Science.gov (United States)

    Bullock, Karen; McGraw, Sarah A.

    2006-01-01

    In the Screening Older Minority Women project, the authors applied a community capacity-enhancement approach to promoting breast and cervical cancer screening among older women of color. Members of informal support networks were recruited for this health promotion intervention to empower Latina and African American women to engage in positive…

  4. Superior performance of liquid-based versus conventional cytology in a population-based cervical cancer screening program

    NARCIS (Netherlands)

    Beerman, H.; van Dorst, E. B. L.; Kuenen-Boumeester, V.; Hogendoorn, P. C. W.

    2009-01-01

    Objective. Liquid-based cytology may offer improvements over conventional cytology for cervical cancer screening. The two cytology techniques were compared in a group of 86,469 women who participated in a population-based screening program. Using a nation-wide pathology database containing both cerv

  5. A molecular monopoly? HPV testing, the Pap smear and the molecularisation of cervical cancer screening in the USA

    NARCIS (Netherlands)

    Hogarth, Stuart; Hopkins, Michael M.; Rodriguez, Victor

    2012-01-01

    DNA-based molecular testing for human papillomavirus has emerged as a novel approach to cervical cancer screening in the context of well-entrenched existing technology, the Pap smear. This article seeks to elucidate the process of molecularisation in the context of screening programmes. We illustrat

  6. The comparative and cost-effectiveness of HPV-based cervical cancer screening algorithms in El Salvador.

    Science.gov (United States)

    Campos, Nicole G; Maza, Mauricio; Alfaro, Karla; Gage, Julia C; Castle, Philip E; Felix, Juan C; Cremer, Miriam L; Kim, Jane J

    2015-08-15

    Cervical cancer is the leading cause of cancer death among women in El Salvador. Utilizing data from the Cervical Cancer Prevention in El Salvador (CAPE) demonstration project, we assessed the health and economic impact of HPV-based screening and two different algorithms for the management of women who test HPV-positive, relative to existing Pap-based screening. We calibrated a mathematical model of cervical cancer to epidemiologic data from El Salvador and compared three screening algorithms for women aged 30-65 years: (i) HPV screening every 5 years followed by referral to colposcopy for HPV-positive women (Colposcopy Management [CM]); (ii) HPV screening every 5 years followed by treatment with cryotherapy for eligible HPV-positive women (Screen and Treat [ST]); and (iii) Pap screening every 2 years followed by referral to colposcopy for Pap-positive women (Pap). Potential harms and complications associated with overtreatment were not assessed. Under base case assumptions of 65% screening coverage, HPV-based screening was more effective than Pap, reducing cancer risk by ∼ 60% (Pap: 50%). ST was the least costly strategy, and cost $2,040 per year of life saved. ST remained the most attractive strategy as visit compliance, costs, coverage, and test performance were varied. We conclude that a screen-and-treat algorithm within an HPV-based screening program is very cost-effective in El Salvador, with a cost-effectiveness ratio below per capita GDP.

  7. The Cost analysis of cervical cancer screening services provided by Damavand health center in 2013

    Directory of Open Access Journals (Sweden)

    Arezoo Chouhdari

    2015-03-01

    Full Text Available Background: Today, the health sector in many countries is facing with severe resource constraints; hence it is absolutely necessary that cost-benefit and cost-effectiveness assessment have a major role in design of health services. The purpose of this study was to evaluate the cost-benefit and effectiveness of cervical cancer screening service (Pap smear test done by the health centers in Damavand County in 2013.  Methods: This is a descriptive study with cross-sectional method. All data was extracted from existing documents in Damavand health network.Cost of service screening for doing Pap smear test (manpower costs of performing the service, the cost of transferring samples, water, electricity, telephone and gas was estimated in all health centers then results, were compared with the incomes of this service.  Results: Screening program coverage was 22.3%, 6.9% and 6.05% in 2011, 2012 and 2013 respectively. All costs and incomes of units performing Pap smear screening test were calculated. Entire costs and incomes of this service during 2013 were respectively 303,009,000 and 11,640,000 RLS equal $12,227 and $496.73. Therefore, the cost-benefit ratio of this screening test was approximately 0.040.  Conclusion: The costs of units performing cervical cancer screening test in Damavand Health Center were much more than this benefit and because of a none-positive Pap smear test in spite of high cost, performing this test in Damavand health centers was not cost effective.

  8. Cervical cancer screening adherence among HIV-positive female smokers from a comprehensive HIV clinic.

    Science.gov (United States)

    Fletcher, Faith E; Vidrine, Damon J; Tami-Maury, Irene; Danysh, Heather E; King, Rachel Marks; Buchberg, Meredith; Arduino, Roberto C; Gritz, Ellen R

    2014-03-01

    HIV-positive women are at elevated risk for developing cervical cancer. While emerging research suggests that gynecologic health care is underutilized by HIV-positive women, factors associated with adherence to Pap testing, especially among HIV-positive female smokers are not well known. We utilized baseline data from a smoking cessation trial and electronic medical records to assess Pap smear screening prevalence and the associated characteristics among the HIV-positive female participants (n = 138). 46 % of the women had at least 1 Pap test in the year following study enrollment. Multiple logistic regression analysis indicated that younger age, African American race, hazardous drinking, increased number of cigarettes smoked per day, and smoking risk perception were associated with non-adherence to Pap smear screening. Cervical cancer screening was severely underutilized by women in this study. Findings underscore the importance of identifying predictors of non-adherence and addressing multiple risk factors and behavioral patterns among HIV-positive women who smoke.

  9. Increasing Cervical Cancer Screening Coverage: A Randomised, Community-Based Clinical Trial

    Science.gov (United States)

    Acera, Amelia; Manresa, Josep Maria; Rodriguez, Diego; Rodriguez, Ana; Bonet, Josep Maria; Trapero-Bertran, Marta; Hidalgo, Pablo; Sànchez, Norman

    2017-01-01

    Background Opportunistic cervical cancer screening can lead to suboptimal screening coverage. Coverage could be increased after a personalised invitation to the target population. We present a community randomized intervention study with three strategies aiming to increase screening coverage. Methods The CRICERVA study is a community-based clinical trial to improve coverage of population-based screening in the Cerdanyola SAP area in Barcelona.A total of 32,858 women residing in the study area, aged 30 to 70 years were evaluated. A total of 15,965 women were identified as having no registration of a cervical cytology in the last 3.5 years within the Public Health data base system. Eligible women were assigned to one of four community randomized intervention groups (IGs): (1) (IG1 N = 4197) personalised invitation letter, (2) (IG2 N = 3601) personalised invitation letter + informative leaflet, (3) (IG3 N = 6088) personalised invitation letter + informative leaflet + personalised phone call and (4) (Control N = 2079) based on spontaneous demand of cervical cancer screening as officially recommended. To evaluate screening coverage, we used heterogeneity tests to compare impact of the interventions and mixed logistic regression models to assess the age effect. We refer a “rescue” visit as the screening visit resulting from the study invitation. Results Among the 13,886 women in the IGs, 2,862 were evaluated as having an adequate screening history after the initial contact; 4,263 were lost to follow-up and 5,341 were identified as having insufficient screening and thus being eligible for a rescue visit. All intervention strategies significantly increased participation to screening compared to the control group. Coverage after the intervention reached 84.1% while the control group reached 64.8%. The final impact of our study was an increase of 20% in the three IGs and of 9% in the control group (p<0.001). Within the intervention arms, age was an important determinant

  10. The advantages of incorporating liquid-based cytology (TACAS™) in mass screening for cervical cancer.

    Science.gov (United States)

    Yokoyama, Yoshihito; Futagami, Masayuki; Watanabe, Jun; Sakuraba, Atsushi; Nagasawa, Kazuma; Maruyama, Hidetoshi; Sato, Shigemi

    2016-04-01

    We incorporated liquid-based cytology (LBC) in population-based screening for cervical cancer. The usefulness of using LBC in mass screening for cervical cancer was examined. From 2009 to 2014, 157,061 individuals underwent mass screening for cervical cancer in Aomori Prefecture. From 2009 to 2011, cells were collected from 82,218 individuals and the specimens were conventionally prepared (CP). From 2012 to 2014, cells were collected from 74,843 individuals and the specimens were prepared using LBC (TACAS™). Cytology results for the 2 sets of specimens were compared and differences in cytologic features were examined. ASC-US and more severe lesions were detected at a rate of 1.13 % by CP and 1.44 % by LBC, so LBC had a 1.3-fold higher rate of detection. LBC had a 1.6-fold higher rate of LSIL detection and a 1.2-fold higher rate of HSIL detection. CP detected cancer in 20 cases at a rate of 0.024 % while LBC detected cancer in 18 cases at a rate of 0.024 %. Cytodiagnosis of the 18 cases of SCC that LBC identified revealed that 7 were SCC, 8 were HSIL, and 3 were ASC-H. Atypical cells tended to be smaller with TACAS™. LBC reduced the time needed for microscopic examination of a single specimen by 42 % in comparison to CP. LBC using TACAS™ allowed the detection of slight lesions and slight changes in cells. LBC can lessen the burden on medical personnel and may lead to improved accuracy.

  11. Factors associated with cervical cancer screening in a safety net population

    Science.gov (United States)

    Heberer, Meredith A; Komenaka, Ian K; Nodora, Jesse N; Hsu, Chiu-Hsieh; Gandhi, Sonal G; Welch, Lauren E; Bouton, Marcia E; Aristizabal, Paula; Weiss, Barry D; Martinez, Maria Elena

    2016-01-01

    AIM To identify factors associated with Papanicolaou-smear (Pap-smear) cervical cancer screening rates in a safety net population. METHODS From January 2012 to May 2013, the use of Pap-smear was determined for all patients seen at the breast clinic in a safety net hospital. Health literacy assessment was performed using the validated Newest Vital Sign. The records of patients were reviewed to determine if they had undergone Pap-smears for cervical cancer screening. Sociodemographic information was collected included age, education, monthly income, race/ethnicity, employment, insurance status, and primary care provider of the patient. Logistic regression analysis was then performed to determine factors associated with utilization of Pap-smears. Crude and adjusted odds ratios derived from multivariate logistic regression models were calculated as well as the associated 95%CIs and P-values. RESULTS Overall, 39% had Pap-smears in the prior 15 mo, 1377 consecutive women were seen during the study period and their records were reviewed. Significantly more patients with adequate health literacy underwent Pap-smears as compared to those with limited health literacy (59% vs 34%, P literacy, younger patients, and those with later age of first live birth were more likely to undergo Pap-smears. Patients whose primary care providers were gynecologists were also significantly more likely to have Pap-smears compared to other specialties (P literacy and primary care physician were associated with Pap-smear utilization. Development of interventions to target low health literacy populations could improve cervical cancer screening. PMID:27777883

  12. Differences in screening history, tumour characteristics and survival between women with screen-detected versus not screen-detected cervical cancer in the east of The Netherlands, 1992-2001.

    NARCIS (Netherlands)

    Aa, M.A. van der; Schutter, E.M.; Looijen-Salamon, M.; Martens, J.E.; Siesling, S.

    2008-01-01

    OBJECTIVE: In The Netherlands, despite a national screening programme since 1996, invasive cervical cancers have been detected in screened and non-screened women. The aim of this study was to determine differences between Pap-smear history, tumour characteristics and survival of patients with a tumo

  13. Cervical screening by visual inspection, HPV testing, liquid-based and conventional cytology in Amazonian Peru.

    Science.gov (United States)

    Almonte, Maribel; Ferreccio, Catterina; Winkler, Jennifer L; Cuzick, Jack; Tsu, Vivien; Robles, Sylvia; Takahashi, Rina; Sasieni, Peter

    2007-08-15

    Cervical cancer is an important public health problem in many developing countries, where cytology screening has been ineffective. We compared four tests to identify the most appropriate for screening in countries with limited resources. Nineteen midwives screened 5,435 women with visual inspection (VIA) and collected cervical samples for HPV testing, liquid-based cytology (LBC) and conventional cytology (CC). If VIA was positive, a doctor performed magnified VIA. CC was read locally, LBC was read in Lima and HPV testing was done in London. Women with a positive screening test were offered colposcopy or cryotherapy (with biopsy). Inadequacy rates were 5% and 11% for LBC and CC respectively, and less than 0.1% for VIA and HPV. One thousand eight hundred eighty-one women (84% of 2,236) accepted colposcopy/cryotherapy: 79 had carcinoma in situ or cancer (CIS+), 27 had severe- and 42 moderate-dysplasia on histology. We estimated a further 6.5 cases of CIS+ in women without a biopsy. Sensitivity for CIS+ (specificity for less than moderate dysplasia) was 41.2% (76.7%) for VIA, 95.8% (89.3%) for HPV, 80.3% (83.7%) for LBC, and 42.5% (98.7%) for CC. Sensitivities for moderate dysplasia or worse were better for VIA (54.9%) and less favourable for HPV and cytology. In this setting, VIA and CC missed the majority of high-grade disease. Overall, HPV testing performed best. VIA gives immediate results, but will require investment in regular training and supervision. Further work is needed to determine whether screened-positive women should all be treated or triaged with a more specific test.

  14. Determinants of Cervical Cancer Screening Uptake among Women in Ilorin, North Central Nigeria: A Community-Based Study

    Directory of Open Access Journals (Sweden)

    Ajibola Idowu

    2016-01-01

    Full Text Available Introduction. Cancer of the cervix is the leading cause of cancer deaths among women in developing countries. Screening is one of the most cost effective control strategies for the disease. This study assessed the determinants of cervical cancer screening uptake among Nigerian women. Methodology. This cross-sectional study was conducted using multistage sampling technique among 338 participants in Ilorin, North Central Nigeria. A pretested questionnaire was used for data collection and data analysis was done using SPSS version 21. Chi-square test was used for bivariate analysis while binary logistic regression was used for multivariate analysis. Statistical significance was set at p<0.05. Results. Only 8.0% of the respondents had ever been screened for cancer of the cervix. The proportion of women who had ever been screened was significantly higher among those who demonstrated positive attitude to screening (81.5%, p=0.001, respondents who were aware of the disease (100.0%, p=0.001, and those who were aware of cervical cancer screening (88.9%, p=0.001. Respondents who had negative attitude had 63% lesser odds of being screened compared to those who had positive attitudes towards screening (AOR; 0.37, 95% CI; 0.01–0.28. Conclusion. There is urgent need to improve the knowledge base and attitude of Nigerian women to enhance cervical cancer screening uptake among them.

  15. Comparative accuracy of anal and cervical cytology in screening for moderate to severe dysplasia by magnification guided punch biopsy: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Wm Christopher Mathews

    Full Text Available BACKGROUND: The accuracy of screening for anal cancer precursors relative to screening for cervical cancer precursors has not been systematically examined. The aim of the current meta-analysis was to compare the relative accuracy of anal cytology to cervical cytology in discriminating between histopathologic high grade and lesser grades of dysplasia when the reference standard biopsy is obtained using colposcope magnification. METHODS AND FINDINGS: The outcome metric of discrimination was the receiver operating characteristic (ROC curve area. Random effects meta-analysis of eligible studies was performed with examination of sources of heterogeneity that included QUADAS criteria and selected covariates, in meta-regression models. Thirty three cervical and eleven anal screening studies were found to be eligible. The primary meta-analytic comparison suggested that anal cytologic screening is somewhat less discriminating than cervical cytologic screening (ROC area [95% confidence interval (C.I.]: 0.834 [0.809-0.859] vs. 0.700 [0.664-0.735] for cervical and anal screening, respectively. This finding was robust when examined in meta-regression models of covariates differentially distributed by screening setting (anal, cervical. CONCLUSIONS: Anal cytologic screening is somewhat less discriminating than cervical cytologic screening. Heterogeneity of estimates within each screening setting suggests that other factors influence estimates of screening accuracy. Among these are sampling and interpretation errors involving both cytology and biopsy as well as operator skill and experience.

  16. Experience in screening for cervical cancer in rural areas of Barsi Tehsil (Maharashtra).

    Science.gov (United States)

    Nene, B M; Jayant, K; Malvi, S G; Dale, P S; Deshpande, R

    1994-03-01

    The organization of cancer detection camps is gaining popularity in our country and it is therefore necessary to evaluate the effectiveness of this approach in the early diagnosis and treatment of cancer. This to our knowledge has not been done. This report analyses an experience in screening for cervical cancer in rural areas of Barsi Tehsil (Maharashtra). The Barsi Tehsil consists of 134 villages with a population of 34,080 women above the age of 30 years (1982-1987). Of these 2,846 were screened through a series of cancer detection camps between 1982 and 1987. The results of the cytological screening in these women have been presented. An evaluation of the camp approach was carried out by the Population based Cancer Registry set up under the National Cancer Registry Programme (Indian Council of Medical Research) in Barsi, Paranda and Bhum tehsils. It was shown that acceptance of cytological screening was poor, thereby indicating that the mere holding of camps was not in itself sufficient to motivate the people, to subject themselves to the Pap smear. Certain suggestions which would appreciably increase the acceptance of cytological screening have been put forward.

  17. New approaches to cervical cancer screening in Latin America and the Caribbean.

    Science.gov (United States)

    Herrero, Rolando; Ferreccio, Catterina; Salmerón, Jorge; Almonte, Maribel; Sánchez, Gloria Ines; Lazcano-Ponce, Eduardo; Jerónimo, José

    2008-08-19

    Cervical cancer remains an important public health problem in the Latin America and Caribbean region (LAC), with an expected significant increase in disease burden in the next decades as a result of population ageing. Prophylactic human papillomavirus (HPV) vaccine is currently unaffordable in LAC countries. However, even if vaccination was implemented, an additional two decades will be required to observe its impact on HPV related disease and cancer. With some exceptions, cytology-based screening programs have been largely ineffective to control the problem in the region, and there is a need for new approaches to the organization of screening and for use of newly developed techniques. Several research groups in LAC have conducted research on new screening methods, some of which are summarized in this paper. A recommendation to reorganize screening programs is presented considering visual inspection for very low resource areas, improvement of cytology where it is operating successfully and HPV DNA testing followed by visual inspection with acetic acid (VIA) or cytology as soon as this method becomes technically and economically sustainable. This could be facilitated by the incorporation of new, low-cost HPV DNA testing methods and the use of self-collected vaginal specimens for selected groups of the population. An important requisite for screening based on HPV testing will be the quality assurance of the laboratory and the technique by validation and certification measures.

  18. Facing possible illness detected through screening--experiences of healthy women with pathological cervical smears

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Petersen, Lone Kjeld; Pedersen, Birthe D

    2007-01-01

    The aim of this study is to gain knowledge about women's perceptions of illness based on their abnormal PAP smears, following screening for cervical cancer. The study uses a phenomenological, hermeneutic approach inspired by Ricoeur's theory of interpretation. Twelve women, aged between 23 and 59...... of a face-value review of participant experiences (naive reading), structural analysis and, critical interpretation of what it means to be potentially ill. The women were unprepared to find that their screening results showed abnormal cells, indicative of incipient genital cancer. They were frustrated...... by the results as they had not experienced any symptoms and felt well, despite being diagnosed with a potential disease. Being diagnosed with abnormal cells caused the participants to feel anxious. Their anxiety had subsided 6 months after the cells had been removed. For those who did not require treatment...

  19. Automatic Glass-Slide Capturing System for Cervical Cancer Pre-Screening Program

    Directory of Open Access Journals (Sweden)

    Nor R.M. Noor

    2008-01-01

    Full Text Available Clinical glass-slide capturing system is becoming an important part of telemedicine, medical database and diagnostic system that involves of microscope and image acquisition device which is digital camera. One of the areas of interest is slide capturing system for cervical cancer pre-screening program. An automated microscope with FireWire digital camera will be used to acquire the image and store in digital lossless format. The capturing procedure involves of 100X and 400 X magnifications that are necessary for further diagnosis actions. The system that comes with software and hardware parts also provides image retrieval or displaying facilities for ease of user who are pathologist and cytologist to perform the screening program.

  20. Intent to participate in future cervical cancer screenings is lower when satisfaction with the decision to be vaccinated is neutral.

    Directory of Open Access Journals (Sweden)

    Natalie Marya Alexander

    Full Text Available HPV vaccination programs have adversely affected participation in future cervical cancer screening. The purpose of this study is to determine the influence of decision satisfaction with accepting/rejecting the HPV vaccine, as well as traditional clinical factors, on the intent to participate in future screening.From January 2011 through August 2012 women 18-26 years old presenting for health care in an urban college student health and wellness clinic in the US Midwest were asked to complete a descriptive and medical history survey including a six element decisional satisfaction survey scored on 5-point Likert scales, where the intent to participate in future cervical cancer screening was measured. Of the 568 women who completed the decisional satisfaction survey, 17% of those <21 years and 7% ≥ 21 years indicated no intent to participate in future cervical cancer screenings. Among women of current screening age, the univariate risk factors of race/ethnicity, contraceptive use, number of lifetime sexual partners, and receipt of HPV vaccine were not predictors of intent for future cervical cancer screening. Instead, only a history of a prior Pap test was a significant positive predictor and only a decisional satisfaction of 'neutral' (Likert score = 3 for any of the four decisional satisfaction elements was a significant negative predictor. For the decisional satisfaction element "best for me personally", there was a 78% decreased likelihood of intending to participate in future screening if the satisfaction was neutral rather than firm (aOR = 0.22, 95% CI: 0.05-0.91 and a 26 fold increased likelihood if she had had a prior Pap test (aOR = 26, 95% CI: 5-133.HPV vaccination implementation programs must help women be the owner of their decision around HPV vaccination and understand the importance of future participation in cervical cancer screening.

  1. What women want. Women's preferences for the management of low-grade abnormal cervical screening tests: a systematic review

    DEFF Research Database (Denmark)

    Frederiksen, Maria Eiholm; Lynge, E; Rebolj, M

    2012-01-01

    cytology in primary cervical screening, the frequency of low-grade abnormal screening tests will double. Several available alternatives for the follow-up of low-grade abnormal screening tests have similar outcomes. In this situation, women's preferences have been proposed as a guide for management......Please cite this paper as: Frederiksen M, Lynge E, Rebolj M. What women want. Women's preferences for the management of low-grade abnormal cervical screening tests: a systematic review. BJOG 2011; DOI: 10.1111/j.1471-0528.2011.03130.x. Background If human papillomavirus (HPV) testing will replace....... Selection criteria Studies asking women to state a preference between active follow-up and observation for the management of low-grade abnormalities on screening cytology or HPV tests. Data collection and analysis Information on study design, participants and outcomes was retrieved using a prespecified form...

  2. [Cervical cancer screening in the State of Maranhão, Brazil].

    Science.gov (United States)

    Silva, Diego Salvador Muniz da; Silva, Ana Maria Nogueira; Brito, Luciane Maria Oliveira; Gomes, Sinara Regina Lisboa; Nascimento, Maria do Desterro Soares Brandão; Chein, Maria Bethânia da Costa

    2014-04-01

    The scope of the study was to analyze the screening for cervical cancer in the state of Maranhão using secondary data from the Cervical Cancer Information System (SISCOLO). A retrospective descriptive study was conducted using secondary data from 139505 cytopathology exams recorded in SISCOLO in Maranhão in 2011. The variables: age, education, adequacy of material, represented epithelia, microbiology and cellular changes detected in Pap smear tests were selected. The age group between 25 to 29 years and incomplete basic schooling were the most frequent findings. The most common microbiological agents detected were bacilli (52.8%), cocci (45.5%) and Lactobacillus sp (32.6%). Inflammation was the most common benign cellular alteration (86.3%). Low-grade intraepithelial lesions were the most prevalent atypical findings in squamous cells (0.6%), followed by high-grade squamous intraepithelial lesions (0.2%). Squamous cell carcinoma was observed in 0.003% and 0.006% for adenocarcinoma. SISCOLO proved a useful tool for studying aspects related to cancer screening of the cervix, which can orient actions to reduce the incidence and mortality from this cancer.

  3. Proposal to institutionalize criteria and quality standards for cervical cancer screening within a health care system

    Directory of Open Access Journals (Sweden)

    Salmerón-Castro Jorge

    1998-01-01

    Full Text Available The uterine cervix is the most common cancer site for females. Approximately 52,000 new cases occur annually in Latin America, thus the need to improve efficiency and effectiveness of Cervical Cancer Screening Programs (CCSP is mandatory to decrease the unnecessary suffering women must bear. This paper is addressing essential issues to revamp the CCSP as proposed by the Mexican official norm. A general framework for institutionaling CCSP is outlined. Furthermore, strategies to strengthen CCSP performance through managerial strategies and quality assurance activities are described. The focus is on the following activities: 1 improving coverage; 2 implementing smear-taking quality control; 3 improving quality in interpretation of Pap test; 4 guaranteeing treatment for women for whom abnormalities are detected; 5 improving follow-up; 6 development of quality control measures and 7 development of monitoring and epidemiological surveillance information systems. Changes within the screening on cervical cancer may be advocated as new technologies present themselves and shortcomings in the existing program appear. It is crucial that these changes should be measured through careful evaluation in order to tally up potential benefits.

  4. Tamizaje en cáncer cervical: conocimiento de la utilidad y uso de citología cervical en México Cervical cancer screening: knowledge of Pap smear benefits and utilization in Mexico

    Directory of Open Access Journals (Sweden)

    José A Aguilar-Pérez

    2003-02-01

    .OBJECTIVE: To identify and evaluate the predisposing factors regarding the utilization of the Pap smears in the population seen in the Cervical Cancer Screening Program in Mexico METHODS: A cross-sectional study was conducted from January 1997 through December 1998 in Mexico city. A questionnaire was applied to a total of 2,107 women of reproductive age who attended a family planning program and data was collected regarding the following topics: social-demographics, reproductive risk factors associated with cervical cancer, sexual behavior and partner history, birth control, knowledge about Pap smear' benefits, and its utilization. Statistic analysis was conducted using Student´s test and non-conditional multiple logistic regression model for determining significance. RESULTS: The predisposing factors were: knowledge about Pap smear's benefits (OR=6.00, CI 95% 4.70-7.67, history of using at least two birth control methods (OR=2.38, CI 95% 1.75-3.24, previous history of vaginal infection (OR=2.18, CI 95% 1.73-2.75, sexual partner's approval of gynecological examinations (OR=1.56, CI 95% 1.07-2.29. CONCLUSIONS: Educational programs on cancer prevention in this population should include the benefits of screening tests. Pap smears for Mexican women of reproductive age are mostly offered opportunely. The previous use of health services is a determinant factor for the utilization of the Cervical Cancer Screening Program. These results show the need to strengthen health promotion programs to women at high risk of cervical cancer and their sexual partners.

  5. p16 immunostaining as a predictor of anal and cervical dysplasia in women attending a sexually transmitted infection clinic

    Directory of Open Access Journals (Sweden)

    Deepika Pandhi

    2016-01-01

    Full Text Available Background: Carcinogenesis caused by human papillomavirus (HPV leads to over-expression of p16 protein. p16 may act as a marker of HPV integration with host genome and serve as a surrogate marker of HPV oncogenesis. Materials and Methods: A single center study of 75 women (35 HIV-positive and 40 HIV-negative women was conducted. Anal and cervical specimens were obtained for cytology and p16 immunostaining. Results: The sensitivity of p16 to diagnose anal and cervical dysplasia was 50% and 58.8%, respectively, whereas specificity was 98.6% and 100%, respectively. Positive predictive value for anal and cervical was 75% and 100%, whereas negative predictive value was 95.8% and 89.2%, respectively. A strong relationship between the grade of dysplasia and intensity of p16 immunoscore was observed (Pearson correlation r = 0.666, P< 0.0001 and r = 0.496, P< 0.0001 for anal and cervical, respectively. Conclusion: p16 immunostaining with greater specificity for high-grade lesions may improve the diagnostic accuracy, especially for high-grade lesions which have a high risk of progression to malignancy and thereby necessitate treatment.

  6. 北京市月坛社区妇女免费宫颈癌筛查结果分析%Results of Cervical Cancer Screening in Yuetan Community in Beijing City

    Institute of Scientific and Technical Information of China (English)

    孙艳格; 张诗敏; 杜雪平; 张树静; 赖爱鸾

    2011-01-01

    Objective To understand the prevalence of cervical diseases in Yuetan community in Beijing, with an attempt to provide evidences for community — based prevention of cervical cancer. Methods Conventional cervical scraping smear screening was performed in 3850 women who attended the " Two Cancers Screening" project in Yuetan community from 2008 to 2009. Results In Yuetan community, 3850 women received screening, with an screening rate of 9. 9% and a government budget of 96250 RMB yuan. Abnormal pelvic conditions were found in 1209 women ( 31. 4% ). Of 165 women ( 4. 3% ) with abnormal cervical cytology, 23 ( 0. 6% ) had cervical lesions, including one case of cervical cancer. Conclusion The screening rate is low in Yuetan community in Beijing. The prevalence of cervical lesions is 0. 6% . Health education should be strengthened in rural communities in Beijing so as to urge more women to accept cervix screening.%目的 了解月坛社区妇女宫颈病变流行状况,为社区宫颈癌的防治提供依据.方法 回顾分析2008-2009年月坛社区"两癌筛查"项目中3 850例传统宫颈刮片筛查结果.结果 宫颈癌筛查妇女3 850例,筛查率为9.9%;政府投入9.625万元;3 850例妇女妇科检查异常者1 209例(31.4%);宫颈细胞学检查异常165例(4.3%);对165例宫颈细胞学异常者行病理检查宫颈病变23例(0.6%),其中宫颈癌1例.结论 月坛社区妇女宫颈癌筛查率较低,宫颈疾病患病率为0.6%,应进一步加对强居民的宣传和教育,使更多的妇女接受宫颈癌的筛查.

  7. Cost-Utility Analysis of Human Papillomavirus Vaccination and Cervical Screening on Cervical Cancer Patient in Indonesia

    NARCIS (Netherlands)

    Setiawan, Didik; Dolk, Franklin Christiaan; Suwantika, Auliya A.; Westra, Tjalke Arend; WIlschut, Jan C.; Postma, Maarten Jacobus

    2016-01-01

    Background: Although cervical cancer is a preventable disease, the clinical and economic burdens of cervical cancer are still substantial issues in Indonesia. Objectives: The main purpose of this study was to model the costs, clinical benefits, and cost-utility of both visual inspection with acetic

  8. A survey of cervical screening among refugee and non-refugee African immigrant women in Brisbane, Australia.

    Science.gov (United States)

    Anaman, Judith A; Correa-Velez, Ignacio; King, Julie

    2016-10-31

    Issue addressed: To compare the level of cervical screening uptake between refugee and non-refugee African immigrant women living in Brisbane, Australia, and examine factors associated with Pap smear testing. Methods: Cross-sectional survey with a convenience sample of 254 women aged 21-62 years from 22 African countries (144 refugees, 110 non-refugees). Chi-square tests were used to compare the demographic and health-related characteristics between refugee and non-refugee women. Bivariate and multiple logistic regression analyses were used to assess the relationship between the outcome variable (Pap smear testing) and the independent variables. Results: Two-thirds of women had used Pap smear services in Australia. Chi-square test analysis established that non-refugee women were significantly more likely to have used Pap smear services than refugee women (73.6% vs 61.8% respectively; P=0.047). Immigration status, however, was not a significant predictor of cervical screening uptake in the multiple regression analyses. The significant predictors for screening uptake in these analyses were work arrangement, parity, healthcare visit, knowledge about Pap smear and perceived susceptibility to cervical cancer. Conclusion: Most women relied on opportunistic screening after receiving invitation letters to screen or after visiting health professionals for antenatal or postnatal care. So what?: The findings suggest that organised cervical screening programs are not reaching most African immigrant women living in Brisbane. It is incumbent on the public health sector, including healthcare professionals and settlement agencies working with African communities, to develop health promotion strategies that meaningfully engage African immigrant women, including those from refugee backgrounds, to enhance their knowledge about cervical cancer and screening practices.

  9. Packaging health services when resources are limited: the example of a cervical cancer screening visit.

    Directory of Open Access Journals (Sweden)

    Jane J Kim

    2006-11-01

    Full Text Available BACKGROUND: Increasing evidence supporting the value of screening women for cervical cancer once in their lifetime, coupled with mounting interest in scaling up successful screening demonstration projects, present challenges to public health decision makers seeking to take full advantage of the single-visit opportunity to provide additional services. We present an analytic framework for packaging multiple interventions during a single point of contact, explicitly taking into account a budget and scarce human resources, constraints acknowledged as significant obstacles for provision of health services in poor countries. METHODS AND FINDINGS: We developed a binary integer programming (IP model capable of identifying an optimal package of health services to be provided during a single visit for a particular target population. Inputs to the IP model are derived using state-transition models, which compute lifetime costs and health benefits associated with each intervention. In a simplified example of a single lifetime cervical cancer screening visit, we identified packages of interventions among six diseases that maximized disability-adjusted life years (DALYs averted subject to budget and human resource constraints in four resource-poor regions. Data were obtained from regional reports and surveys from the World Health Organization, international databases, the published literature, and expert opinion. With only a budget constraint, interventions for depression and iron deficiency anemia were packaged with cervical cancer screening, while the more costly breast cancer and cardiovascular disease interventions were not. Including personnel constraints resulted in shifting of interventions included in the package, not only across diseases but also between low- and high-intensity intervention options within diseases. CONCLUSIONS: The results of our example suggest several key themes: Packaging other interventions during a one-time visit has the

  10. Review on the medical and health economic evidence for an inclusion of colposcopy in primary screening programs for cervical cancer

    Science.gov (United States)

    Nocon, Marc; Mittendorf, Thomas; Roll, Stephanie; Greiner, Wolfgang; Willich, Stefan N.; von der Schulenburg, Johann-Matthias

    2007-01-01

    Introduction With 3.2% of all cancer cases in 2002, cervical carcinoma is the tenth most common cancer in Germany and causes 1.8% of all cancer deaths in women in Germany. To date diagnosis in Germany solely has been based on cervical cytology which has been criticised due to its low sensitivity and consequently high rate of false negative results. Objectives How does colposcopy compare to cytological tests in terms of sensitivity and specificity, and what may be the effects of changes in screening for cervical carcinoma in Germany? Is there health economic evidence that may foster an inclusion of colposcopy into national screening programms? Methods A systematic literature review was performed, including studies that compared colposcopy to cervical cytology in terms of sensitivity and specificity. In addition, a systematic review of the relevant health economic literature was performed to analyse cost-effectiveness issues relevant to the German setting. Results A total of four studies fulfilled the inclusion criteria, of which only two were of high methodologic quality. In all studies, the sensitivity of colposcopy was lower than that of cytology. In three studies the specificity of colposcopy was lower than that of cytology, in one study specificity of colposcopy and cytology was similar. No health economic data suggesting positive effects of adding colposcopy in primary screening could be identified. Discussion Only few studies have compared the test criteria of colposcopy with those of cytology for screening in cervical cancer. In all studies, sensitivity of colposcopy was even lower than the sensitivity of cytology, which has been critisized because of its low sensitivity. Conclusion Based on the present data, an inclusion of colposcopy in primary cervical cancer screening programmes can not be recommended. PMID:21289941

  11. Introduction of molecular HPV testing as the primary technology in cervical cancer screening: Acting on evidence to change the current paradigm.

    Science.gov (United States)

    Tota, Joseph E; Bentley, James; Blake, Jennifer; Coutlée, François; Duggan, Máire A; Ferenczy, Alex; Franco, Eduardo L; Fung-Kee-Fung, Michael; Gotlieb, Walter; Mayrand, Marie-Hélène; McLachlin, Meg; Murphy, Joan; Ogilvie, Gina; Ratnam, Sam

    2017-05-01

    Since being introduced in the 1940s, cervical cytology - despite its limitations - has had unequivocal success in reducing cervical cancer burden in many countries. However, we now know that infection with human papillomavirus (HPV) is a necessary cause of cervical cancer and there is overwhelming evidence from large-scale clinical trials, feasibility studies and real-world experience that supports the introduction of molecular testing for HPV as the primary technology in cervical cancer screening (i.e., "HPV primary screening"). While questions remain about the most appropriate age groups for screening, screening interval and triage approach, these should not be considered barriers to implementation. Many countries are in various stages of adopting HPV primary screening, whereas others have not taken any major steps towards introduction of this approach. As a group of clinical experts and researchers in cervical cancer prevention from across Canada, we have jointly authored this comprehensive examination of the evidence to implement HPV primary screening. Our intention is to create a common understanding among policy makers, agencies, clinicians, researchers and other stakeholders about the evidence concerning HPV primary screening to catalyze the adoption of this improved approach to cervical cancer prevention. With the first cohort of vaccinated girls now turning 21, the age when routine screening typically begins, there is increased urgency to introduce HPV primary screening, whose performance may be less adversely affected compared with cervical cytology as a consequence of reduced lesion prevalence post-vaccination.

  12. Adherence to cervical cancer screening varies by human papillomavirus vaccination status in a high-risk population.

    Science.gov (United States)

    Paynter, Christopher A; Van Treeck, Benjamin J; Verdenius, Inge; Lau, Agnes W Y; Dhawan, Twinkle; Lash, Kayla A; Bergamini, Elizabeth A; Ekekezie, Chiazotam N; Hilal, Amna M; James, Kristen N; Alongi, Sadie; Harper, Sean M; Bonham, Aaron J; Baumgartner, Kathy B; Baumgartner, Richard N; Harper, Diane M

    2015-01-01

    Cervical cancer screening has reduced the incidence of cervical cancer over the past 75 years. The primary aim of this study was to determine if women receiving Gardasil™ (HPV4 vaccine) participated in future cervical cancer screening at the same rate as that observed for unvaccinated women matched on birth year and health care campus. This is a retrospective cohort study of subjects selected from 27,786 females born from 1980 to 1992 who received health care in the Truman Medical Center safety net health system in Kansas City Missouri, USA. 1154 women 14-26 years old who received at least one dose of HPV4 vaccine between 2006 and 2009 were chosen at random from the vaccine records. 1154 randomly chosen unvaccinated women were age and health campus matched to the vaccinated women and all were followed until July 1, 2013. Women who were screened after 21 years and received three vaccine doses before 21 years, had the lowest screening rate of 24%. Their only predictive factor for screening, compared to the unvaccinated, was being closer to 21 years than 14 years at vaccination (aOR = 1.71 95% CI: 1.45, 2.00). Women vaccinated with three doses and screened at or after 21 years had the highest screening rate of 84% predicting a six-fold increase in screening participation over no vaccine received (aOR = 5.94 95% CI: 3.77, 9.35). Our results suggest that women who receive HPV4 vaccination closer to 21 years, not 14, are more likely to participate in cervical cancer screening in an underserved US population.

  13. Adherence to cervical cancer screening varies by human papillomavirus vaccination status in a high-risk population

    Directory of Open Access Journals (Sweden)

    Christopher A. Paynter

    2015-01-01

    Full Text Available Cervical cancer screening has reduced the incidence of cervical cancer over the past 75 years. The primary aim of this study was to determine if women receiving Gardasil™ (HPV4 vaccine participated in future cervical cancer screening at the same rate as that observed for unvaccinated women matched on birth year and health care campus. This is a retrospective cohort study of subjects selected from 27,786 females born from 1980 to 1992 who received health care in the Truman Medical Center safety net health system in Kansas City Missouri, USA. 1154 women 14–26 years old who received at least one dose of HPV4 vaccine between 2006 and 2009 were chosen at random from the vaccine records. 1154 randomly chosen unvaccinated women were age and health campus matched to the vaccinated women and all were followed until July 1, 2013. Women who were screened after 21 years and received three vaccine doses before 21 years, had the lowest screening rate of 24%. Their only predictive factor for screening, compared to the unvaccinated, was being closer to 21 years than 14 years at vaccination (aOR = 1.71 95% CI: 1.45, 2.00. Women vaccinated with three doses and screened at or after 21 years had the highest screening rate of 84% predicting a six-fold increase in screening participation over no vaccine received (aOR = 5.94 95% CI: 3.77, 9.35. Our results suggest that women who receive HPV4 vaccination closer to 21 years, not 14, are more likely to participate in cervical cancer screening in an underserved US population.

  14. Significance of cyclin E, pl6ink4a and ki67 Overexpression in Cervical Exfoliated-cell Specimens for Primary Screening of HPV-related Cervical Carcinoma

    Institute of Scientific and Technical Information of China (English)

    赵富玺; 郭俊成; 崔克; 熊思东

    2004-01-01

    The aim of this study is to investigate cyclin E, pl6inkda and ki67 as possible diagnostic biomarkers for cervical preneoplasia using cervical exfoliated-cell specimens, and evaluate the significance for screening patients at high risk of developing cervical carcinoma. The expression of cyclin E, pl6inkda and ki67 was examinated in 78 cervical exfoliated epithelial specimens diagnosed as atypical squamous cells of undetermined significance (ASCUS) (12 cases), cervical intraepithelial neoplasia (CIN) of type 1 (17 cases), CIN2_3 (38 cases) and invasive carcinoma (11 cases) using immunohistochemical analysis, and simultaneously, the DNA status of human papillomavims (HPY) type 16/18 was detected by polymerase chain reaction (PCR) using type specific primers, cyclin E, pl6inkda and ki67 were all overexpressed in CINs and invasive carcinoma, compared with little expression in ASCUS ( P <0.005). Overexpression of cyclin E was observed in CIN1(94.1%, X2 = 21.16, P < 0.01), and p16inkda and ki67 were overexpressed in invasive carcinoma (100% and 90.9% respectively). The degree of pl6inkda and ki67 expression correlated well with that of epithelial lesions ( P < 0.005). HPV16/18 infection was assessed in C1Ns and invasive carcinoma samples, and revealed a significant relationship with the degree of cervical epithelial lession. The expression level of pl6inkda and ki67 seemed more closely associated with HPVI6 infection than that of cyclin E (rs= 1.0 vs rs=0.4). Only 1 case in CINI and d cases in CIN2-3 of HPV18 positive samples were detected. Therefore no statistical significance was found by statistical analysis. Overexpression of cyclin E, pl6inkda and ki67 in CINs and invasive carcinoma cells demonstrates the potential use of cyclin E, pl6inkda and ki67 as diagnostic biomarkers for HPV-related cervical neoplastic lesions. In addition, this technique can be used for screening patients at high risk of developing cervical carcinoma.

  15. Determinants of gastric cancer screening attendance in Korea: a multi-level analysis

    OpenAIRE

    Chang, Yunryong; Cho, Belong; Son, Ki Young; Shin, Dong Wook; Shin, Hosung; Yang, Hyung-Kook; Shin, Aesun; Yoo, Keun-Young

    2015-01-01

    Background We aimed to assess individual and area-level determinants of gastric cancer screening participation. Method Data on gastric cancer screening and individual-level characteristics were obtained from the 2007–2009 Fourth Korea National Health and Nutrition Examination Survey. The area-level variables were collected from the 2005 National Population Census, 2008 Korea Medical Association, and 2010 National Health Insurance Corporation. The data were analyzed using multilevel logistic r...

  16. Visual inspection after acetic acid (VIA is highly heterogeneous in primary cervical screening in Amazonian Peru.

    Directory of Open Access Journals (Sweden)

    Maribel Almonte

    Full Text Available BACKGROUND: Conventional cytology (Pap and visual inspection after the application of acetic acid (VIA are currently used in primary screening in Peru. Studies suggest that the quality of VIA is highly variable. Over 36 000 women were screened with Pap and VIA in the TATI (Tamizaje y Tratamiento Inmediato de Lesiones Cervico-uterinas project conducted in Amazonian Peru. Within a nested study to compare several screening techniques (C-TATI, a total of 5435 women were additionally screened with liquid-based cytology (LBC and high-risk human papillomavirus testing (HR-HPV. We investigate the variation of positivity rates of VIA, Pap, LBC and HR-HPV in C-TATI and of VIA in the full TATI intervention. METHODS: At the screening visit, midwives collected three cervical samples for Pap, LBC and HC2 before performing VIA. The dispersion factor "D" (D = Pearson chi-square value/degrees-of-freedom was used to measure the variability of tests results. Within C-TATI, the variability of positivity rates of VIA, Pap, LBC and HR-HPV was also graphically assessed with box- and scatter plots by midwife and month of screening. Funnel plots and smoothed scatter plots were used to correlate the variation of VIA by the number of examinations performed by each midwife over the full TATI intervention. RESULTS: Consistently over TATI, VIA results were highly variable, independently of the examiner, the time when the test was performed and the number of tests the examiner performed (D>6, p-values25, p-values0.05 for HR-HPV. No evidence for correlation between the number of VIAs done per midwife and the variability of VIA results was observed. CONCLUSION: The lack of over-dispersion for HR-HPV detection suggests that the variable VIA results do not reflect true variation in underlying disease, but a lack of consistency in human judgement.

  17. Provider beliefs associated with cervical cancer screening interval recommendations: A pilot study in Federally Qualified Health Centers

    Directory of Open Access Journals (Sweden)

    Katherine B. Roland

    2015-01-01

    Conclusion: Messages that promote the benefits of longer screening intervals after a normal co-test, the natural history of human papillomavirus and cervical cancer, and low risk of developing cancer with a longer interval may be useful to promote evidence-based screening in this population of Federally Qualified Health Center providers. Dissemination of targeted messages through professional journals and specialty organizations should be considered.

  18. Assessment of factors impacting cervical cancer screening among low-income women living with HIV-AIDS.

    Science.gov (United States)

    Ogunwale, Abayomi N; Coleman, Maame Aba; Sangi-Haghpeykar, Haleh; Valverde, Ivan; Montealegre, Jane; Jibaja-Weiss, Maria; Anderson, Matthew L

    2016-01-01

    Very little is currently known about factors impacting the prevalence of cervical cancer screening among women living with HIV-AIDS (WLHA). To better understand this issue, we surveyed low-income, medically underserved women receiving subsidized gynecologic care through an integrated HIV clinic. A self-administered questionnaire was completed by 209 women who self-identified as HIV positive. A total of 179 subjects (85.7%) reported having had a Pap test in the last three years. The majority of WLHA (95%) knew that the Pap test screens for cervical cancer. However, overall knowledge of cervical cancer risk factors, such as multiple sexual partners or sex with a man with multiple partners, was low (43% and 35%, respectively). Unscreened women were younger and more likely to be single with multiple current sexual partners. In multivariable analyses, the only factors associated with Pap testing were a woman's perception that her partner wants her to receive regular screening (aOR 4.64; 95% CI: 1.15-23.76; p = .04), number of clinic visits during the past year (aOR 1.36, 95% CI: 1.05-1.94; p = .04) and knowledge that the need for a Pap test does not depend on whether or not a woman is experiencing vaginal bleeding (aOR 6.52, 95% CI: 1.04-49.71; p = .05). We conclude that support from male partners in addition to effective contact with the health system and knowledge of cervical cancer risk factors influence Pap utilization among low-income WLHA. Future measures to improve the care for this population should increase knowledge of cervical cancer risk factors and encourage social support for cervical cancer screening among WLHA.

  19. A randomized trial comparing the diagnostic accuracy of visual inspection with acetic acid to Visual Inspection with Lugol's Iodine for cervical cancer screening in HIV-infected women.

    Directory of Open Access Journals (Sweden)

    Megan J Huchko

    Full Text Available Visual inspection with Acetic Acid (VIA and Visual Inspection with Lugol’s Iodine (VILI are increasingly recommended in various cervical cancer screening protocols in low-resource settings. Although VIA is more widely used, VILI has been advocated as an easier and more specific screening test. VILI has not been well-validated as a stand-alone screening test, compared to VIA or validated for use in HIV-infected women. We carried out a randomized clinical trial to compare the diagnostic accuracy of VIA and VILI among HIV-infected women. Women attending the Family AIDS Care and Education Services (FACES clinic in western Kenya were enrolled and randomized to undergo either VIA or VILI with colposcopy. Lesions suspicious for cervical intraepithelial neoplasia 2 or greater (CIN2+ were biopsied. Between October 2011 and June 2012, 654 were randomized to undergo VIA or VILI. The test positivity rates were 26.2% for VIA and 30.6% for VILI (p = 0.22. The rate of detection of CIN2+ was 7.7% in the VIA arm and 11.5% in the VILI arm (p = 0.10. There was no significant difference in the diagnostic performance of VIA and VILI for the detection of CIN2+. Sensitivity and specificity were 84.0% and 78.6%, respectively, for VIA and 84.2% and 76.4% for VILI. The positive and negative predictive values were 24.7% and 98.3% for VIA, and 31.7% and 97.4% for VILI. Among women with CD4+ count < 350, VILI had a significantly decreased specificity (66.2% compared to VIA in the same group (83.9%, p = 0.02 and compared to VILI performed among women with CD4+ count ≥ 350 (79.7%, p = 0.02. VIA and VILI had similar diagnostic accuracy and rates of CIN2+ detection among HIV-infected women.

  20. A randomized trial comparing the diagnostic accuracy of visual inspection with acetic acid to Visual Inspection with Lugol's Iodine for cervical cancer screening in HIV-infected women.

    Science.gov (United States)

    Huchko, Megan J; Sneden, Jennifer; Zakaras, Jennifer M; Smith-McCune, Karen; Sawaya, George; Maloba, May; Bukusi, Elizabeth Ann; Cohen, Craig R

    2015-01-01

    Visual inspection with Acetic Acid (VIA) and Visual Inspection with Lugol’s Iodine (VILI) are increasingly recommended in various cervical cancer screening protocols in low-resource settings. Although VIA is more widely used, VILI has been advocated as an easier and more specific screening test. VILI has not been well-validated as a stand-alone screening test, compared to VIA or validated for use in HIV-infected women. We carried out a randomized clinical trial to compare the diagnostic accuracy of VIA and VILI among HIV-infected women. Women attending the Family AIDS Care and Education Services (FACES) clinic in western Kenya were enrolled and randomized to undergo either VIA or VILI with colposcopy. Lesions suspicious for cervical intraepithelial neoplasia 2 or greater (CIN2+) were biopsied. Between October 2011 and June 2012, 654 were randomized to undergo VIA or VILI. The test positivity rates were 26.2% for VIA and 30.6% for VILI (p = 0.22). The rate of detection of CIN2+ was 7.7% in the VIA arm and 11.5% in the VILI arm (p = 0.10). There was no significant difference in the diagnostic performance of VIA and VILI for the detection of CIN2+. Sensitivity and specificity were 84.0% and 78.6%, respectively, for VIA and 84.2% and 76.4% for VILI. The positive and negative predictive values were 24.7% and 98.3% for VIA, and 31.7% and 97.4% for VILI. Among women with CD4+ count < 350, VILI had a significantly decreased specificity (66.2%) compared to VIA in the same group (83.9%, p = 0.02) and compared to VILI performed among women with CD4+ count ≥ 350 (79.7%, p = 0.02). VIA and VILI had similar diagnostic accuracy and rates of CIN2+ detection among HIV-infected women.

  1. A Qualitative Study about Cervical Cancer Screening among Latinas Living in a Rural Area of California: Lessons for Health Educators

    Science.gov (United States)

    Pinzon-Perez, Helda; Perez, Miguel; Torres, Victor; Krenz, Vickie

    2005-01-01

    Cervical cancer is a major health concern for Latinas, who are also less likely to undergo a Pap smear exam than the general population. This study identifies alterable determinants of Pap smear screening for Latino women living in a rural area of California. It involved the design and pilot testing of a culturally appropriate instrument and the…

  2. Role of Protein Biomarkers in the Detection of High-Grade Disease in Cervical Cancer Screening Programs

    Directory of Open Access Journals (Sweden)

    Charlotte A. Brown

    2012-01-01

    Full Text Available Since the Pap test was introduced in the 1940s, there has been an approximately 70% reduction in the incidence of squamous cell cervical cancers in many developed countries by the application of organized and opportunistic screening programs. The efficacy of the Pap test, however, is hampered by high interobserver variability and high false-negative and false-positive rates. The use of biomarkers has demonstrated the ability to overcome these issues, leading to improved positive predictive value of cervical screening results. In addition, the introduction of HPV primary screening programs will necessitate the use of a follow-up test with high specificity to triage the high number of HPV-positive tests. This paper will focus on protein biomarkers currently available for use in cervical cancer screening, which appear to improve the detection of women at greatest risk for developing cervical cancer, including Ki-67, p16INK4a, BD ProEx C, and Cytoactiv HPV L1.

  3. Overview of Human Papillomavirus-Based and Other Novel Options for Cervical Cancer Screening in Developed and Developing Countries

    NARCIS (Netherlands)

    Cuzick, Jack; Arbyn, Marc; Sankaranarayanan, Rengaswamy; Tsu, Vivien; Ronco, Guglielmo; Mayrand, Marie-Helene; Dillner, Joakim; Meijer, Chris J. L. M.

    2008-01-01

    Screening for cervical cancer precursors by cytology has been very successful in countries where adequate resources exist to ensure high quality and good coverage of the population at risk. Mortality reductions in excess of 50% have been achieved in many developed countries; however the procedure is

  4. The Role of Learning Disability Nurses in Promoting Cervical Screening Uptake in Women with Intellectual Disabilities: A Qualitative Study

    Science.gov (United States)

    Lloyd, Jennifer L.; Coulson, Neil S.

    2014-01-01

    Research suggests that the uptake of cervical screening by women with intellectual disabilities (commonly known as learning disabilities within UK policy frameworks, practice areas and health services) is poor compared to women without intellectual disabilities. The present study explored learning disability nurses' experiences of supporting women…

  5. European guidelines for quality assurance in cervical cancer screening: recommendations for collecting samples for conventional and liquid-based cytology.

    NARCIS (Netherlands)

    Arbyn, M.; Herbert, A.; Schenck, U.; Nieminen, P.; Jordan, J.; Mcgoogan, E.; Patnick, J.; Bergeron, C.; Baldauf, J.J.; Klinkhamer, P.; Bulten, J.; Martin-Hirsch, P.

    2007-01-01

    The current paper presents an annex in the second edition of the European Guidelines for Quality Assurance in Cervical Cancer Screening. It provides guidance on how to make a satisfactory conventional Pap smear or a liquid-based cytology (LBC) sample. Practitioners taking samples for cytology should

  6. DNA methylation analysis in liquid-based cytology for cervical cancer screening.

    Science.gov (United States)

    Apostolidou, Sophia; Hadwin, Richard; Burnell, Matthew; Jones, Allison; Baff, Donna; Pyndiah, Nitisha; Mould, Tim; Jacobs, Ian J; Beddows, Simon; Kocjan, Gabrijela; Widschwendter, Martin

    2009-12-15

    Cervical cancer is the second most common type of cancer in women worldwide. Preinvasive disease can be detected by cervical cytology. All currently available cytology technologies rely on the visual analysis of exfoliated cells from the uterine cervix. Improvement of conventional cytological screening has been proposed by the introduction of molecular-based markers applied to liquid-based cytology (LBC), the suspension of cells collected from the cervix. DNA methylation changes occur very early in carcinogenesis and identification of appropriate DNA methylation markers in such samples should be able to distinguish high-grade squamous intraepithelial lesions (HSIL) from nonspecific cytology changes and the normal cervix. To address this potential, we have undertaken a proof-of-principle study of methylation status of LBC samples from HSIL cytology cases compared against matched normal controls. Using quantitative methylation-specific PCR on 28 genes, we found SOX1, HOXA11 and CADM1 to significantly discriminate between the groups analyzed (p<0.01). Area under the receiver operating characteristic (ROC) curve (AUC) demonstrated that methylation of SOX1, HOXA11 and CADM1 could discriminate between HSIL cases and controls with high sensitivity and specificity (AUC 0.910, 0.844 and 0.760, respectively). The results were further validated in an independent set. This proof-of-principle study is the first to validate the results in an independent case/control set and presents HOXA11, a gene that is important for cervical development, as a potentially useful DNA marker in LBC samples. Further assessment of these preliminary estimates will need to be performed in a larger cohort to confirm clinical utility.

  7. Impact of technology on cytology outcome in cervical cancer screening of young and older women

    DEFF Research Database (Denmark)

    Rask, J; Lynge, E; Franzmann, M

    2014-01-01

    Little is known about age-dependent variation in outcomes of cervical cytology with modern technologies. This population-based study evaluated age-dependent changes after routine implementation of ThinPrep and SurePath technology in two independent laboratories, and controlled for time trends in ...... with unchanged technology no trends in abnormality proportions were observed. The impact of LBC implementation on cytological abnormality proportions varied considerably across age groups.......Little is known about age-dependent variation in outcomes of cervical cytology with modern technologies. This population-based study evaluated age-dependent changes after routine implementation of ThinPrep and SurePath technology in two independent laboratories, and controlled for time trends...... and technology phase. The study included 489,960 cytological samples with no recent abnormality from women aged 23-59 years, routinely screened between 1998 and 2007. Implementation of SurePath liquid-based cytology (LBC) was followed by an increase in abnormal cytology in women aged 23-29 years from 4.6 to 6...

  8. The cervical cancer screening program in Mexico: problems with access and coverage.

    Science.gov (United States)

    Lazcano-Ponce, E C; Nájera-Aguilar, P; Buiatti, E; Alonso-de-Ruiz, P; Kuri, P; Cantoral, L; Hernández-Avila, M

    1997-09-01

    A cross-sectional study was carried out in two geographic regions of Mexico - Oaxaca (rural area) and Mexico City (urban area) - to determine the main factors for predicting participation in Cervical Cytology Screening Programs (CCSP), in populations with high mortality due to cervical cancer. We included 4,208 women aged between 15 and 49 years, randomly selected through a national household-sample frame. Knowledge of what the Pap test is used for strongly predisposes use of CCSP in Mexico City (odds ratio [OR] = 46.1, 95 percent confidence interval [CI] = 33.1-64.1) and Oaxaca state (OR = 61.5, CI = 42.0-89.9), as well as high socioeconomic level (Mexico: OR = 2.0, CI = 1.1-7.6; Oaxaca: OR = 4.1, CI = 3.1-5.3), high education level (Mexico: OR = 3.6, CI = 1.5-8.8; Oaxaca: OR = 5.3, CI = 2.8-10.0), and access to social security (Mexico: OR = 1.7, CI = 1.4-2.2; Oaxaca: OR = 2.2, CI = 1.8-2.7). Low coverage of the CCSP is confirmed as an important problem in Mexico.

  9. Factors Affecting Cervical Cancer Screening Behaviors Based On the Precaution Adoption Process Model: A Qualitative Study.

    Science.gov (United States)

    Bahmani, Afshin; Baghianimoghadam, Mohammah Hossein; Enjezab, Behnaz; Mazloomy Mahmoodabad, Seyed Saeed; Askarshahi, Mohsen

    2015-11-17

    One of the most preventable cancers in women is cervical cancer. Pap smear test is an effective screening program; however, it is not conducted very frequently. The aim of this study is explaining the determinants affecting women's participation in the Pap smear test based on precaution adoption process model with a qualitative approach. This study was a qualitative approach using a Directed Content Analysis methodology which was conducted in 2014. Participants were 30 rural women who participated in this study voluntarily in sarvabad, Iran. Purposive sampling was initiated and continued until data saturation. Semi-structured interviews were the primary method of data collection. Data were analyzed using qualitative content analysis and continuous comparisons. Women`s information and awareness about cervical cancer and Pap smear is insufficient and most of them believed that they were not at risk; however, they perceived the severity of the disease. Some of them had no adequate understanding of the test benefits. They pointed to the lack of time, financial difficulties, fear of test result and lack of awareness as the main barriers against the Pap smear test; however, they did not say that they were not willing to do the test. Findings could help health policy makers to find the right area and purpose to facilitate the participation of women in the Pap smear test.

  10. Type-specific prevalence of human papillomavirus in women screened for cervical cancer in Labrador, Canada

    Directory of Open Access Journals (Sweden)

    Alberto Severini

    2013-02-01

    Full Text Available Background. A higher incidence of cervical cancer and human papillomavirus (HPV infection has been reported in northern Canada and in First Nation, Métis and Inuit women, with some evidence to suggest that the HPV type distribution in these populations may be different from the rest of Canada. Objective. The objective of this study was to measure the HPV type prevalence in Labrador women to determine if significant differences in HPV types could reduce the effectiveness of HPV vaccination. Design. The prevalence of HPV types was determined in 1,370 women presenting for routine pap screening in Labrador between February and November 2010. Cervical cytology and HPV genotyping were performed on the same liquid-based cytology specimens. Results. The overall prevalence of HPV was 21.4%; cytological abnormalities were found in 8.8% of the participants. HPV 16 and 18 were the most common high-risk HPV types. These two types were found in 52.4% of high-grade lesions. The prevalence in HPV infections was comparable across the Labrador regions. Conclusions. The present results support the potential effectiveness of the HPV immunization program in Labrador.

  11. HPV testing for primary cervical screening: Laboratory issues and evolving requirements for robust quality assurance.

    Science.gov (United States)

    Carozzi, Francesca Maria; Del Mistro, Annarosa; Cuschieri, Kate; Frayle, Helena; Sani, Cristina; Burroni, Elena

    2016-03-01

    This review aims to highlight the importance of Quality Assurance for Laboratories performing HPV test for Cervical Cancer Screening. An HPV test, to be used as primary screening test, must be validated according to international criteria, based on comparison of its clinical accuracy to HC2 or GP5+/6+ PCR-EIA tests. The number of validated platforms is increasing and appropriate Quality Assurance Programs (QAPs) which can interrogate longitudinal robustness and quality are paramount. This document describes the following topics: (1) the characteristics of an HPV laboratory and the personnel training needs, to ensure an elevated quality of the entire process and the optimal use of the resources; (2) the Quality Assurance, as both internal (IQA) and external quality assessment (EQA) systems, to be implemented and performed, and the description of the existing EQAs, including limitations; (3) general considerations for an optimal EQA program for hrHPV primary screening Due to the importance of Quality Assurance for this field, international efforts are necessary to improve QA International Collaboration.

  12. Visual inspection for cervical cancer screening; evaluation by doctor versus paramedical worker

    Directory of Open Access Journals (Sweden)

    Bhatla Neerja

    2004-01-01

    Full Text Available BACKGROUND : In the absence of an effective cervical cancer screening programme, efforts are being made to explore the feasibility of using the existing infrastructure to develop effective low-cost screening methods. AIMS : To evaluate and compare test performance of visual inspection of the cervix by a doctor and a paramedical worker. SETTING AND DESIGN : Gynaecology outpatient department (OPD, All India Institute of Medical Sciences, New Delhi; cross-sectional study. MATERIAL AND METHODS : One hundred women with complaints of vaginal discharge, irregular bleeding, post coital bleeding or unhealthy cervix underwent visual inspection with acetic acid (VIA and Lugol′s iodine (VILI by a doctor and nurse, followed by colposcopy and biopsy. STATISTICAL ANALYSIS USED : Sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV were calculated for each test and compared. Concordance was determined by kappa statistics. RESULTS : VIA by nurse had a higher sensitivity (100% versus 87.5%, but lower specificity (53% versus 63% when compared with the doctor, but it was not statistically significant. There was moderate agreement between their VIA findings (kappa=0.56. VILI findings were comparable to that of the VIA, both by the doctor and nurse. There was almost perfect agreement (kappa=0.89 between VILI by the doctor and nurse. CONCLUSION : Visual inspection can be performed reliably by trained paramedical workers and doctors and is an effective screening option in low resource settings.

  13. A cohort study of cervical screening using partial HPV typing and cytology triage.

    Science.gov (United States)

    Schiffman, Mark; Hyun, Noorie; Raine-Bennett, Tina R; Katki, Hormuzd; Fetterman, Barbara; Gage, Julia C; Cheung, Li C; Befano, Brian; Poitras, Nancy; Lorey, Thomas; Castle, Philip E; Wentzensen, Nicolas

    2016-12-01

    HPV testing is more sensitive than cytology for cervical screening. However, to incorporate HPV tests into screening, risk-stratification ("triage") of HPV-positive women is needed to avoid excessive colposcopy and overtreatment. We prospectively evaluated combinations of partial HPV typing (Onclarity, BD) and cytology triage, and explored whether management could be simplified, based on grouping combinations yielding similar 3-year or 18-month CIN3+ risks. We typed ∼9,000 archived specimens, taken at enrollment (2007-2011) into the NCI-Kaiser Permanente Northern California (KPNC) HPV Persistence and Progression (PaP) cohort. Stratified sampling, with reweighting in the statistical analysis, permitted risk estimation of HPV/cytology combinations for the 700,000+-woman KPNC screening population. Based on 3-year CIN3+ risks, Onclarity results could be combined into five groups (HPV16, else HPV18/45, else HPV31/33/58/52, else HPV51/35/39/68/56/66/68, else HPV negative); cytology results fell into three risk groups ("high-grade," ASC-US/LSIL, NILM). For the resultant 15 HPV group-cytology combinations, 3-year CIN3+ risks ranged 1,000-fold from 60.6% to 0.06%. To guide management, we compared the risks to established "benchmark" risk/management thresholds in this same population (e.g., LSIL predicted 3-year CIN3+ risk of 5.8% in the screening population, providing the benchmark for colposcopic referral). By benchmarking to 3-year risk thresholds (supplemented by 18-month estimates), the widely varying risk strata could be condensed into four action bands (very high risk of CIN3+ mandating consideration of cone biopsy if colposcopy did not find precancer; moderate risk justifying colposcopy; low risk managed by intensified follow-up to permit HPV "clearance"; and very low risk permitting routine screening.) Overall, the results support primary HPV testing, with management of HPV-positive women using partial HPV typing and cytology.

  14. Incidence of cervical dysplasia and cervical cancer in women living with HIV in Denmark

    DEFF Research Database (Denmark)

    Thorsteinsson, K; Ladelund, S; Jensen-Fangel, S;

    2016-01-01

    OBJECTIVES: Women living with HIV (WLWH) are reportedly at increased risk of invasive cervical cancer (ICC). A recent publication found that WLWH in Denmark attend the national ICC screening programme less often than women in the general population. We aimed to estimate the incidence of cervical...... performed to include prior screening outcome, screening intensity and treatment of CIN/ICC in the interpretation of results. RESULTS: We followed 1140 WLWH and 17 046 controls with no prior history of ICC or hysterectomy for 9491 and 156 865 person-years, respectively. Compared with controls, the overall...

  15. Individual and community effectiveness of a cervical cancer screening program for semi-urban Mexican women.

    Science.gov (United States)

    Figueroa-Muñoz Ledo, Adriana A; Márquez-Serrano, Margarita; Idrovo, Alvaro J; Allen-Leigh, Betania

    2014-06-01

    The effectiveness at the individual and community level of an educational intervention to increase cervical cancer screening self-efficacy among semi-urban Mexican women was evaluated and changes in reported community barriers were measured after the intervention was implemented. The educational intervention was evaluated with a quasi-experimental pre-test/post-test design and a control group, based on the Integrative Model of Behavior Prediction and AMIGAS project materials. For the intervention group, increased self-efficacy increased requests to obtain a Pap (p system affect the women's perceived ability to get a Pap. Better care for users is needed to increase consistent use of the test. The study shows the importance of using culturally adapted, multilevel, comprehensive interventions to achieve successful results in target populations.

  16. Remote quality assurance in cervical cancer screening in low resource settings using a handheld smartphone-based colposcope

    Science.gov (United States)

    Millien, Christophe; Jean-Baptiste, Meredith C.; Manite, Garçon; Levitz, David

    2015-03-01

    Cervical cancer is a leading cause of cancer death for women all across the developing world, where much of the infrastructure required for effective cervical cancer screening is unavailable because of limited resources. One of the most common method to screen for cervical cancer is by visual inspection with acetic acid (VIA), in which the cervix is imaged with the naked eye. Given inherent challenges in analysis and documentation when characterizing cervical tissue with the naked eye, an optical solution is needed. To address this challenge, a smartphone was modified and transformed into a mobile colposcope (a device used to image the cervix from outside) by adding a custom-fit light source and optics. The mobile smartphone colposcope was designed such that it augments VIA and easily integrates within the standard of care. The mobile smartphone colposcope is controlled by an app, which, stores cervical images captured on the mobile smartphone colposcope on a portal, enabling remote doctors to evaluate images and the treatment chosen by the health worker. Images from patients undergoing cervical cancer screening by a nurse using VIA in the University Hospital of Mirebalais (HUM) GYN outpatient clinic in Haiti were captured on the mobile smartphone colposcope. These images were later analyzed by an experienced OB/GYN at HUM, who determined whether or not the patient should be treated with cryoablation; more complicated cases were also shared with a consulting doctor in the US. The opinions of the experienced OB/GYN doctors at HUM, as well as the experts from the US, were used to educate nurses and midwives performing mobile colposcopy. These results suggest that remote assessment offered by mobile colposcopy can improve training of health workers performing VIA, and ultimately affect the therapy administered to patients.

  17. Demographic, knowledge, attitudinal, and accessibility factors associated with uptake of cervical cancer screening among women in a rural district of Tanzania: Three public policy implications

    Directory of Open Access Journals (Sweden)

    Lyimo Frida S

    2012-01-01

    Full Text Available Abstract Background Cervical cancer is an important public health problem worldwide, which comprises approximately 12% of all cancers in women. In Tanzania, the estimated incidence rate is 30 to 40 per 100,000 women, indicating a high disease burden. Cervical cancer screening is acknowledged as currently the most effective approach for cervical cancer control, and it is associated with reduced incidence and mortality from the disease. The aim of the study was to identify the most important factors related to the uptake of cervical cancer screening among women in a rural district of Tanzania. Methods A cross sectional study was conducted with a sample of 354 women aged 18 to 69 years residing in Moshi Rural District. A multistage sampling technique was used to randomly select eligible women. A one-hour interview was conducted with each woman in her home. The 17 questions were modified from similar questions used in previous research. Results Less than one quarter (22.6% of the participants had obtained cervical cancer screening. The following characteristics, when examined separately in relation to the uptake of cervical cancer screening service, were significant: husband approval of cervical cancer screening, women's level of education, women's knowledge of cervical cancer and its prevention, women's concerns about embarrassment and pain of screening, women's preference for the sex of health provider, and women's awareness of and distance to cervical cancer screening services. When examined simultaneously in a logistic regression, we found that only knowledge of cervical cancer and its prevention (OR = 8.90, 95%CI = 2.14-16.03 and distance to the facility which provides cervical cancer screening (OR = 3.98, 95%CI = 0.18-5.10 were significantly associated with screening uptake. Conclusions Based on the study findings, three recommendations are made. First, information about cervical cancer must be presented to women. Second, public education of

  18. 'We do the impossible': women overcoming barriers to cervical cancer screening in rural Honduras--a positive deviance analysis.

    Science.gov (United States)

    Garrett, Jenna J; Barrington, Clare

    2013-01-01

    Cervical cancer is the leading cause of cancer death for women in Honduras, and sexual behaviour and low screening uptake are two major factors contributing to high rates of morbidity and mortality. A qualitative study was conducted to investigate barriers that prevent rural Honduran women from engaging in screening and ways that women overcome those barriers. This study examined examples of positive deviance, or individuals engaging in the uncommon but beneficial practise of screening. Amor por sí misma (self-love), and social support were identified as two constructs women employed to overcome barriers to screening. Participants defined self-love as the act of displaying care and concern for oneself and one's health and suggested that it compels women to participate in screening. Social support was defined as receiving tangible aid and advice from others that facilitated women's screening participation. Findings suggest that the concept of self-love could be used in future screening promotion efforts and that integrating social support would also be beneficial. Engaging men in sexual and reproductive health programming is suggested in order to ensure male partners offer social support for screening and to challenge the cultural, gender and sexual norms that place women at higher risk for cervical cancer.

  19. Family and cultural influences on cervical cancer screening among immigrant Latinas in Miami-Dade County, USA.

    Science.gov (United States)

    Madhivanan, Purnima; Valderrama, Diana; Krupp, Karl; Ibanez, Gladys

    2016-01-01

    Cervical cancer disproportionately affects minorities, immigrants and low-income women in the USA, with disparities greatest among Latino immigrants. We examined barriers and facilitators to cervical cancer screening practices among a group of immigrant Latino women in Florida, USA. Between January and May 2013, six focus group discussions, involving 35 participants, were conducted among Hispanic women in Miami to explore their knowledge, beliefs about cervical cancer and facilitators and barriers to cervical cancer screening using a theoretical framework. The data showed that family support, especially from female relatives, was an important facilitator of screening and treatment. Women, however, reported prioritising family health over their own, and some expressed fatalistic beliefs about cancer. Major obstacles to receiving a Pap smear included fear that it might result in removal of the uterus, discomfort about being seen by a male doctor and concern that testing might stigmatise them as being sexually promiscuous or having a sexually transmitted disease. Targeted education on cancer and prevention is critically needed in this population. Efforts should focus on women of all ages since younger women often turn to older female relatives for advice.

  20. HPV-Based Screening, Triage, Treatment, and Followup Strategies in the Management of Cervical Intraepithelial Neoplasia

    OpenAIRE

    Oscar Peralta-Zaragoza; Jessica Deas; Claudia Gómez-Cerón; Wendy Argelia García-Suastegui; Geny del Socorro Fierros-Zárate; Nadia Judith Jacobo-Herrera

    2013-01-01

    Cervical cancer is the second most common cause of death from cancer in women worldwide, and the development of new diagnostic, prognostic, and treatment strategies merits special attention. Many efforts have been made to design new drugs and develop immunotherapy and gene therapy strategies to treat cervical cancer. HPV genotyping has potentially valuable applications in triage of low-grade abnormal cervical cytology, assessment of prognosis and followup of cervical intraepithelial neoplasia...

  1. Cervical Cancer Screening Service Uptake and Associated Factors among Age Eligible Women in Mekelle Zone, Northern Ethiopia, 2015: A Community Based Study Using Health Belief Model.

    Directory of Open Access Journals (Sweden)

    Hinsermu Bayu

    Full Text Available Cervical cancer is the third most common cancer among women worldwide, with about 500,000 new patients diagnosed and over 250,000 deaths every year. Cervical cancer screening offers protective benefits and is associated with a reduction in the incidence of invasive cervical cancer and cervical cancer mortality. But there is very low participation rate in screening for cervical cancer among low and middle-income countries.This study aimed to determine cervical cancer screening service uptake and its associated factor among age eligible women in Mekelle zone, northern Ethiopia, 2015.A community based cross-sectional study was conducted in Mekelle zone among age eligible women from February to June 2015. Systematic sampling technique was used to select 1286 women in to the study. A pre-tested structured questionnaire was used to collect relevant data. Data was entered and cleaned using EPINFO and analyzed using SPSS version 20 software package. Bivariate and Multivariate logistic regression was performed to assess association between dependent and independent variables with 95% CI and p-value less than 0.05 was set for association.The study revealed that among 1186 age eligible women, only 235(19.8% have been screened for cervical cancer. Age (AOR = 1.799, 95%CI = 1.182-2.739, history of multiple sexual partners (AOR = 1.635, 95%CI = 1.094-2.443, history of sexually transmitted disease (AOR = 1.635,95%CI = 1.094-2.443, HIV sero status (AOR = 5.614, 95%CI = 2.595-12.144, perceived susceptibility to cervical cancer (AOR = 2.225, 95%CI = 1.308-3.783, perceived barriers to premalignant cervical lesions screening (AOR = 2.256, 95%CI = 1.447-3.517 and knowledge on cervical cancer and screening (AOR = 2.355, 95%CI = 1.155-4.802 were significant predictors of cervical cancer screening service uptake.Magnitude of cervical cancer screening service uptake among age eligible women is still unacceptably low. Age of the women, history of multiple sexual partners

  2. Discovery of new methylation markers to improve screening for cervical intraepithelial neoplasia grade 2/3

    NARCIS (Netherlands)

    Boers, A; Wang, R; van Leeuwen, R W; Klip, H G; de Bock, G H; Hollema, H; van Criekinge, W; de Meyer, T; Denil, S; van der Zee, A G J; Schuuring, E; Wisman, G B A

    2016-01-01

    BACKGROUND: Assessment of DNA promoter methylation markers in cervical scrapings for the detection of cervical intraepithelial neoplasia (CIN) and cervical cancer is feasible, but finding methylation markers with both high sensitivity as well as high specificity remains a challenge. In this study, w

  3. Cervical cancer screening in Turkey: a community-based experience after 60 years of pap smear usage.

    Science.gov (United States)

    Demirhindi, Hakan; Nazlican, Ersin; Akbaba, Muhsin

    2012-01-01

    Cervical cancer is the second most common cancer in females in the World with around 500,000 new cases occurring annually, but the first in the developing countries with a high mortality if not diagnosed early. Papanicolau (Pap) smear is a cheap, easy-to-apply and widely accepted test which has been long used to detect cervical cancer at very early stages. However, despite being available for nearly 60 years, the test can hardly be considered to have become successfully applied in many communities. We aimed in this study to present the results of a screening survey for cervical cancer which targeted a women population aged between 35 and 40 living in a semi-rural area in the province of Hatay, located in the eastern Mediterranean region of Turkey, with specific aims of increasing early diagnosis, education and raising population awareness about cancers. This community-based descriptive study covered 512 women between 35 and 40 years of age living at Armutlu with a mean age of 37.6±1.7. Gynecologic examinations revealed cervical erosion in 8 (1.6%), vaginitis in 193 (37.7%) and normal findings in 311 (60.7%); pathological evaluation reports of the smears were negative in 290 (56.6%), inflammation in 218 (42.6%) and ASC-US in 4 (0.8%), according to the 2001 Bethesda classification. It can be concluded that Pap smear test - proven to be a very valuable test at the clinical level- should also be widely used at the community level to detect cervical cancer at very early stages to reduce both the mortality and morbidity among healthy people. The need for continuous community-based cervical cancer screening programs is strongly suggested.

  4. Screening and detection of blunt vertebral artery injury in patients with upper cervical fractures: The role of cervical CT and CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Payabvash, Seyedmehdi, E-mail: spayab@gmail.com [Department of Radiology, University of Minnesota Medical Center, Minneapolis, MN (United States); McKinney, Alexander M., E-mail: mckinrad@umn.edu [Department of Radiology, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN (United States); McKinney, Zeke J., E-mail: zeke.mckinney@hcmed.org [Department of Radiology, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN (United States); Palmer, Christopher S., E-mail: palme018@umn.edu [Department of Radiology, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN (United States); Truwit, Charles L., E-mail: truwit@umn.edu [Department of Radiology, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN (United States)

    2014-03-15

    Objective: To evaluate the clinical utility of nonenhanced CT (NECT)-based screening criteria and CTA in detection of blunt vertebral artery injury (BVAI) in trauma patients with C1 and/or C2 fractures. Methods: We retrospectively reviewed the clinical records of all blunt trauma patients with C1 and/or C2 fractures between 8/2006 and 9/2011. Cervical CTA was prompted by cervical fractures involving/adjacent to a transverse foramen, and/or subluxation on NECT. Two neuroradiologists independently reviewed the CTA studies, and graded the BVAI. Results: 210 patients were included; of these, 124 underwent CTA (21/124 with digital subtraction angiography, DSA), and 2 underwent DSA only. Overall, 30/126 suffered BVAI. Among 21 patients who underwent both CTA and DSA, there was 1 false negative and 1 false positive (both grade 1). There was strong interobserver agreement regarding CTA-based BVAI detection (kappa = 0.93, p < 0.001) and grading (kappa = 0.90, p < 0001). Only 3/30 BVAI patients suffered a posterior circulation stroke; none of the patients who had a negative CTA or were not selected for CTA, based on NECT screening criteria, suffered symptomatic stroke. While C1/C2 comminuted fracture was more common in patients with high grade BVAI (p = 0.039), simultaneous C3–C7 comminuted fracture increased the overall BVAI risk (p = 0.011). Conclusion: CTA reliably detects symptomatic BVAI in patients with upper cervical fractures. Utilization of NECT-based screening criteria such as transverse foraminal involvement or subluxation may be adequate in deciding whether to perform CTA, as no patients who were not selected for CTA suffered a symptomatic stroke. However, CTA may miss lower grade, asymptomatic BVAI.

  5. Visual inspection with acetic acid (via screening program: 7 years experience in early detection of cervical cancer and pre-cancers in rural South India

    Directory of Open Access Journals (Sweden)

    Usha Rani Poli

    2015-01-01

    Full Text Available Cervical cancer continues to be a major public health problem in India in the absence of wide spread organised cervical screening programs. Visual inspection of the cervix with acetic acid (VIA is an effective, inexpensive screening test that can be combined with simple treatment procedures for early cervical lesions, provided by trained health workers. We report 7 years experience in early detection of cervical cancer and pre-cancers using the VIA test in a community-based program in rural Andhra Pradesh, India where there are no existing organised cervical screening programs. Materials and Methods: Eligible women aged between 26 and 60 were opportunistically screened by trained health wor kers using the VIA test. Women who tested positive were further evaluated and those with cervical lesions were treated either by cryotherapy in the screening clinic or referred to a higher center. Results: A total of 18,869 women were screened by a single round of VIA testing with a positive rate of 10.75%. Biopsy proven high-grade squamous intraepithelials (HSILs were 90 (0.48% and low-grade squamous intraepithelials (LSILs were 43 (0.28%. The overall prevalence of cervical intraepithelial neoplasia (CIN 2+ lesion rate is 1.05%. A total of 312 (1.65% cryotherapies were done and 49 women underwent hysterectomy. Conclusions: VIA by trained female health workers is a safe, acceptable, and effective test that can save lives from cervical cancer even in remote areas with few resources. These results have important implications for efficient service delivery in cervical screening programs in low-resourced settings.

  6. Knowledge, practices and education of clients on cervical cancer screening among female health care workers in Plateau State Nigeria

    Directory of Open Access Journals (Sweden)

    P M Utoo

    2011-01-01

    Full Text Available Background: Most patients with cancer of the cervix present late with poor prognosis. Health workers′ knowledge and utilization of the screening services might influence their clients. The aim of this study was to determine the knowledge, practice and education of clients on cervical cancer and its screening among female healthcare workers in plateau state. Material and Methods: This was a cross-sectional survey of 182 female healthcare workers in selected Primary Healthcare Centres (PHC in Plateau state Nigeria. Semi-structured, self- administered questionnaires were used to obtain data which was analyzed using Epi info statistical software version 3.3.2 Results: Those aware of cancer of the cervix comprised of Community Health Extension Workers (44.0% and Nurse/ Midwives (17.6% among others. Human Papilloma Virus (HPV, multiple sexual partners and early sexual intercourse were among the cited risk factors. Although, 136(87.2% of the "aware" respondents accepted that cancer of the cervix could be prevented, 33.8% of them could not identify regular cervical screening as a preventive strategy. Similarly, 140(89% knew about the cervical cancer screening but only 12(8.6% had actually been screened (p < 0.005. Additionally, only 40% of the "aware" respondents had ever educated their clients. Conclusion: The knowledge and practice of the health workers about cancer of the cervix has not been commensurately translated to utilization of screening services or education of clients. Strategies such as seminars and workshops to train as well as motivate health workers towards the utilization of screening services should be explored.

  7. Are treatments for cervical precancerous lesions in less-developed countries safe enough to promote scaling-up of cervical screening programs? A systematic review

    Directory of Open Access Journals (Sweden)

    Stringer Jeffrey SA

    2010-04-01

    Full Text Available Abstract Background Since the mid-1990s, there have been growing efforts to prevent cervical cancer in less-developed countries through the development of innovative screening approaches such as visual inspection of the cervix associated with same day management of cervical lesions with cryotherapy or loop electrosurgical excision procedure (LEEP. In the past, promising cancer screening interventions have been widely promoted despite incomplete evidence, only to become the subject of intense controversies about ensuing net health benefit. Because the efficacy and effectiveness of the new protocols for global cervical cancer screening have not been well characterized yet, and as a contribution to the evaluation of the balance between the benefits and risks of these protocols, we reviewed the literature on the safety of cryotherapy and LEEP for cervical intraepithelial neoplasia (CIN in low- and middle-income countries. Methods We searched 12 databases (Medline, Google Scholar, Scopus, Cochrane Library, Web of Science, OCLC, PAIS International Database, WHO Global Health Library, CINAHL, Science.gov, NYAM Grey Literature Report, and POPLINE for original research published between January 1995 and April 2009. Both peer-reviewed publications and items of "grey" literature were retrieved; no language restriction was applied. We calculated the median (minimum, maximum reported rate for each harm considered. Because of limitations and heterogeneity in the data, no formal meta-analysis was performed. Results The search identified 32 articles that reported safety data from 24 cryotherapy and LEEP studies. The combined sample consisted of 6,902 women treated by cryotherapy and 4,524 women treated by LEEP. Most studies were conducted in reference or research settings in Asia and Africa. Short-term harms of cryotherapy and LEEP appeared to be similar to those described in the literature from high-income countries. Information was sparse on HIV-related harms

  8. Smartphone Use for Cervical Cancer Screening in Low-Resource Countries: A Pilot Study Conducted in Madagascar.

    Directory of Open Access Journals (Sweden)

    Rosa Catarino

    Full Text Available Visual inspection of the cervix after application of 5% acetic acid (VIA is a screening technique for cervical cancer used widely in low and middle-income countries (LMIC. To improve VIA screening performance, digital images after acid acetic application (D-VIA are taken. The aim of this study was to evaluate the use of a smartphone for on- and off-site D-VIA diagnosis.Women aged 30-65 years, living in the city of Ambanja, Madagascar, were recruited through a cervical cancer screening campaign. Each performed a human papillomavirus (HPV self-sample as a primary screen. Women testing positive for HPV were referred for VIA followed by D-VIA, cervical biopsy and endocervical curettage according to routine protocol. In addition, the same day, the D-VIA was emailed to a tertiary care center for immediate assessment. Results were scored as either D-VIA normal or D-VIA abnormal, requiring immediate therapy or referral to a tertiary center. Each of the three off-site physicians were blinded to the result reported by the one on-site physician and each gave their individual assessment followed by a consensus diagnosis. Statistical analyses were conducted using STATA software.Of the 332 women recruited, 137 (41.2% were HPV-positive and recalled for VIA triage; compliance with this invitation was 69.3% (n = 95. Cervical intraepithelial neoplasia was detected in 17.7% and 21.7% of digital images by on-site and off-site physicians, respectively. The on-site physician had a sensitivity of 66.7% (95%CI: 30.0-90.3 and a specificity of 85.7% (95%CI: 76.7-91.6; the off-site physician consensus sensitivity was 66.7% (95%CI: 30.0-90.3 with a specificity of 82.3% (95%CI: 72.4-89.1.This pilot study supports the use of telemedicine for off-site diagnosis of cervical intraepithelial neoplasia, with diagnostic performance similar to those achieved on-site. Further studies need to determine if smartphones can improve cervical cancer screening efficiency in LMIC.

  9. Incomplete follow-up of positive HPV tests: overview of randomised controlled trials on primary cervical screening

    DEFF Research Database (Denmark)

    Rebolj, M; Lynge, E

    2010-01-01

    Background:It has been suggested that adjustment for incomplete compliance with follow-up in women with positive human papillomavirus (HPV) tests would be appropriate for estimating the true sensitivity of cervical screening with HPV testing. We assessed the compliance and its impact on >/=CIN3...... for colposcopy was around 90% in all RCTs, whereas compliance with repeated testing among HPV-positive/cytology-negative women was around 60% in three RCTs and 73% in one RCT. Detection of >/=CIN3 was significantly increased in two out of six RCTs with reported data. The correlation between compliance...... with follow-up in HPV-positive women and relative >/=CIN3 detection was 0.48 (P=0.33).Conclusion:There is at present scant evidence to support the view that the measured sensitivity of HPV screening is a simple reflection of compliance with follow-up. Adjustment of measured cervical intraepithelial neoplasia...

  10. Does the Neighborhood Area of Residence Influence Non-Attendance in an Urban Mammography Screening Program? A Multilevel Study in a Swedish City

    Science.gov (United States)

    Lagerlund, Magdalena; Merlo, Juan; Vicente, Raquel Pérez; Zackrisson, Sophia

    2015-01-01

    Background and aim The public health impact of population-based mammography screening programs depends on high participation rates. Thus, monitoring participation rates, as well as understanding and considering the factors influencing attendance, is important. With the goal to acquire information on the appropriate level of intervention for increasing screening participation our study aimed to (1) examine whether, over and above individual factors, the neighborhood of residence influences a woman’s mammography non-attendance, and (2) evaluate, whether knowing a woman’s neighborhood of residence would be sufficient to predict non-attendance. Methods We analyze all women invited to mammography screening in 2005–09, residing in the city of Malmö, Sweden. Information regarding mammography screening attendance was linked to data on area of residence, demographic and socioeconomic characteristics available from Statistics Sweden. The influence of individual and neighborhood factors was assessed by multilevel logistic regression analysis with 29,901 women nested within 212 neighborhoods. Results The prevalence of non-attendance among women was 18.3%. After adjusting for individual characteristics, the prevalence in the 212 neighborhoods was 3.6%. Neighborhood of residence had little influence on non-attendance. The multilevel analysis indicates that 8.4% of the total individual differences in the propensity of non-attendance were at the neighborhood level. However, when adjusting for specific individual characteristics this general contextual effect decreased to 1.8%. This minor effect was explained by the sociodemographic characteristic of the neighborhoods. The discriminatory accuracy of classifying women according to their non-attendance was 0.747 when considering only individual level variables, and 0.760 after including neighborhood level as a random effect. Conclusion Our results suggest that neighborhoods of residence in Malmö, Sweden (as defined by small

  11. HPV-Based Screening, Triage, Treatment, and Followup Strategies in the Management of Cervical Intraepithelial Neoplasia

    Directory of Open Access Journals (Sweden)

    Oscar Peralta-Zaragoza

    2013-01-01

    Full Text Available Cervical cancer is the second most common cause of death from cancer in women worldwide, and the development of new diagnostic, prognostic, and treatment strategies merits special attention. Many efforts have been made to design new drugs and develop immunotherapy and gene therapy strategies to treat cervical cancer. HPV genotyping has potentially valuable applications in triage of low-grade abnormal cervical cytology, assessment of prognosis and followup of cervical intraepithelial neoplasia, and in treatment strategies for invasive cervical cancer. It is known that during the development of cervical cancer associated with HPV infection, a cascade of abnormal events is induced, including disruption of cellular cycle control, alteration of gene expression, and deregulation of microRNA expression. Thus, the identification and subsequent functional evaluation of host proteins associated with HPV E6 and E7 oncoproteins may provide useful information in understanding cervical carcinogenesis, identifying cervical cancer molecular markers, and developing specific targeting strategies against tumor cells. Therefore, in this paper, we discuss the main diagnostic methods, management strategies, and followup of HPV-associated cervical lesions and review clinical trials applying gene therapy strategies against the development of cervical cancer.

  12. 宫颈细胞DNA定量分析系统用于宫颈癌筛查的临床意义%The clinical significance of quantitative analysis of cervical cellular DNA in cervical cancer screening

    Institute of Scientific and Technical Information of China (English)

    钟培根; 李末娟

    2011-01-01

    Objective: To discuss the clinical significance of quantitative analysis of cellular DNA combined with hquidbased cytology in cervical cancer screening.Methods: 5 886 cases attending cervical cancer screening from October 2009 to April 2010 in our hospital were given quantitative analysis of celhdar DNA and liquid-based cytology.The cases whose results exceeding LSIL in cytological diagnosis or exceeding 3 heteroploid cells in quantitative analysis of cellular DNA were suggested to make a biopsy of histopathology of cervical celhdar, with the results of pathological diagnosis as a standard.Results: 285 cases were diagnosed positive by liquid-based cytology and 486 cases were diagnosed positive by quantitative analysis of cellular DNA, each positive diagnosis rate was 4.84% (285/5 886) and 8.25% (486/5 886).525 cases were diagnosed positive by quantitative analysis of cellular DNA and liquid-based cytology, the positive diagnosis rate of which was 8.92% (525/5 886).525 cases were made biopsyofcervix, among which, 375 cases were diagnosed positive, the positive diagnosis rate was 71.4% (375/525).Conclusion: Quantitative analysis of cellular DNA combined with liquid-based cytology can enhance the positive rate of cervical cancer screening obviously%目的:探讨宫颈细胞DNA定量分析结合液基细胞学诊断方法进行宫颈癌筛查的临床意义.方法:对2009年10月~2010年4月参加我院宫颈癌筛查的5 886例妇女,进行液基细胞学检查和细胞DNA定量分析诊断,在细胞学诊断≥低度鳞状上皮内病变或细胞DNA分析有≥3个异倍体细胞,建议做宫颈病理组织学活检,以病理诊断结果为标准.结果:液基细胞学诊断阳性285例,阳性率为4.84%(285/5 886);细胞DNA异倍体检出阳性486例,检出率为8.25%(486/5 886);细胞DNA定量分析结合液基细胞学诊断检出阳性525例,总阳性率为8.92%(525/5 886).525例患者需做宫颈组织活检,活检结果:阳性375例,阳性率为71

  13. Effects of Application of Social Marketing Theory and the Health Belief Model in Promoting Cervical Cancer Screening among Targeted Women in Sisaket Province, Thailand.

    Science.gov (United States)

    Wichachai, Suparp; Songserm, Nopparat; Akakul, Theerawut; Kuasiri, Chanapong

    2016-01-01

    Cervical cancer is a major public health problem in Thailand, being ranked second only to breast cancer. Thai women have been reported to have a low rate of cervical cancer screening (27.7% of the 80% goal of WHO). We therefore aimed to apply the social marketing theory and health belief model in promoting cervical cancer screening in Kanthararom District, Sisaket Province. A total of 92 from 974 targeted women aged 3060 years were randomly divided into two groups. The experimental group underwent application of social marketing theory and a health belief model program promoting cervical cancer screening while the control group received normal services. Two research tools were used: (1) application of social marketing theory and health belief model program and (2) questionnaire used to evaluate perceptions of cervical cancer. Descriptive and inferential statistics including paired sample ttest and independent ttest were used to analyze the data. After the program had been used, the mean score of perception of cervical cancer of experimental group was at a higher level (x=4.09; S.D. =0.30), than in the control group (x=3.82; S.D. =0.20) with statistical significance (psocial marketing and the health belief model be used to promote cervical cancer screening in targeted women and it can be promoted as a guideline for other health services, especially in health promotion and disease prevention.

  14. Prevalence of human papillomavirus infection among women presenting for cervical cancer screening in Chile, 2014-2015.

    Science.gov (United States)

    Balanda, Monserrat; Quiero, Andrea; Vergara, Nicolás; Espinoza, Gloria; Martín, Héctor San; Rojas, Giovanna; Ramírez, Eugenio

    2016-12-01

    Cervical cancer is the fourth most common malignancy in women worldwide. In Chile, cervical cancer is the second leading cause of death among women of reproductive age, causing more than 600 deaths annually. This study was carried out to determine the burden and confirm the predominant human papillomavirus (HPV) genotypes among women presenting for cervical cancer screening in public health services in Chile. Women aged 18-64 years residing in the north and central areas covered by six primary care centers of Santiago, Chile, were invited to participate from March 2014 to August 2015. Cervical swabs were examined both HPV genotyping by PCR and Reverse Line Blot, and cervical cytology by Pap testing. A total of 1738 women were included in this study: 11.1 % were HPV positive, 9.7 % were high-risk types positive, 3.2 % were low-risk types positive, 1.4 % were Pap positive and 0.9 % were positive by both tests. The four most predominant genotypes were 16, 66, 51 and 59, with prevalence of 2.8, 1.4, 1.2 and 1.2 %, respectively. Multiple HPV infections were detected among 3.8 % participants. Age-specific prevalence of HPV showed a peak in HPV infection at younger ages (≤30 years), declining to a plateau in middle age. Among women with normal cytology, the 9.4 % were HPV positive, while 58.3 % of women with abnormal cytology were HPV positive. These findings show new epidemiological data confirming HPV 16 and 66 as the most predominant genotypes in Chile. These data are important for design successful strategies for prevention of cervical cancer in Chile.

  15. Implementing visual cervical cancer screening in Senegal: a cross-sectional study of risk factors and prevalence highlighting service utilization barriers

    Science.gov (United States)

    Dykens, J Andrew; Linn, Annē M; Irwin, Tracy; Peters, Karen E; Pyra, Maria; Traoré, Fatoumata; Touré Diarra, Mariama; Hasnain, Memoona; Wallner, Katie; Linn, Patrick; Ndiaye, Youssoupha

    2017-01-01

    Background Senegal ranks 15th in the world in incidence of cervical cancer, the number one cause of cancer mortality among women in this country. The estimated participation rate for cervical cancer screening throughout Senegal is very low (6.9% of women 18–69 years old), especially in rural areas and among older age groups (only 1.9% of women above the age of 40 years). There are no reliable estimates of the prevalence of cervical dysplasia or risk factors for cervical dysplasia specific to rural Senegal. The goals of this study were to estimate the prevalence of cervical dysplasia in a rural region using visual inspection of the cervix with acetic acid (VIA) and to assess risk factors for cervical cancer control. Patients and methods We conducted a cross-sectional study in which we randomly selected 38 villages across the Kédougou region using a three-stage clustering process. Between October 2013 and March 2014, we collected VIA screening results for women aged 30–50 years and cervical cancer risk factors linked to the screening result. Results We screened 509 women; 5.6% of the estimated target population (9,041) in the region. The point prevalence of cervical dysplasia (positive VIA test) was 2.10% (95% confidence interval [CI]: 0.99–3.21). Moreover, 287 women completed the cervical cancer risk factor survey (56.4% response rate) and only 38% stated awareness of cervical cancer; 75.9% of the screened women were less than 40 years of age. Conclusion The overall prevalence of dysplasia in this sample was lower than anticipated. Despite both overall awareness and screening uptake being less than expected, our study highlights the need to address challenges in future prevalence estimates. Principally, we identified that the highest-risk women are the ones least likely to seek screening services, thus illustrating a need to fully understand demand-side barriers to accessing health services in this population. Targeted efforts to educate and motivate older

  16. Colposcopy and High Resolution Anoscopy in Screening For Anal Dysplasia in Patients With Cervical, Vaginal, or Vulvar Dysplasia or Cancer

    Science.gov (United States)

    2012-06-08

    Cervical Intraepithelial Neoplasia Grade 1; Cervical Intraepithelial Neoplasia Grade 2; Cervical Intraepithelial Neoplasia Grade 3; Recurrent Cervical Cancer; Recurrent Vaginal Cancer; Recurrent Vulvar Cancer; Stage 0 Cervical Cancer; Stage 0 Vaginal Cancer; Stage 0 Vulvar Cancer; Stage I Vaginal Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Vaginal Cancer; Stage III Vulvar Cancer; Stage IV Vulvar Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer

  17. Automation-assisted cervical cancer screening in manual liquid-based cytology with hematoxylin and eosin staining.

    Science.gov (United States)

    Zhang, Ling; Kong, Hui; Ting Chin, Chien; Liu, Shaoxiong; Fan, Xinmin; Wang, Tianfu; Chen, Siping

    2014-03-01

    Current automation-assisted technologies for screening cervical cancer mainly rely on automated liquid-based cytology slides with proprietary stain. This is not a cost-efficient approach to be utilized in developing countries. In this article, we propose the first automation-assisted system to screen cervical cancer in manual liquid-based cytology (MLBC) slides with hematoxylin and eosin (H&E) stain, which is inexpensive and more applicable in developing countries. This system consists of three main modules: image acquisition, cell segmentation, and cell classification. First, an autofocusing scheme is proposed to find the global maximum of the focus curve by iteratively comparing image qualities of specific locations. On the autofocused images, the multiway graph cut (GC) is performed globally on the a* channel enhanced image to obtain cytoplasm segmentation. The nuclei, especially abnormal nuclei, are robustly segmented by using GC adaptively and locally. Two concave-based approaches are integrated to split the touching nuclei. To classify the segmented cells, features are selected and preprocessed to improve the sensitivity, and contextual and cytoplasm information are introduced to improve the specificity. Experiments on 26 consecutive image stacks demonstrated that the dynamic autofocusing accuracy was 2.06 μm. On 21 cervical cell images with nonideal imaging condition and pathology, our segmentation method achieved a 93% accuracy for cytoplasm, and a 87.3% F-measure for nuclei, both outperformed state of the art works in terms of accuracy. Additional clinical trials showed that both the sensitivity (88.1%) and the specificity (100%) of our system are satisfyingly high. These results proved the feasibility of automation-assisted cervical cancer screening in MLBC slides with H&E stain, which is highly desirable in community health centers and small hospitals.

  18. Accuracy of visual inspection with acetic acid and with Lugol's iodine for cervical cancer screening: Meta-analysis.

    Science.gov (United States)

    Qiao, Liang; Li, Bo; Long, Mei; Wang, Xiao; Wang, Anrong; Zhang, Guonan

    2015-09-01

    The aim of this review was to provide an updated summary estimation of the accuracy of visual inspection with acetic acid (VIA) and with Lugol's iodine (VILI) in detecting cervical cancer and precancer. Studies on VIA/VILI accuracy were eligible in which VIA/VILI was performed on asymptomatic women who all underwent confirmatory testing of histology, combination of colposcopy and histology, or combination of multiple screening tests, colposcopy and histology, to detect cervical intraepithelial neoplasia grade 2 or worse (CIN2+ or CIN3+). A bivariate model was fitted to estimate the accuracy of VIA/VILI and provide estimates of heterogeneity. Subgroup analysis was used to investigate the source of heterogeneity. A total of 29 studies on VIA and 19 studies on VILI were included finally in the meta-analysis. The summary sensitivity and specificity of VIA for CIN2+ were 73.2% (95%CI: 66.5-80.0%) and 86.7% (95%CI: 82.9-90.4%), respectively, and those for VILI were 88.1% (95%CI: 81.5-94.7%) and 85.9% (95%CI: 81.7-90.0%), respectively. VIA and VILI were both more sensitive in detecting more severe outcome, although there was a slight loss in specificity. Apparent heterogeneity existed in sensitivity and specificity for both VIA and VILI. High sensitivity of both VIA and VILI for CIN2+ was found when a combination of colposcopy and histology was used as disease confirmation. VIA, VILI, even a combination of them in parallel, could be good options for cervical screening in low-resource settings. Significant differences in sensitivity between different gold standards might provide a proxy for optimization of ongoing cervical cancer screening programs.

  19. [Health technology assessment report. Use of liquid-based cytology for cervical cancer precursors screening].

    Science.gov (United States)

    Ronco, Guglielmo; Confortini, Massimo; Maccallini, Vincenzo; Naldoni, Carlo; Segnan, Nereo; Sideri, Mario; Zappa, Marco; Zorzi, Manuel; Calvia, Maria; Giorgi Rossi, Paolo

    2012-01-01

    OBJECTIVE OF THE PROJECT: Purpose of this Report is to evaluate the impact of the introduction of liquid-based cytology (LBC) in cervical cancer screening in terms of efficacy, undesired effects, costs and implications for organisation. EFFICACY AND UNDESIRED EFFECTS: LBC WITH MANUAL INTERPRETATION: The estimates of cross-sectional accuracy for high-grade intraepithelial neoplasia (CIN2 or more severe and CIN3 or more severe) obtained by a systematic review and meta-analysis published in 2008 were used. This review considered only studies in which all women underwent colposcopy or randomised controlled trials (RCTs) with complete verification of test positives. A systematic search of RCTs published thereafter was performed. Three RCTs were identified. One of these studies was conducted in 6 Italian regions and was of large size (45,174 women randomised); a second one was conducted in another Italian region (Abruzzo) and was of smaller size (8,654 women randomised); a third RCT was conducted in the Netherlands and was of large size (89,784 women randomised). No longitudinal study was available. There is currently no clear evidence that LBC increases the sensitivity of cytology and even less that its introduction increases the efficacy of cervical screening in preventing invasive cancers. The Italian randomised study NTCC showed a decrease in specificity, which was not observed in the other two RCTs available. In addition, the 2008 meta-analysis observed a reduction - even if minimal - in specificity just at the ASC-US cytological cut-off, but also a remarkable heterogeneity between studies. These results suggest that the effect of LBC on specificity is variable and plausibly related to the local style of cytology interpretation. There is evidence that LBC reduces the proportion of unsatisfactory slides, although the size of this effect varies remarkably. LBC WITH COMPUTER-ASSISTED INTERPRETATION: An Australian study, based on double testing, showed a statistically

  20. Cervical Cancer Screening in the US–Mexico Border Region: A Binational Analysis

    Science.gov (United States)

    Schiefelbein, Emily L.; Smith, Ruben; Rojas, Rosalba; Mirchandani, Gita G.; McDonald, Jill A.

    2015-01-01

    Cervical cancer mortality is high along the US–Mexico border. We describe the prevalence of a recent Papanicolaou screening test (Pap) among US and Mexican border women. We analyzed 2006 cross-sectional data from Mexico’s National Survey of Health and Nutrition and the US Behavioral Risk Factor Surveillance System. Women aged 20–77 years in 44 US border counties (n = 1,724) and 80 Mexican border municipios (n = 1,454) were studied. We computed weighted proportions for a Pap within the past year by age, education, employment, marital status, health insurance, health status, risk behaviors, and ethnicity and adjusted prevalence ratios (APR) for the US, Mexico, and the region overall. Sixty-five percent (95 %CI 60.3–68.6) of US women and 32 % (95 %CI 28.7–35.2) of Mexican women had a recent Pap. US residence (APR = 2.01, 95 %CI 1.74–2.33), marriage (APR = 1.31, 95 %CI 1.17–1.47) and insurance (APR = 1.38, 95 %CI 1.22–1.56) were positively associated with a Pap test. Among US women, insurance and marriage were associated (APR = 1.21, 95 %CI 1.05–1.38 and 1.33, 95 %CI 1.10–1.61, respectively), and women aged 20–34 years were about 25 % more likely to have received a test than older women. Insurance and marriage were also positively associated with Pap testing among Mexican women (APR = 1.39, 95 %CI 1.17–1.64 and 1.50; 95 %CI 1.23–1.82, respectively), as were lower levels of education (≤8th grade or 9th–12th grade versus some college) (APR = 1.74; 95 %CI 1.21–2.52 and 1.60; 95 %CI 1.03–2.49, respectively). Marriage and insurance were associated with a recent Pap test on both sides of the border. Binational insurance coverage increases and/or cost reductions might bolster testing among unmarried and uninsured women, leading to earlier cervical cancer diagnosis and potentially lower mortality. PMID:22965734

  1. Prevalência do HPV em mulheres rastreadas para o câncer cervical Prevalence of genital HPV infection among women screened for cervical cancer

    Directory of Open Access Journals (Sweden)

    Cristina Helena Rama

    2008-02-01

    Full Text Available OBJETIVO: Analisar a prevalência da infecção genital por papilomavírus humano (HPV de alto risco por faixa etária e fatores associados. MÉTODOS: Estudo transversal com amostra de 2.300 mulheres (15-65 anos que buscaram rastreamento para o câncer cervical entre fevereiro de 2002 e março de 2003 em São Paulo e Campinas, estado de São Paulo. Aplicou-se questionário epidemiológico e realizou-se coleta cervical para citologia oncológica e teste de captura híbrida II. As análises estatísticas empregadas foram teste de qui-quadrado de Pearson e análise multivariada pelo método forward likelihood ratio. RESULTADOS: A prevalência total da infecção genital por HPV de alto risco foi de 17,8%, distribuída nas faixas etárias: 27,1% (OBJECTIVE: To assess the prevalence of high-risk genital human papillomavirus (HPV infection by age group and risk factors associated. METHODS: Cross-sectional study in a sample of 2,300 women (15-65 years old who self-referred to cervical cancer screening in Sao Paulo and Campinas, Southeastern Brazil, between February 2002 and March 2003. An epidemiological questionnaire was applied and cervical specimens were obtained for cytology and hybrid capture II test (HCII for HPV detection. Statistical analysis included Pearson Chi-square and unconditional multiple logistic regression model (forward likelihood ratio. RESULTS: High-risk genital HPV infection prevalence in this sample was 17.8% and age distribution was as follows: 27.1% (<25 years, 21.3% (25-34 years, 12.1% (35-44 years, 12.0% (45-54 years and 13.9% (55-65 years. Subjects with the highest number of lifetime sexual partners had the highest rates of genital HPV infection. To be living with a partner, aged 35 to 44 years, and former smokers were protective factors. High-risk genital HPV infection was 14.3% in normal cytology, 77.8% in high grade squamous intraepithelial lesions and in the two cases (100% of cervical cancer. CONCLUSIONS: High-risk HPV

  2. A Proof of Concept Imaging System for Automated Cervical Cancer Screening in Peru

    Science.gov (United States)

    Raza Garcia, Mabel Karel

    2013-01-01

    Cervical cancer is the second most frequent cancer in women around the world and affects half a million women per year. The World Health Organization (WHO) estimates that 275,000 women die every year, and 80% to 85% of these deaths occur in low-resource countries in Africa and South America. In Peru, cervical cancer has the highest incidence and…

  3. Cervical cytology screening among low-income, minority adolescents in New York City following the 2009 ACOG guidelines

    Science.gov (United States)

    Tsui, Jennifer; Hofstetter, Annika M.; Soren, Karen

    2014-01-01

    Objectives In December 2009, the American College of Obstetricians and Gynecologists recommended cervical cancer screening begin at age 21 for young women. In this study, we examine receipt of first lifetime Papanicolaou (Pap) test and predictors of over-screening among adolescents within a large urban ambulatory care network. Methods We compared the proportion of first lifetime Pap test of adolescents aged 13-20 years between June 2007-November 2009 (n=7700) and December 2009-June 2012 (n=9637) using electronic health records. We employed multivariable regression models to identify demographic and health care factors associated with receiving a first lifetime Pap test at age <21 years in the post-guideline period (over-screening). Results The proportion of Pap tests declined from 19.3% to 4.2% (p <0.001) between the two periods. Multivariable logistic regression results showed receiving care from gynecology/obstetrics/family planning clinics compared to pediatric clinics, having more clinic encounters, and older age were associated with over-screening in the post-guideline period. Conclusions We found that guideline adherence differed by clinic type, insurance status, and health care encounters. In the quickly evolving field of cervical cancer control, it is important to monitor practice trends as they relate to shifts in population-based guidelines, especially in high-risk populations. PMID:24650625

  4. [Assessment of the cervical cancer screening in the Family Health Strategy in Amparo, São Paulo State, Brazil].

    Science.gov (United States)

    Vale, Diama Bhadra Andrade Peixoto do; Morais, Sirlei Siani; Pimenta, Aparecida Linhares; Zeferino, Luiz Carlos

    2010-02-01

    Uterine cervical cancer mortality has not been declining. The territorial distribution and registration of families in Brazil's Family Health Strategy help identify women that have performed a Pap smear or that have not had one for more than three years. This study analyzed whether cervical cancer screening in Amparo, São Paulo State, Brazil, made progress in complying with the prevailing guidelines during the seven years of experience with the Strategy. The annual examination rate remained high, with a slight trend towards greater intervals between follow-up tests. Distribution of tests tended to increase in the 40-59-year age bracket and decrease in the over-60 age group, while annual coverage tended to decrease. The proportions of excess tests varied from 61.2% to 65.5%. Concluding, the upgrading of cervical cancer screening was slight, and did not change the opportunistic pattern of follow-up tests. Considering that community health agents can act to increase the coverage of these measures, it is essential to train them for this work.

  5. Racial and ethnic differences in personal cervical cancer screening amongst post-graduate physicians: Results from a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Ross Joseph S

    2008-10-01

    Full Text Available Abstract Background Racial and ethnic disparities in cervical cancer screening have been attributed to socioeconomic, insurance, and cultural differences. Our objective was to explore racial and ethnic differences in adherence to cervical cancer screening recommendations among female post-graduate physicians. Methods We conducted a cross-sectional survey at one university hospital among a convenience sample of 204 female post-graduate physicians (52% of all potential participants, examining adherence to United States Preventive Services Task Force cervical cancer screening recommendations, perception of adherence to recommendations, and barriers to obtaining care. Results Overall, 83% of women were adherent to screening recommendations and 84% accurately perceived adherence or non-adherence. Women who self-identified as Asian were significantly less adherent when compared with women who self-identified as white (69% vs. 87%; Relative Risk [RR] = 0.79, 95% Confidence Interval [CI], 0.64–0.97; P Conclusion Among a small group of insured, highly-educated physicians who have access to health care, we found racial and ethnic differences in adherence to cervical cancer screening recommendations, suggesting that culture may play a role in cervical cancer screening.

  6. Impact of technology on cytology outcome in cervical cancer screening of young and older women.

    Science.gov (United States)

    Rask, J; Lynge, E; Franzmann, M; Hansen, B; Hjortebjerg, A; Rygaard, C; Schledermann, D; Wåhlin, A; Rebolj, M

    2014-05-01

    Little is known about age-dependent variation in outcomes of cervical cytology with modern technologies. This population-based study evaluated age-dependent changes after routine implementation of ThinPrep and SurePath technology in two independent laboratories, and controlled for time trends in a third laboratory using manually read conventional cytology continually. Data were collected from the Danish National Health Care Registers. For each laboratory, we compared proportions of abnormal cytology defined as atypical squamous cells of undetermined significance or worse (ASCUS+) by age and technology phase. The study included 489,960 cytological samples with no recent abnormality from women aged 23-59 years, routinely screened between 1998 and 2007. Implementation of SurePath liquid-based cytology (LBC) was followed by an increase in abnormal cytology in women aged 23-29 years from 4.6 to 6.1%, relative proportion (RP): 1.31 [95% confidence interval (CI): 1.08-1.61], and a decrease in women aged 45-59 years from 2.9 to 2.0%, RP: 0.71 (95% CI: 0.60-0.83). Implementation of ThinPrep LBC was followed by a decrease in abnormal cytology both in women aged 23-29 years from 7.7 to 6.8%, RP: 0.89 (95% CI: 0.78-1.02) and in women aged 45-59 years from 3.4 to 1.0%, RP: 0.30 (95% CI: 0.24-0.37). With implementation of imaging-assisted reading, regardless of the brand of technology, the proportion of abnormality increased by around 30% in all age groups (range from 19 to 41%). In the laboratory with unchanged technology no trends in abnormality proportions were observed. The impact of LBC implementation on cytological abnormality proportions varied considerably across age groups.

  7. Comparison of conventional Papanicolaou smear and SurePath® liquid-based cytology in the Copenhagen population screening programme for cervical cancer

    DEFF Research Database (Denmark)

    Kirschner, Benny; Simonsen, Kåre; Junge, Jette

    2006-01-01

    OBJECTIVE: To compare diagnostic performance of conventional Papanicolaou smear with SurePath liquid-based cytology in a population screening programme. METHODS: A retrospective comparison was performed on data from two 18-month periods of the screening programme for cervical cancer...

  8. Women's experiences with cervical cancer screening in a colposcopy referral clinic in Cape Town, South Africa: a qualitative analysis

    Science.gov (United States)

    Momberg, Mariette; Botha, Matthys H; Van der Merwe, Frederick H; Moodley, Jennifer

    2017-01-01

    Objective The aim of this study was to explore and understand women's experience with cervical cancer screening and with the referral pathways for abnormal Papanicolau (Pap) smears. Design and setting Focus group discussions were conducted with first time colposcopy clinic attendees at a tertiary hospital colposcopy clinic in Cape Town, South Africa during November 2014. A thematic analysis was conducted to identify key themes. Initial coding categories were drawn from the interview guide. Participants 27 women participated in 4 focus group discussions. Results Participants mean age was 34 years, most did not complete secondary level education and were unemployed. Negative community opinions relating to Pap smears and colposcopy referral might deter women from seeking treatment. Having a gynaecological symptom was the most commonly cited reason for having a Pap smear. Fear of having a HIV test performed at the same time as Pap smear and low encouragement from peers, were factors identified as potential access barriers. Participants commented on insufficient or lack of information from primary providers on referral to the colposcopy clinic and concerns and apprehension during waiting periods between receiving results and the colposcopy appointment were discussed. Conclusions There is a strong and urgent need to improve current knowledge about cervical cancer and Pap smears and the necessity and benefits of timely access to screening programmes, results and treatment. Strategies such as community health education programmes and mass media interventions could be employed to disseminate cervical cancer information and address negative community perceptions. Better training and support mechanisms to equip healthcare providers with the skills to convey cervical cancer information to women are needed. The use of short message service (SMS) to deliver Pap smear results and provide patients with more information should be considered to improve waiting times for results

  9. Breast and cervical cancer-screening uptake among females in Ardabil, northwest Iran: a community-based study

    Science.gov (United States)

    Farzaneh, Esmaeil; Heydari, Heshmatolah; Shekarchi, Ali Akbar; Kamran, Aziz

    2017-01-01

    Purpose Breast and cervical cancers are the most commonly diagnosed type of cancer and cause of cancer-related deaths in Iranian females. In contrast to previous studies, this study was carried out with a large sample size for assessment of breast self-examination (BSE)-, clinical breast examination (CBE)-, mammography-, and Pap smear-uptake rates and determination of associations among these screening behaviors with sociodemographic and cognitive variables in Azeri females. Materials and methods This was a cross-sectional, community-based study that was carried out among 1,134 females 20–60 years old during March–June 2016. Data-collection variables included sociodemographic questions, screening behaviors for breast and cervical cancer, self-efficacy, beliefs, and barriers to breast and cervical cancer screening. Collected data were analyzed by SPSS version 13 using χ2, Mann–Whitney U, and logistic regression tests. Results Among the 1,134 participants, 53.9%, 9.8%, and 28.1% had done BSE, CBE, and Pap smear tests, respectively, and among the 625 females aged >40 years, 187 (29.9%) had done the mammography test. Moreover, 416 (36.7%), 103 (16.5%), and 64 (5.6%) females had done BSE, mammography, and CBE regularly, respectively. Beliefs, barriers, income, health insurance, number of children, and age were all important factors for BSE and regular BSE and mammography. Females who had high belief scores were more likely to undertake mammography (odds ratio [OR]: 1.2, 95% confidence interval [CI]: 1.03–1.5), regular mammography (OR: 4.2, 95% CI: 1.9–9.3), regular CBE (OR: 1.25, 95% CI: 1.2–1.3), and Pap smears (OR: 1.2, 95% CI: 1.1–1.4). Also, females who had high self-efficacy scores were more likely to perform regular BSE (OR: 1.8, 95% CI: 1.4–2.5) and mammography (OR: 2.5, 95% CI: 1.4–4.6) than females with lower self-efficacy scores. Conclusion The frequency of breast and cervical cancer screening was low in our study. The findings of this study

  10. Neuropsychological screening of children of substance-abusing women attending a Special Child Welfare Clinic in Norway

    Directory of Open Access Journals (Sweden)

    Skogmo Idar

    2010-07-01

    Full Text Available Abstract Background Exposure to alcohol and illicit substances during pregnancy can have an impact on the child for the rest of his/her life. A Special Child Welfare Clinic (SCWC in Norway provides care for pregnant women with substance abuse problems. Treatment and support are provided without replacement therapy. Methods We performed a neuropsychological screening of 40 children aged four to 11 years whose mothers had attended the SCWC during pregnancy, and of a comparison group of 80 children of women without substance abuse problems. The children were presented with tests chosen from Wechsler Intelligence Scale for Children, third version (WISC-III, Nepsy, Halstead-Reitan and Raven's Progressive Matrices, Coloured Version. The tests were grouped into five main domains; (1 learning and memory, (2 visual scanning, planning and attention, (3 executive function, (4 visuo-motor speed and dexterity and (5 general intellectual ability Results No children in the study had test results in the clinical range in any domain. Bivariate analyses revealed that children of short-term substance-abusing mothers (who stopped substance abuse within the first trimester had significantly lower test scores than the comparison group in three out of five domains (domain 2,3,4. Children of long-term substance abusers (who maintained moderate substance abuse throughout pregnancy had significantly lower test results than the comparison group in one domain of the test results (domain 1. All but one child in the long-term group were or had been in foster homes. Most children in the short-term group stayed with their mothers. Multivariate regression analyses revealed that foster care minimum 50% of life time was associated with better scores on domains (1 learning and memory, (2 visual scanning, planning and attention, and (3 executive functions, while no significant associations with test scores was found for substance abuse and birth before 38 weeks of gestation

  11. Screening mod livmoderhalskræft. Fynske kvinders erfaringer, holdninger og viden

    DEFF Research Database (Denmark)

    Andreasen, L J; Hølund, B; Jeune, B;

    1998-01-01

    Questionnaires on women's attitudes and knowledge of cervical screening in the County of Funen were mailed to a sample of 1505 attenders aged 23-59 years, stratified on age and residence. A high proportion of attenders (80.4%) answered the questionnaire. Two-thirds of the women had been informed ...

  12. Treatment Option Overview (Cervical Cancer)

    Science.gov (United States)

    ... Cancer Prevention Cervical Cancer Screening Research Cervical Cancer Treatment (PDQ®)–Patient Version General Information About Cervical Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) depends on ...

  13. Screening for psychosocial problems in children attending the pediatric clinic at king Khalid university hospital (KKUH in Riyadh (KSA

    Directory of Open Access Journals (Sweden)

    Ibrahim H Al-Ayed

    2008-01-01

    Conclusion: This study revealed the feasibility of screening for behavioral problems of children in an outpatient setting. It is necessary to implement screening procedures for psycho-behavioral problems, and train pediatricians to screen children presenting at clinics.

  14. Breast- and cervical-cancer screening among Korean women--Santa Clara County, California, 1994 and 2002.

    Science.gov (United States)

    2004-08-27

    Asians account for an increasing proportion of the U.S. population. Koreans are the fifth largest Asian subpopulation, totaling 1.2 million in 2000. In Santa Clara County (2000 population: 1.7 million), California, Koreans constitute 1.3% of the population. In 1994 and 2002, two population-based surveys were conducted among Korean women (2000 population: approximately 12,000) in Santa Clara County regarding breast- and cervical-cancer screening. The results were contrasted with two surveys of the general population of California women conducted during the same years. This report summarizes the findings of those surveys, which indicated that Korean women received less frequent breast- and cervical-cancer screening compared with all California women. This report also assesses compliance with the 2010 national health objectives for Papanicolaou (Pap) tests and mammography screening. Multifaceted community programs that include culturally and linguistically sensitive education of community members and their health-care providers, along with improved health-care access, will be required to achieve the 2010 national health objectives.

  15. Negative HPV screening test predicts low cervical cancer risk better than negative Pap test

    Science.gov (United States)

    Based on a study that included more than 1 million women, investigators at NCI have determined that a negative test for HPV infection compared to a negative Pap test provides greater safety, or assurance, against future risk of cervical cancer.

  16. A Suggested Approach To Simplify and Improve Cervical Screening in the United States

    OpenAIRE

    Schiffman, Mark; Wentzensen, Nicolas

    2016-01-01

    Cervical cancer prevention strategies in the United States have become complicated and even controversial, despite advanced understanding of carcinogenic human papillomavirus (HPV) infection as the necessary causal agent. Twenty years ago, etiologic and methodologic studies had already yielded two powerful preventive approaches. There are excellent vaccines to prevent the most carcinogenic types of HPV infection; reduced HPV endemicity will ultimately prevent a large fraction of cervical prec...

  17. 宫颈刮片脱落细胞学检查在筛选宫颈癌中的应用分析%Application Analysis the Cervical Scraping Cytology in Screening of Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    张鸥

    2016-01-01

    目的:对宫颈刮片脱落细胞学检查在筛选宫颈癌中的应用进行观察分析。方法选取我院2014年1月~2015年12月收治的214例进行宫颈癌筛查患者作为研究对象,进行宫颈刮片脱落细胞学检查,将宫颈刮片脱落细胞学检查结果同宫颈活组织病理检查相比较,观察分析宫颈刮片脱落细胞学检查在诊断宫颈癌、癌前病变的敏感度、特异度、阴性预测值和阳性预测值等。结果宫颈刮片脱落细胞学检查诊断宫颈癌、癌前病变敏感度为90.43%,特异度为89.17%,阳性预测值为86.73%,阴性预测值为92.24%,诊断准确率为89.72%。结论宫颈刮片脱落细胞学检查在筛查宫颈癌方面具有较高的敏感度。%Objective To observe and analyze the application of cervical scraping cytology in screening of cervical cancer.Methods Selected 214 cases of patients with cervical cancer screening from January 2014 to December 2015 in our hospital, for example, cervical scraping cytology, cervical scraping cytology results with cervical biopsy compared toobserve and analyze the cervical scraping off cytology in the diagnosis of cervical cancer and precancerous lesions of sensitivity, speciifcity, negative predictive and positive predictive value.Results The sensitivity of cervical cancer and precancerous lesion was 90.43%, the speciifcity was 89.17%, the positive predictive value was 86.73%, the negative predictive value was 92.24%, the diagnostic accuracy rate was 89.72%.Conclusion Cervical scraping cytology test in the screening of cervical cancer has a high sensitivity.

  18. Screening for cervical cancer: new alternatives and research Detección oportuna de cáncer cervical: nuevas alternativas y pautas de investigación

    Directory of Open Access Journals (Sweden)

    Attila T Lörincz

    2003-01-01

    Full Text Available Evidence for the clinical utility of human papillomavirus (HPV DNA testing has increased over the years and has now become very convincing. Some specific uses of HPV detection are a triage of women with cytological determinations of atypical squamous cells of undetermined significance (ASC-US and related management strategies, b as a marker for test of cure post-treatment, and c most importantly, as an adjunct to cytology in routine cervical disease screening programs. There are many studies that support each of these applications and include 8 studies on ASC-US triage, 10 on test of cure and 13 on adjunctive or stand-alone HPV screening. The most notable investigation of ASC-US triage was ALTS, a randomized controlled trial of 3 488 women. With respect to routine HPV screening the combined studies included 77 000 women, providing as a histological endpoint more than 1 000 cases of high-grade cervical intraepithelial neoplasia (CIN or cancer. Testing methods were either the Hybrid Capture 2 (HC2 test or the polymerase chain reaction (PCR test. HPV testing of women with ASC-US cytology had on average a higher sensitivity (90% and specificity (70% than repeating the cytological test (sensitivity 75%, specificity 60% and was also more sensitive than colposcopy for follow-up. As an adjunct to the Papanicolaou (Pap cytology test in routine screening, HPV DNA testing was a more sensitive indicator for prevalent high-grade CIN than either conventional or liquid cytology. A combination of HPV DNA and Papanicolaou testing had almost 100% sensitivity and negative predictive value. The specificity of the combined tests was slightly lower than the specificity of the Papanicolaou test. One "double-negative" HPV DNA and Papanicolaou test indicated a higher prognostic assurance against risk of future CIN 3 than three subsequent negative conventional Papanicolaou tests and may safely allow three-year or longer screening intervals for such low- risk women. It

  19. Design and methods of the evaluation of an HPV-based cervical cancer screening strategy in Mexico: the Morelos HPV study Diseño y métodos de la evaluación del uso de la prueba de virus de papiloma humano para tamizaje de cáncer cervical en México: el estudio de VPH en Morelos

    Directory of Open Access Journals (Sweden)

    Yvonne Flores

    2002-07-01

    Full Text Available Objective. The purpose of this paper is to describe the design and methodology of the Morelos HPV Study. The main objective of this study is to examine the use of two different methods for obtaining HPV DNA specimens, self-collected vaginal and clinician-collected cervical, to detect pre-invasive cervical lesions and cancer. Material and Methods. This study was conducted within the regular population-based framework of the Mexican Institute of Social Security (IMSS cervical cancer screening program in Morelos. A total of 7,868 women were recruited between May and October 1999 and are representative of the population of women attending cervical cancer screening services at the 23 IMSS clinics in the state of Morelos in 1999. Women were provided with a detailed description of the study before signing an informed consent form. Basic data were obtained from all participants using a standard IMSS registration form. During the initial recruitment visit, a randomly selected subsample of 1 069 participants were interviewed to collect additional information about cervical cancer risk factors, acceptability of the HPV and Pap tests, as well as patient costs. Before the pelvic exam, participants were asked to provide a self-collected vaginal specimen for HPV testing. All participants underwent a pelvic examination that involved collecting a cervical sample for the Pap smear and a clinician-collected HPV specimen. Data were evaluated from 7 732 women with complete information for the three tests. The 1 147 women who received at least one positive result (Pap, self- and/or clinician-HPV tests were invited to return for a colposcopic examination. During colposcopy, biopsies were taken as appropriate, to histologically confirm a diagnosis of cervical intraepithelial neoplasia (CIN 2/3 or invasive cancer. A total of 1,015 women attended colposcopy, and 101 women received a histologically-confirmed CIN 2/3 or cervical cancer diagnosis. Conclusions. The initial

  20. A review of screening strategies for cervical cancer in human immunodeficiency virus-positive women in sub-Saharan Africa

    Science.gov (United States)

    Viviano, Manuela; DeBeaudrap, Pierre; Tebeu, Pierre-Marie; Fouogue, Jovanny T; Vassilakos, Pierre; Petignat, Patrick

    2017-01-01

    Cervical cancer (CC) is a leading cause of cancer-related death and a major public health issue in sub-Saharan Africa. This heavy burden parallels that of the human immunodeficiency virus (HIV) infection, which increases the risk of developing CC. Despite the progressive reduction of HIV prevalence in the past decade, the CC incidence and mortality rates in sub-Saharan Africa remain high. The heterogeneity of the distribution of the two diseases in the African continent, together with the different availability of human and material resources, stands in the way of finding an appropriate screening strategy. The lack of high-quality evidence on the prevention of CC for HIV-positive women, which is necessary for the implementation of efficient screening and treatment strategies, results in the absence of a clearly defined program, which is responsible for the low screening uptake and high mortality rates in sub-Saharan Africa. By taking advantage of the HIV-positive women’s frequent access to health facilities, one way to increase the CC screening coverage rates would be by providing integrated HIV and screening services within the same infrastructure. With the increasing availability of cost-effective methods, screening is becoming more and more available to women who have limited access to health care. Moreover, the introduction of point-of-care technologies for human papillomavirus testing and the subsequent implementation of screen-and-treat strategies, by reducing the number of clinical appointments and, in the long term, the loss to follow-up rates, open up new opportunities for all women, regardless of their HIV status. The purpose of this review is to provide an insight into the different screening practices for CC in order to help define one that is adapted to the resources and necessities of HIV-positive women living in middle-to-low income countries. PMID:28203108

  1. Cost-effectiveness of adding vaccination with the AS04-adjuvanted human papillomavirus 16/18 vaccine to cervical cancer screening in Hungary

    Directory of Open Access Journals (Sweden)

    Vokó Zoltán

    2012-10-01

    Full Text Available Abstract Background The cervical cancer screening program implemented in Hungary to date has not been successful. Along with screening, vaccination is an effective intervention to prevent cervical cancer. The aim of this study was to assess the cost-effectiveness of adding vaccination with the human papillomavirus 16/18 vaccine to the current cervical cancer screening program in Hungary. Methods We developed a cohort simulation state-transition Markov model to model the life course of 12-year-old girls. Eighty percent participation in the HPV vaccination program at 12 years of age was assumed. Transitional probabilities were estimated using data from the literature. Local data were used regarding screening participation rates, and the costs were estimated in US $. We applied the purchasing power parity exchange rate of 129 HUF/$ to the cost data. Only direct health care costs were considered. We used a 3.7% discount rate for both the cost and quality-adjusted life years (QALYs. The time horizon was 88 years. Results Inclusion of HPV vaccination at age 12 in the cervical cancer prevention program was predicted to be cost-effective. The incremental cost-effectiveness ratio (ICER of adding HPV vaccination to the current national cancer screening program was estimated to be 27 588 $/QALY. The results were sensitive to the price of the vaccine, the discount rate, the screening participation rate and whether herd immunity was taken into account. Conclusions Our modeling analysis showed that the vaccination of 12-year-old adolescent girls against cervical cancer with the AS04-adjuvanted human papillomavirus 16/18 vaccine would be a cost-effective strategy to prevent cervical cancer in Hungary.

  2. 2009-2013年广州北部山区妇女宫颈癌筛查结果分析%Analysis about cervical cancer screening results of women in Guangzhou northern mountainous area from 2009 to 2013

    Institute of Scientific and Technical Information of China (English)

    高晓波; 付君红; 彭秀瑜; 毕婉仪

    2014-01-01

    Objective To analyze screening rate,detection rate,early diagnosis rate about cervical cancer of rural women in Guangzhou northern mountainous area.Method By using the epidemiological retrospective method,studied cervical cancer screening results of agricultural census register 35 ~ 64 years old women in Guangzhou northern mountainous area from 2009 to 2013.Results A total of 62,147 women attended the screening with an average age of 48.65 years old.The screening rate of cervical cancer was 110.76% (62,147/56,112).The detectable rate of CIN Ⅱ and above precancerous lesions and] a period of cervical lesions was 135.16/100,000 (84/62,147).The detectable rate of CIN Ⅱ and above precancerous lesions and cervical cancer was 156.08/100,000 (97/62,147).The detectable rate of cervical cancer was 20.92/100,000 (13/62,147).The early diagnosis rate was 86.60% (84/97).Conclusion Rural women's reproductive health are not allowed to ignore.Regular cervical cancer screening should be carried out for early detection and treatment of precancerous lesions and to improve women's health.%目的 分析广州市北部山区农村适龄妇女宫颈癌筛查率、检出率、早诊率状况.方法 采用流行病学回顾性研究方法,对2009至2013年广州北部山区农业户籍35~64岁妇女的宫颈癌筛查结果进行分析.结果 本次宫颈癌筛查62 147例,宫颈癌筛查平均年龄48.65岁,宫颈癌筛查率为110.76%(62 147/56 112).宫颈癌筛查检出宫颈上皮内瘤变(CINⅡ、CINⅢ/原位癌)+Ⅰa期宫颈癌病变检出率135.16/10万(84/62 147),宫颈癌及癌前病变(CINⅡ、CINⅢ)检出率为156.08/10万(97/62 147),其中宫颈癌检出率为20.92/10万(13/62 147).宫颈癌的早诊率为86.60%(84/97).结论 山区适龄妇女生殖健康状况不容忽视,应定期开展宫颈癌筛查,早期发现并治疗宫颈癌前病变,提高妇女健康水平.

  3. Decision aid on breast cancer screening reduces attendance rate: results of a large-scale, randomized, controlled study by the DECIDEO group.

    Science.gov (United States)

    Bourmaud, Aurelie; Soler-Michel, Patricia; Oriol, Mathieu; Regnier, Véronique; Tinquaut, Fabien; Nourissat, Alice; Bremond, Alain; Moumjid, Nora; Chauvin, Franck

    2016-03-15

    Controversies regarding the benefits of breast cancer screening programs have led to the promotion of new strategies taking into account individual preferences, such as decision aid. The aim of this study was to assess the impact of a decision aid leaflet on the participation of women invited to participate in a national breast cancer screening program. This Randomized, multicentre, controlled trial. Women aged 50 to 74 years, were randomly assigned to receive either a decision aid or the usual invitation letter. Primary outcome was the participation rate 12 months after the invitation. 16 000 women were randomized and 15 844 included in the modified intention-to-treat analysis. The participation rate in the intervention group was 40.25% (3174/7885 women) compared with 42.13% (3353/7959) in the control group (p = 0.02). Previous attendance for screening (RR = 6.24; [95%IC: 5.75-6.77]; p aid reduced the participation rate. The decision aid activate the decision making process of women toward non-attendance to screening. These results show the importance of promoting informed patient choices, especially when those choices cannot be anticipated.

  4. Using community engagement to inform and implement a community-randomized controlled trial in the Anishinaabek Cervical Cancer Screening Study (ACCSS

    Directory of Open Access Journals (Sweden)

    Brianne eWood

    2014-02-01

    Full Text Available Social, political, and economic factors are directly and indirectly associated with the quality and distribution of health resources across Canada. First Nations (FN women in particular endure a disproportionate burden of ill health in contrast to the mainstream population. The complex relationship of health, social, and historical determinants are inherent to increased cervical cancer in FN women. This can be traced back to the colonial oppression suffered by Canadian FN and the social inequalities they have since faced. Screening - the Papinacolaou (Pap test – and early immunization have rendered cervical cancer almost entirely preventable but despite these options, FN women endure notably higher rates of diagnosis and mortality due to cervical cancer. The Anishinaabek Cervical Cancer Screening Study (ACCSS is a participatory action research project investigating the factors underlying the cervical cancer burden in FN women. ACCSS is a collaboration with 11 FN communities in Northwest Ontario, Canada and a multidisciplinary research team from across Canada with expertise in cancer biology, epidemiology, medical anthropology, public health, virology, women’s health, and pathology. Interviews with healthcare providers and community members revealed that prior to any formal data collection education must be offered. Consequently, an educational component was integrated into the existing quantitative design of the study: a two-armed, community-randomized trial that compares the uptake of two different cervical screening modalities. In ACCSS, the Research Team integrates community engagement and the flexible nature of participatory research with the scientific rigor of a randomized controlled trial. ACCSS findings will inform culturally appropriate screening strategies, aiming to reduce the disproportionate burden of cervical disease in concert with priorities of the partner FN communities.

  5. Cervical Cancer Screening between 35–40 Aged Women at Kisecik Region of Hatay Provinence

    Directory of Open Access Journals (Sweden)

    Ersin Nazlican

    2010-10-01

    Full Text Available AIM: Cervical cancer is the most frequently seen genital system cancer in women after endometrium adenocarcinoma. Because cervical is an easy reach organ, early diagnosis can be done due to Papanicolau (Pap smear in the cancer cases of this organ and prognosis ameliorates considerably. In this ailment there are two peaks. The first one is around the ages 35-39, the second one is around the ages 60-64. The aim of the study is to scan cervical cancer among the women between the ages of 35-40 in the district of Kisecik health office. METHOD: This study is a definitional, society based sectional study performed among the women between the ages of 35- 40 in the district of Kisecik in Hatay. 187 women between the ages of 35- 40 were enrolled to the study; 10 out of 187 women who were single were not included to the study. The study was completed after enrolling 150 women out of 177. Cervical smear samples were taken from the participants; and these samples were evaluated in a pathology laboratory according to the Bethesda 2001 scale. RESULTS: The avarage age of the participants was 37.55±1.77. After the evaluation of the cervical smears in the pathology laboratory, the results were normal for 73 participants (%48.7. 36 participants (%24.0 had non specific inflamation, 20 participants (%13.3 had bacterial vaginosis, 19 participants (%12.7 had seconder reactive changes to the inflamation and 2 participants (%1.3 was reported to be ASC-US. CONCLUSION: By the help of cheap and easily applied Pap smear test, society based scanning programmes can be performed frequently and thus; servical lesions may be detected in early phases. Furthermore through education, the level of information about cervical cancer should be raised and consciousness should be created. [TAF Prev Med Bull 2010; 9(5.000: 471-474

  6. Mitosis is a source of potential markers for screening and survival and therapeutic targets in cervical cancer.

    Directory of Open Access Journals (Sweden)

    Ana María Espinosa

    Full Text Available The effect of preventive human papillomavirus (HPV vaccination on the reduction of the cervical cancer (CC burden will not be known for 30 years. Therefore, it's still necessary to improve the procedures for CC screening and treatment. The objective of this study was to identify and characterize cellular targets that could be considered potential markers for screening or therapeutic targets. A pyramidal strategy was used. Initially the expression of 8,638 genes was compared between 43 HPV16-positive CCs and 12 healthy cervical epitheliums using microarrays. A total of 997 genes were deregulated, and 21 genes that showed the greatest deregulation were validated using qRT-PCR. The 6 most upregulated genes (CCNB2, CDC20, PRC1, SYCP2, NUSAP1, CDKN3 belong to the mitosis pathway. They were further explored in 29 low-grade cervical intraepithelial neoplasias (CIN1 and 21 high-grade CIN (CIN2/3 to investigate whether they could differentiate CC and CIN2/3 (CIN2+ from CIN1 and controls. CCNB2, PRC1, and SYCP2 were mostly associated with CC and CDC20, NUSAP1, and CDKN3 were also associated with CIN2/3. The sensitivity and specificity of CDKN3 and NUSAP1 to detect CIN2+ was approximately 90%. The proteins encoded by all 6 genes were shown upregulated in CC by immunohistochemistry. The association of these markers with survival was investigated in 42 CC patients followed up for at least 42 months. Only CDKN3 was associated with poor survival and it was independent from clinical stage (HR = 5.9, 95%CI = 1.4-23.8, p = 0.01. CDKN3 and NUSAP1 may be potential targets for the development of screening methods. Nevertheless, further studies with larger samples are needed to define the optimal sensitivity and specificity. Inhibition of mitosis is a well-known strategy to combat cancers. Therefore, CDKN3 may be not only a screening and survival marker but a potential therapeutic target in CC. However, whether it's indispensable for tumor growth remains

  7. Mitosis is a source of potential markers for screening and survival and therapeutic targets in cervical cancer.

    Science.gov (United States)

    Espinosa, Ana María; Alfaro, Ana; Roman-Basaure, Edgar; Guardado-Estrada, Mariano; Palma, Ícela; Serralde, Cyntia; Medina, Ingrid; Juárez, Eligia; Bermúdez, Miriam; Márquez, Edna; Borges-Ibáñez, Manuel; Muñoz-Cortez, Sergio; Alcántara-Vázquez, Avissai; Alonso, Patricia; Curiel-Valdez, José; Kofman, Susana; Villegas, Nicolas; Berumen, Jaime

    2013-01-01

    The effect of preventive human papillomavirus (HPV) vaccination on the reduction of the cervical cancer (CC) burden will not be known for 30 years. Therefore, it's still necessary to improve the procedures for CC screening and treatment. The objective of this study was to identify and characterize cellular targets that could be considered potential markers for screening or therapeutic targets. A pyramidal strategy was used. Initially the expression of 8,638 genes was compared between 43 HPV16-positive CCs and 12 healthy cervical epitheliums using microarrays. A total of 997 genes were deregulated, and 21 genes that showed the greatest deregulation were validated using qRT-PCR. The 6 most upregulated genes (CCNB2, CDC20, PRC1, SYCP2, NUSAP1, CDKN3) belong to the mitosis pathway. They were further explored in 29 low-grade cervical intraepithelial neoplasias (CIN1) and 21 high-grade CIN (CIN2/3) to investigate whether they could differentiate CC and CIN2/3 (CIN2+) from CIN1 and controls. CCNB2, PRC1, and SYCP2 were mostly associated with CC and CDC20, NUSAP1, and CDKN3 were also associated with CIN2/3. The sensitivity and specificity of CDKN3 and NUSAP1 to detect CIN2+ was approximately 90%. The proteins encoded by all 6 genes were shown upregulated in CC by immunohistochemistry. The association of these markers with survival was investigated in 42 CC patients followed up for at least 42 months. Only CDKN3 was associated with poor survival and it was independent from clinical stage (HR = 5.9, 95%CI = 1.4-23.8, p = 0.01). CDKN3 and NUSAP1 may be potential targets for the development of screening methods. Nevertheless, further studies with larger samples are needed to define the optimal sensitivity and specificity. Inhibition of mitosis is a well-known strategy to combat cancers. Therefore, CDKN3 may be not only a screening and survival marker but a potential therapeutic target in CC. However, whether it's indispensable for tumor growth remains to be

  8. Patterns of cervical coinfection with multiple human papilloma virus types in a screening population in Denmark

    DEFF Research Database (Denmark)

    Goldman, Bryan; Rebolj, Matejka; Rygaard, Carsten

    2013-01-01

    Patterns of cervical human papillomavirus (HPV) infection suggest that HPV genotypes are not independent of each other. This may be explained by risk factors common to all HPV infections, but type-specific biological factors may also play a role. This raises the question of whether widespread use...

  9. Cervical cancer screening in partly HPV vaccinated cohorts - A cost-effectiveness analysis

    NARCIS (Netherlands)

    S.K. Naber (Steffie); S.M. Matthijsse (Suzette); K. Rozemeijer (Kirsten); C. Penning (Corine); I.M.C.M. de Kok (Inge); M. van Ballegooijen (Marjolein)

    2016-01-01

    textabstractBackground: Vaccination against the oncogenic human papillomavirus (HPV) types 16 and 18 will reduce the prevalence of these types, thereby also reducing cervical cancer risk in unvaccinated women. This (measurable) herd effect will be limited at first, but is expected to increase over t

  10. Screening for cervical cancer precursors with p16/Ki-67 dual-stained cytology

    DEFF Research Database (Denmark)

    Ikenberg, Hans; Bergeron, Christine; Schmidt, Dietmar

    2013-01-01

    Pap cytology is known to be more specific but less sensitive than testing for human papillomavirus (HPV) for the detection of high-grade cervical intraepithelial neoplasia (CIN2+). We assessed whether p16/Ki-67 dual-stained cytology, a biomarker combination indicative of transforming HPV infections...

  11. Evaluation of Human Papilloma Virus Communicative Education Strategies: A Pilot Screening Study for Cervical Cancer

    Science.gov (United States)

    Barrera-Clavijo, Lizeth K.; Wiesner-Ceballos, Carolina; Rincón-Martínez, Lina M.

    2016-01-01

    Background: High-risk human papilloma virus (HR-HPV) is highly prevalent in sexually active men and women; HR-HPV has been classified as a sexually transmitted infection (STI) and as a necessary, but not sufficient, causal agent for cervical cancer. Women who test positive for HPV often experience serious psychosocial consequences such as fear,…

  12. Screening and management of risk factors for cardiovascular disease in HIV-positive patients attending an Australian urban sexual health clinic.

    Science.gov (United States)

    Kakar, Sheena; Drak, Douglas; Amin, Tahiya; Cheung, Jason; O'Connor, Catherine; Gracey, David

    2016-11-11

    Background: Few data exist regarding cardiovascular risk among HIV-infected patients attending sexual health clinics (SHC) in Australia. Methods: The medical records of 188 patients attending an inner-city SHC between August 2013 and July 2014 were retrospectively reviewed for cardiovascular risk factors and associated screening and management practices. Results: Cardiovascular risk factors were common among attendees of the SHC, including smoking (38%), hypertension (14%) and dyslipidaemia (11%). Of the 188 patients, 23% reported using potentially cardiotoxic recreational drugs, 25% of dyslipidaemic patients were not on therapy and 10% of patients were hypertensive; none were prescribed treatment. A smoking cessation program was offered to all patients. Conclusion: A high prevalence of risk factors for cardiovascular disease was demonstrated. Modification of risk factors could be improved.

  13. 铜陵县顺安镇3775例农村妇女宫颈癌筛查结果分析%Result analysis of 3775 cases of the rural women cervical cancer screening in Shunan town of Tongling county

    Institute of Scientific and Technical Information of China (English)

    胡爱萍

    2015-01-01

    目的:通过筛查了解农村妇女生殖健康及宫颈癌发病情况,探索开展农村群体宫颈癌筛查的可行方法及防治措施。方法:对参加筛查的3775例农村妇女进行常规妇科检查,阴道分泌物检查,宫颈细胞学检查及阴道镜检查,将结果进行回顾性分析。结果:经组织病理学检查,宫颈癌前病变者为11例。结论:宫颈细胞学筛查是早期发现宫颈上皮内瘤变及宫颈癌的主要措施,做好农村妇女宫颈癌防治的健康教育宣传,促进农村妇女自觉进行宫颈癌筛查,可有效降低宫颈癌的发病率及病死率。%Objec tiv e:To understand the rural women's reproductive health and the IR of cervical cancer, by screening method, and explore the feasible methods and measures of prevention and control of cervical cancer in rural areas.Methods:3775 women from rural areas have attended the routine gynecological check, vaginal secretion exami-nation ,cervical cytological examination and colposcopy, then all these examinations were retrospectively evaluated. Results: by histopathological examination, cervical cancer, before the lesion in 11 cases. Conclusion: cervical cytological screening is the main measure of early detection of cervical intraepithelial neoplasia.We should increase publicity of health education in rural women and do a good job in cervical cancer prevention and control measures. Promoting rural women's consciousness in cervical cancer screening can effectively reduce the IR of cervical cancer.

  14. Research Development of Early Screening of Cervical Cancer%子宫颈癌早期筛查方法的研究进展

    Institute of Scientific and Technical Information of China (English)

    陈雨

    2011-01-01

    Cervical canrer , which threatens the health and life of women , is one of the gynecological malignant tumors. Early screening has great significance in prevention and treatment of cervical cancer. Conventional screening methods such as Pap smear, visual inspection, and recently developed methods such as liquid-based cytology, HPV-DNA testing, and colposcopy are non-invasive examinations. Invasive examinations include cervical biopsy , cervical conization ,etc. . Here is to review the research development of early screening of cervical cancer.%子宫颈癌是女性常见恶性肿瘤之一,严重危害着广大妇女的健康与生命.进行早期筛查,对子宫颈癌的防治有着重要的意义.传统筛查方法巴氏涂片、肉眼观察,以及如今发展的液基细胞学、人类乳头瘤病毒检测、阴道镜检查等都属于无创检查.有创检查包括子宫颈活检、锥切等病理检查.在此就子宫颈癌早期筛查方法研究进展予以综述.

  15. The Cervical Cancer Screening Technique of Application and Progression%子宫颈癌筛查方法的应用及研究进展

    Institute of Scientific and Technical Information of China (English)

    张文娟; 东燕; 孙绪兰; 王萍; 曾燕

    2012-01-01

    Cervical cancer is a common gynecologic tumor and it is the second-leading cause of death from cancer in women worldwide. It is critical to construct a sustainable, reasonable and efficient general survey method for the early detection of precancerosis of Cervical Cancer. At present, cervical cancer screening technique includes: (a) cervical cytological screening (papanicolaou smear, TCT and DNA quantification); (b) visual inspection with acetic acid (VIA) and visual inspection with Lugol'S iodine (VH.I) ; (c) vaginoscopy; (d) HPV detection. The article is to summarize the application and progression of technique for cervical cancer screening.%子宫颈癌是妇科常见恶性肿瘤之一,发病率居女性恶性肿瘤第二位.建立可持续、合理、有效的普查方法,早期发现癌前病变是防治宫颈癌的关键.目前宫颈癌筛查方法有宫颈细胞学筛查(巴氏涂片、液基薄层细胞学检测、细胞DNA定量分析技术)、肉眼观察辅以醋酸白和Lugol碘溶液检测法、阴道镜检查、病毒-HPV检测,本文就当前各种筛查方法的应用及研究进展进行概括.

  16. Effect Observation on HPV, TCT and Vaginal Examination in Cervical Le-sions and Cervical Screening%宫颈病变和宫颈筛查应用HPV、TCT和阴道镜检查的效果探讨

    Institute of Scientific and Technical Information of China (English)

    金伟蓉; 孔彩霞

    2015-01-01

    目的:探讨宫颈病变和宫颈筛查应用HPV、TCT和阴道镜检查的效果。方法整群选取2013年5月—2015年5月于该院接受TCT及HPV检查的妇女1280例。对这些患者再进行阴道镜检查以及宫颈组织活检,然后将检验的结果与病理结果进行统计学的分析比对。结果 TCT检查的阳性检出率为9.61%(123/1280);HPV检查的阳性检出率为12.03%(154/1280)。结论临床上对宫颈病变结合筛查可联合CTC、HPV以及阴道镜检查,这样可提高宫颈病变的检出率,减少漏诊,对临床的及时治疗提供极大的帮助。%Objective To observe the effect of HPV, TCT and vaginal examination in cervical lesions and cervical screen-ing. Methods 1280 cases of women who received TCT and HPV examination in our hospital from May 2013 to May 2015 were selected and were given vaginal examination and cervical biopsy, the test results and the pathological results were compared and analyzed statistically. Results The positive detection rate of TCT was 9.61% (123/1280)and 12.03%(154/1280)of HPV. Conclusion HPV, TCT and vaginal examination in treatment of cervical lesions and cervical screening can improve the detection rate of cervical lesions, reduce missed diagnosis and offer great help to timely treatment clinically.

  17. Chlamydia trachomatis detection in cervical PreservCyt specimens from an Irish urban female population.

    LENUS (Irish Health Repository)

    Keegan, H

    2012-02-01

    OBJECTIVE: The aim of this study was to determine the prevalence of cervical Chlamydia trachomatis infection by polymerase chain reaction (PCR) in urban women undergoing routine cervical cytological screening and to investigate the relationship with age, cytology, smoking status and concurrent human papillomavirus (HPV) infection. METHODS: A total of 996 women (age range 16-69 years) attending general practitioners for routine liquid-based cervical smear screening in the Dublin area were recruited in the study of prevalence of C. trachomatis. Informed consent was obtained and liquid-based cytology (LBC) specimens were sent for cytological screening. DNA was extracted from residual LBC and tested for C. trachomatis by PCR using the highly sensitive C. trachomatis plasmid (CTP) primers and for HPV infection using the MY09\\/11 primers directed to the HPV L1 gene in a multiplex format. RESULTS: The overall prevalence of C. trachomatis was 5.4%. Prevalence was highest in the <25 years age group (10%). Coinfection with HPV and C. trachomatis occurred in 1% of the screening population. A higher rate of smoking was observed in women positive for C. trachomatis, HPV infections or those with abnormal cervical cytology. Chlamydia trachomatis infection was not associated with abnormal cytology. CONCLUSIONS: Women (5.4%) presenting for routine cervical screening are infected with C. trachomatis. Opportunistic screening for C. trachomatis from PreservCyt sample taken at the time of cervical cytological screening may be a possible strategy to screen for C. trachomatis in the Irish female population.

  18. Evaluation of visual inspection with acetic acid and Lugol's iodine as cervical cancer screening tools in a low-resource setting.

    Science.gov (United States)

    Qureshi, Sabuhi; Das, Vinta; Zahra, Fatima

    2010-01-01

    In view of the failure of cytology screening programmes for cervical cancer in developing countries, the World Health Organization suggested unaided visual inspection of the cervix after an application of acetic acid (VIA) and Lugol's iodine (VILI) as alternative screening methods. Our study evaluates the effectiveness of VIA and VILI compared to Pap smear as screening methods for carcinoma of the cervix in a low-resource setting. Three hundred and twenty-eight women were subjected to a Pap smear test, VIA, VILI and colposcopy. The results were as follows: Pap smear test (20.83%, specificity 98.38%), VIA (55.5%, 71.39%) and VILI (86.84%, 48.93%). Although VIA and VILI are less specific in comparison to the Pap smear test, they are more sensitive in detecting pre-invasive lesions. Hence VIA and VILI can be used as cervical cancer screening tools in low-resource settings.

  19. The Peru Cervical Cancer Screening Study (PERCAPS): the design and implementation of a mother/daughter screen, treat, and vaccinate program in the Peruvian jungle.

    Science.gov (United States)

    Abuelo, Carolina E; Levinson, Kimberly L; Salmeron, Jorge; Sologuren, Carlos Vallejos; Fernandez, Maria Jose Vallejos; Belinson, Jerome L

    2014-06-01

    Peru struggles to prevent cervical cancer (CC). In the jungle, prevention programs suffer from significant barriers although technology exists to detect CC precursors. This study used community based participatory research (CBPR) methods to overcome barriers. The objective was to evaluate the utility of CBPR techniques in a mother-child screen/treat and vaccinate program for CC prevention in the Peruvian jungle. The CC prevention program used self-sampling for human papillomavirus (HPV) for screening, cryotherapy for treatment and the HPV vaccine Gardasil for vaccination. Community health leaders (HL) from around Iquitos participated in a two half day educational course. The HLs then decided how to implement interventions in their villages or urban sectors. The success of the program was measured by: (1) ability of the HLs to determine an implementation plan, (2) proper use of research forms, (3) participation and retention rates, and (4) participants' satisfaction. HLs successfully registered 320 women at soup kitchens, schools, and health posts. Screening, treatment, and vaccination were successfully carried out using forms for registration, consent, and results with minimum error. In the screen/treat intervention 100% of participants gave an HPV sample and 99.7% reported high satisfaction; 81% of HPV + women were treated, and 57% returned for 6-month followup. Vaccine intervention: 98% of girls received the 1st vaccine, 88% of those received the 2nd, and 65% the 3rd. CBPR techniques successfully helped implement a screen/treat and vaccinate CC prevention program around Iquitos, Peru. These techniques may be appropriate for large-scale preventive health-care interventions.

  20. Diagnostic accuracy of VIA and HPV detection as primary and sequential screening tests in a cervical cancer screening demonstration project in India.

    Science.gov (United States)

    Basu, Partha; Mittal, Srabani; Banerjee, Dipanwita; Singh, Priyanka; Panda, Chinmay; Dutta, Sankhadeep; Mandal, Ranajit; Das, Pradip; Biswas, Jaydip; Muwonge, Richard; Sankaranarayanan, Rengaswamy

    2015-08-15

    Visual inspection after acetic acid application (VIA) and human papillomavirus (HPV) detection tests have been recommended to screen women for cervical cancer in low and middle income countries. A demonstration project in rural India screened 39,740 women with both the tests to compare their accuracies in real population setting. The project also evaluated the model of screening women in the existing primary health care facilities, evaluating the screen positive women with colposcopy (and biopsy) in the same setup and recalling the women diagnosed to have disease for treatment at tertiary center. Accuracy of VIA and HPV test used sequentially was also studied. VIA was performed by trained health workers and Hybrid Capture II (HC II) assay was used for oncogenic HPV detection. Test positivity was 7.1% for VIA and 4.7% for HC II. Detection rate of CIN 3+ disease was significantly higher with HC II than VIA. Sensitivities of VIA and HC II to detect 162 histology proved CIN 3+ lesions were 67.9 and 91.2%, respectively after adjusting for verification bias. Specificity for the same disease outcome and verification bias correction was 93.2% for VIA and 96.9% for HC II. Triaging of VIA positive women with HPV test would have considerably improved the positive predictive value (4.0 to 37.5% to detect CIN 3+) without significant drop in sensitivity. All VIA positive women and 74.0% of HC II positive women had colposcopy. There was high compliance to treatment and significant stage-shift of the screen-detected cancers towards more early stage.

  1. Self-perceived risk and barriers to cervical cancer screening among patients seeking care at a tertiary care teaching hospital in Tamil Nadu

    Directory of Open Access Journals (Sweden)

    Lokeshwari Jayaraman

    2016-03-01

    Conclusions: self-perception of not being at risk is documented to be associated with low uptake of screening. Concerned health education programs need to bring clearly to the end user the difference between precancerous lesions and invasive cervical cancer and the treatment options available. [Int J Res Med Sci 2016; 4(3.000: 766-769

  2. Manual liquid based cytology in primary screening for cervical cancer--a cost effective preposition for scarce resource settings.

    Science.gov (United States)

    Nandini, N M; Nandish, S M; Pallavi, P; Akshatha, S K; Chandrashekhar, A P; Anjali, S; Dhar, Murali

    2012-01-01

    Conventional pap smear (CPS) examination has been the mainstay for early detection of cervical cancer. However, its widespread use has not been possible due to the inherent limitations, like presence of obscuring blood and inflammation, reducing its sensitivity considerably. Automated methods in use in developed countries may not be affordable in the developing countries due to paucity of resources. On the other hand, manual liquid based cytology (MLBC) is a technique that is cost effective and improves detection of precursor lesions and specimen adequacy. Therefore the aim of the study was to compare the utility of MLBC with that of CPS in cervical cancer screening. A prospective study of 100 cases through MLBC and CPS was conducted from October 2009 to July 2010, in a Medical College in India, by two independent pathologists and correlated with histopathology (22 cases). Morphological features as seen through MLBC and CPS were compared. Subsequently, all the cases were grouped based on cytological diagnosis according to two methods into 10 groups and a subjective comparison was made. In order to compare the validity of MLBC with CPS in case of major diagnoses, sensitivity and specificity of the two methods were estimated considering histological examination as the gold standard. Increased detection rate with MLBC was 150%. The concordance rate by LBC/histopathology v/s CPS/histopathology was also improved (86% vs 77%) The percentage agreement by the two methods was 68%. MLBC was more sensitive in diagnosis of LSIL and more specific in the diagnosis of inflammation. Thus, MLBC was found to be better than CPS in diagnosis of precursor lesions. It provided better morphology with increased detection of abnormalities and preservation of specimen for cell block and ancillary studies like immunocytochemistry and HPV detection. Therefore, it can be used as alternative strategy for cervical cancer prevention in limited resource settings.

  3. Has the ThinPrep method of cervical screening maintained its improvement over conventional smears in terms of specimen adequacy?

    LENUS (Irish Health Repository)

    Treacy, A

    2009-04-01

    Liquid-based cytology (LBC) has replaced conventional smear assessment in many centers over recent years. In our laboratory this transfer took place in 1999. At that time we performed a split sample study comparing the conventional method of cervical smear evaluation with the ThinPrep system. This split sample study identified a dramatic improvement in specimen adequacy with LBC. While 11% of conventional preparations were reported as unsatisfactory and almost 9% were reported as suboptimal, evaluation of the same cases using LBC saw this combined figure reduced to 2.3%. AIM: To evaluate whether this dramatic fall in unsatisfactory smears has been maintained with the use of LBC. The database for all smears reported for 2005 (100% LBC) was interrogated. The number of unsatisfactory reports was calculated. The reason for an unsatisfactory report was recorded for each case. The overall unsatisfactory rate was compared with that reported in the 1999 split sample study. A total of 41,312 smear tests were reported in 2005. 1,342 (3.25%) were reported as unsatisfactory. Our findings support the ongoing value of LBC in a routine cervical screening laboratory in terms of continuing to maintain a low rate of unsatisfactory smears.

  4. Knowledge, attitude and practice of cervical cancer screening in women visiting a tertiary care hospital of Delhi

    Directory of Open Access Journals (Sweden)

    M Singh

    2014-01-01

    Full Text Available Background: Cervical cancer being a major cause of morbidity and mortality in women in developing countries, its awareness is essential. Aim: The aim of this study is to assess the knowledge, attitude and practices of women regarding the basic screening test for detection of cancer cervix. Settings and Design: Population based cross-sectional study. Materials and Methods: Cross-sectional prospective study was conducted. Information from consenting participants (450 was collected using structured questionnaire. Answers were described in terms of knowledge, attitude and practice and their respective adequacy with respect to Papanicolaou (Pap test, the most common test used for early detection of cervical cancer. Adequacy was compared between the categories of socio demographic and clinical variables. Statistical Analysis: The data collected was analyzed using statistical package (SPSS version 18.0. Adequacy was compared between the categories of the control variables by χ2 test with a 5% significance level. Results: Knowledge, attitude and practices regarding Pap test were adequate in 32.7%, 18.2% and 7.3% of women respectively. Major impediment to adequate practice was lack of request by physician. Knowledge, attitudes and practices were found to increase significantly with increasing age and education. Conclusion: Effective information, education and communication strategies are required to improve the level of awareness of public. Health-care professional should be proactive in imparting knowledge at every opportunity.

  5. A molecular monopoly? HPV testing, the Pap smear and the molecularisation of cervical cancer screening in the USA.

    Science.gov (United States)

    Hogarth, Stuart; Hopkins, Michael M; Rodriguez, Victor

    2012-02-01

    DNA-based molecular testing for human papillomavirus has emerged as a novel approach to cervical cancer screening in the context of well-entrenched existing technology, the Pap smear. This article seeks to elucidate the process of molecularisation in the context of screening programmes. We illustrate how, although Pap has long been problematised and could be seen as a competing technological option, the existing networks and regime for Pap were important in supporting the entrenchment process for the artefacts, techniques and new diagnostics industry entrant, Digene, associated with the new test. The article provides insights into how the molecularisation of screening unfolds in a mainstream market. We reveal an incremental and accretive, rather than revolutionary, process led by new commercial interests in an era when diagnostic innovation is increasingly privatised. We show Digene's reliance on patents, an international scientific network and their position as an obligatory point of passage in the clinical research field with regard to the new technology's role, as well as on controversial new marketing practices. The article is based on a mixed method approach, drawing on a wide range of contemporary sources (including patents, statutory filings by companies, scientific literature and news sources) as well as interviews.

  6. Decision-analytic modeling to evaluate the long-term effectiveness and cost-effectiveness of HPV-DNA testing in primary cervical cancer screening in Germany

    Directory of Open Access Journals (Sweden)

    Krämer, Alexander

    2010-01-01

    Full Text Available Background: Persistent infections with high-risk types of human papillomavirus (HPV are associated with the development of cervical neoplasia. Compared to cytology HPV testing is more sensitive in detecting high-grade cervical cancer precursors, but with lower specificity. HPV based primary screening for cervical cancer is currently discussed in Germany. Decisions should be based on a systematic evaluation of the long-term effectiveness and cost-effectiveness of HPV based primary screening. Research questions: What is the long-term clinical effectiveness (reduction in lifetime risk of cervical cancer and death due to cervical cancer, life years gained of HPV testing and what is the cost-effectiveness in Euro per life year gained (LYG of including HPV testing in primary cervical cancer screening in the German health care context? How can the screening program be improved with respect to test combination, age at start and end of screening and screening interval and which recommendations should be made for the German health care context? Methods: A previously published and validated decision-analytic model for the German health care context was extended and adapted to the natural history of HPV infection and cervical cancer in order to evaluate different screening strategies that differ by screening interval, and tests, including cytology alone, HPV testing alone or in combination with cytology, and HPV testing with cytology triage for HPV-positive women. German clinical, epidemiological and economic data were used. In the absence of individual data, screening adherence was modelled independently from screening history. Test accuracy data were retrieved from international meta-analyses. Predicted outcomes included reduction in lifetime-risk for cervical cancer cases and deaths, life expectancy, lifetime costs, and discounted incremental cost-effectiveness ratios (ICER. The perspective of the third party payer and 3% annual discount rate were

  7. 宫颈病变筛查策略的效果分析%The Evaluation of the Effect of Cervical Lesions Screening Strategies

    Institute of Scientific and Technical Information of China (English)

    龙腾飞

    2011-01-01

    Cervical cancer is one of the most common female malignant cancers , with an increasing incidence and earlier onset ages. In developed countries, the systematic screening programmes have reduced the morbidity and mortality resulting from cervical cancer. The screening program is the main means to prevent and control cervical cancer. The main screening tools are visual inspection, cytology, human papillomavirus testing and colposcopy. The scholars all over the world made great efforts to seek appropriate cervical cancer screening solutions in either single or comhines use of various methods. Here is to review on the effert of cervical lesions screening strategies in recent years inside and outside China.%宫颈癌是妇科常见的恶性肿瘤之一,其发病率逐年升高,且发病年龄有年轻化的趋势.对宫颈癌的筛查是预防和控制宫颈癌的主要手段,也是极大限度防治宫颈癌的最好途径.宫颈癌筛查方法包括肉眼观察、宫颈细胞学、人类乳头瘤病毒检测及阴道镜检查等.世界各地学者做了许多努力来寻求适宜的宫颈癌筛查方案,包括各种方法的单独及联合使用.现就近年来国内外宫颈病变筛查策略的效果予以综述.

  8. Evaluation of a cervical cancer screening program based on HPV testing and LLETZ excision in a low resource setting.

    Directory of Open Access Journals (Sweden)

    Margaret McAdam

    Full Text Available We conducted studies in Vanuatu to evaluate potential screening and treatment strategies to assist with control of cervical cancer. In a pilot study of 496 women, visual inspection and cytology were evaluated as screening tests for detection of CIN 2 or worse (CIN2+, observed in 21 of 206 subjects biopsied on the basis of abnormal visual inspection or cytology. Sensitivity of visual inspection with Lugol's Iodine for detection of CIN2+ on biopsy was 0.63, specificity was 0.32, and the positive predictive value was 0.09. For HSIL cytology, sensitivity was 0.99, specificity was 0.77, and the positive predictive value was 0.88. HSIL cytology was significantly more sensitive and had a significantly higher PPV for CIN 2+ than visual inspection (p<0.01. In a further study of 514 women, we compared testing for HR HPV and cytology as predictors of biopsy proven CIN 2+. Sensitivity of HSIL cytology for CIN2+ as established by loop excision of the cervix was 0.81, specificity was 0.94, and positive predictive value was 0.48. Sensitivity of a positive test for HR HPV for detection of CIN2+ was non-significantly different from cytology at 0.81, specificity was 0.94, and positive predictive value was 0.42. Combining the two tests gave a significantly lower sensitivity of 0.63, a specificity of 0.98, and a positive predictive value of 0.68. For women over 30 in a low resource setting without access to cytology, a single locally conducted test for high risk HPV with effective intervention could reduce cervical cancer risk as effectively as intervention based on cytology conducted in an accredited laboratory.

  9. Dynamic Contrast-Enhanced MRI of Cervical Cancers: Temporal Percentile Screening of Contrast Enhancement Identifies Parameters for Prediction of Chemoradioresistance

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, Erlend K.F. [Department of Medical Physics, Oslo University Hospital, Oslo (Norway); Hole, Knut Hakon; Lund, Kjersti V. [Department of Radiology, Oslo University Hospital, Oslo (Norway); Sundfor, Kolbein [Department of Gynaecological Oncology, Oslo University Hospital, Oslo (Norway); Kristensen, Gunnar B. [Department of Gynaecological Oncology, Oslo University Hospital, Oslo (Norway); Institute for Medical Informatics, Oslo University Hospital, Oslo (Norway); Lyng, Heidi [Department of Radiation Biology, Oslo University Hospital, Oslo (Norway); Malinen, Eirik, E-mail: eirik.malinen@fys.uio.no [Department of Medical Physics, Oslo University Hospital, Oslo (Norway); Department of Physics, University of Oslo, Oslo (Norway)

    2012-03-01

    Purpose: To systematically screen the tumor contrast enhancement of locally advanced cervical cancers to assess the prognostic value of two descriptive parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Methods and Materials: This study included a prospectively collected cohort of 81 patients who underwent DCE-MRI with gadopentetate dimeglumine before chemoradiotherapy. The following descriptive DCE-MRI parameters were extracted voxel by voxel and presented as histograms for each time point in the dynamic series: normalized relative signal increase (nRSI) and normalized area under the curve (nAUC). The first to 100th percentiles of the histograms were included in a log-rank survival test, resulting in p value and relative risk maps of all percentile-time intervals for each DCE-MRI parameter. The maps were used to evaluate the robustness of the individual percentile-time pairs and to construct prognostic parameters. Clinical endpoints were locoregional control and progression-free survival. The study was approved by the institutional ethics committee. Results: The p value maps of nRSI and nAUC showed a large continuous region of percentile-time pairs that were significantly associated with locoregional control (p < 0.05). These parameters had prognostic impact independent of tumor stage, volume, and lymph node status on multivariate analysis. Only a small percentile-time interval of nRSI was associated with progression-free survival. Conclusions: The percentile-time screening identified DCE-MRI parameters that predict long-term locoregional control after chemoradiotherapy of cervical cancer.

  10. An adverse event in a well-established cervical cancer screening program: an observational study of 19,000 females unsubscribed to the program

    Directory of Open Access Journals (Sweden)

    Larsen MB

    2016-10-01

    Full Text Available Mette Bach Larsen,1 Hans Svanholm,1,2 Berit Andersen1 1Department of Public Health Programmes, 2Department of Pathology, Randers Regional Hospital, Randers, Denmark Introduction: In Denmark, an organized approach to cervical cancer screening has had national coverage since 1998. However, in 2013, it was discovered that 19,000 females had been unsubscribed from the Danish National Cervical Cancer Screening Program and had thus not received invitations or reminders as recommended by the health authorities. The study aims to report the essence of this adverse event and describe the outcomes of reestablishing invitations in terms of participation rates and screening results. Furthermore, patient compensations to affected females diagnosed with cervical cancer and coverage in the mass media was reported.Methods: An observational study based on information from the Danish Pathology Databank, the Department of Public Health Programs, and Infomedia (a Danish database of media coverage was carried out.Results: A total of 19,106 females were affected. Of those still in the screening age, 37.7% had been tested within 3 years or 5 years despite not receiving any invitation. A total of 21.6% reconfirmed their status as unsubscribed. Of the remaining females, 55.6% were tested within a year, and 94.6% of these test results were normal. Among females aged >64 years, 12.7% accepted the offer of a final screening test. Totally, 90% of these tests were normal. Nineteen females diagnosed with cervical cancer were compensated by the Danish Patient Compensation Association with a total of €693,000, ranging from €8,900 to €239,700. Coverage of cervical cancer screening in the mass media increased from 25 items in the 3 months prior to this adverse event to 590 items in the month when it became public.Conclusion: Even though more than one-third of the affected females were tested despite not receiving regular invitations to participate in the screening

  11. Population-based cervical screening with a 5-year interval in the Netherlands - Stabilization of the incidence of squamous cell carcinoma and its precursor lesions in the screened population

    NARCIS (Netherlands)

    Siemens, FC; Boon, ME; Kuypers, JC; Kok, LP

    2004-01-01

    OBJECTIVE: To evaluate the outcome of population based cervical screening at 5-year intervals. STUDY DESIGN: Results from the west region of the Netherlands (population 2 million) were used. The 1995-2000 round was compared with the first 2 years of the second (2001-2002). All results were prospecti

  12. What are GPs' preferences for financial and non-financial incentives in cancer screening? Evidence for breast, cervical, and colorectal cancers.

    Science.gov (United States)

    Sicsic, Jonathan; Krucien, Nicolas; Franc, Carine

    2016-10-01

    General practitioners (GPs) play a key role in the delivery of preventive and screening services for breast, cervical, and colorectal cancers. In practice, GPs' involvement varies considerably across types of cancer and among GPs, raising important questions about the determinants of GPs' implication in screening activities: what is the relative impact of financial and non-financial incentives? Are GPs' preferences for financial and non-financial incentives cancer-specific? Is there preference heterogeneity and how much does it differ according to the screening context? This study investigates the determinants of GPs' involvement in cancer screening activities using the discrete choice experiment (DCE) methodology. A representative sample of 402 GPs' was recruited in France between March and April 2014. Marginal rates of substitution were used to compare GPs' preferences for being involved in screening activities across three types of cancers: breast, cervical, and colorectal. Variability of preferences was investigated using Hierarchical Bayes mixed logit models. The results indicate that GPs are sensitive to both financial and non-financial incentives, such as a compensated training and systematic transmission of information about screened patients, aimed to facilitate communication between doctors and patients. There is also evidence that the level and variability of preferences differ across screening contexts, although the variations are not statistically significant on average. GPs appear to be relatively more sensitive to financial incentives for being involved in colorectal cancer screening, whereas they have higher and more heterogeneous preferences for non-financial incentives in breast and cervical cancers. Our study provides new findings for policymakers interested in prioritizing levers to increase the supply of cancer screening services in general practice.

  13. Application effect of TruScreen system in cervical cancer screening%TruScreen系统在宫颈癌筛查中的应用效果

    Institute of Scientific and Technical Information of China (English)

    李佩; 王金声; 康媛

    2016-01-01

    Objective To investigate the effect of TruScreen (TS) system as applied in cervical cancer screening. Method 368 patients were included in the retrospective analysis, and were randomized into TS group or TCT group, with 184 cases in each. The TS group was tested with TS detection, while the TCT group was administered with Thin Prep cytology test (TCT), and the effect of the two tests were compared with histopathology as the diagnostic standard. Result The detection sensitivity, specificity and the positive rate of the TS and TCT group were 93.2%and 100%, 76.0%and 75.0%, 64.7% and 55.7%, respectively. Conclusion TS detection is as good as TCT detection in cervical cancer screening, which is clinically applicable.%目的:探讨宫颈癌筛查系统TruScreen(TS)在宫颈癌筛查中的应用效果。方法回顾性分析368例检查者,分为TS检测组和TCT检测组,每组184例,TS检测组行TS检测,TCT检测组行液基薄层细胞学(TCT)检测,以组织病理学为诊断标准,比较TS与TCT检查在宫颈癌筛查中的应用效果。结果 TS检测组与TCT检测组检测敏感度分别为93.2%、100%,特异度分别为76.0%、75.0%,阳性符合率分别为64.7%、55.7%。结论 TS检测与TCT检测在宫颈癌筛查中具有相似的检测效果,值得临床推广和运用。

  14. Effectiveness of cervical length screening by transvaginal sonography and use of progesterone for preventing preterm labour

    Directory of Open Access Journals (Sweden)

    Snehal S. Dhobale

    2016-08-01

    Conclusions: The study concluded that use of vaginal progesterone 200 mg in women with cervical length 25 mm or less measured by transvaginal sonography (as a good predictor of preterm labour has useful effect in preventing preterm labour as well as associated neonatal mortality and morbidity. Neonatal survival is critically dependent on maturity of an infant and progressively increases with gestational age. Each day critically impacts on maturity and survival. Thus prevention and/or effective management of preterm labour will improve neonatal outcome and will have a profound impact on societal and long-term public healthcare costs. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2813-2818

  15. 子宫颈抹片检查常规筛选宫颈组织、癌前病变或癌变 在发展中国家门诊中的运用%Screening of premalignant and malignant cervical lesions in underdeveloped countries by using Pap smear as routine investigation in outpatient department

    Institute of Scientific and Technical Information of China (English)

    Rubina Mukhtar; Maham Munir; Allah Rakha; Abdul Mateen; Rab Nawaz Maken; Muhammad Arif

    2011-01-01

    Objective: Papanicolou (Pap) smear screening has dramatically reduced the incidence of invasive cervical can-cer worldwide. Pap smear screening is still not widely available in developing countries and therefore cannot be used as mass screening tool. This study was designed to establish the role of Pap smear as a routine investigation for females presented to gynecological department. Methods: It was a hospital based study. Patients attending with complaints including irregular vagi-nal bleeding, vagina discharge, dyspareunia, low backache or lower abdominal pain and primary or secondary infertility were included in the study. All these patients underwent pap smear. Results: Age of females was 25 to 60 years. Ninety females had dysplasia. Mild to moderate dysplasia was positive in 84 females. Six patients had severe dysplasia suspicious for squa-mous cell carcinoma (SCC) which was confirmed as invasive SCC on biopsy. All patients with mild to moderate dysplasia were regularly followed at 4 to 6 months. Thirty patients were lost during follow up. Forty had negative smear at 6 months, while fourteen having persistent dysplasia on repeated pap smears were referred for biopsies. Histopathology confirmed invasive SCC in five patients while chronic cervicitis was reported in nine patients. Only two of screened patients with high suspicion for cancer showed false negative results. Directed biopsies done in these confirmed invasive SCC. Conclusion: Pap smear is a useful, simple, non-invasive and reliable screening tool for cervical cancer. It may be practiced as a routine investigation in outpatients in developing countries, where mass screening is not available.

  16. Everybody's talking: using entertainment-education video to reduce barriers to discussion of cervical cancer screening among Thai women.

    Science.gov (United States)

    Love, G D; Mouttapa, Michele; Tanjasiri, S P

    2009-10-01

    Although Southeast Asian women are at exceedingly high risk for cervical cancer, low rates of the Pap testing necessary for early detection and successful treatment continue among this group. Previous research suggests that discussions about Pap testing with important people in a woman's life, particularly her doctor, may increase the likelihood of screening; therefore increasing women's discussions about cancer screenings is an important step toward behavior change. The purpose of this study was to determine the effectiveness of a culturally sensitive, seven-minute video intervention in reducing barriers to discussions about Pap tests among Thai women. This unique video presented Thai actors, speaking in Thai, in a soap opera format. Participants completed a self-report questionnaire at baseline, immediately after the intervention and at 3-month follow-up. The comparison group received an educational pamphlet. Although the results indicated that both groups experienced reductions in barriers to communicating with others about Pap tests, the intervention group had significantly stronger outcomes than the comparison group for communicating about Pap tests in general as well as to doctors. These findings suggest that intermediate communication effects such as self-efficacy, collective efficacy and perhaps interpersonal communication may reduce barriers to discussion and positive decision making regarding Pap tests.

  17. Neuropsychological screening of children of substance-abusing women attending a Special Child Welfare Clinic in Norway

    OpenAIRE

    Skogmo Idar; Lindbæk Morten; Hjerkinn Bjørg; Rosvold Elin

    2010-01-01

    Background Exposure to alcohol and illicit substances during pregnancy can have an impact on the child for the rest of his/her life. A Special Child Welfare Clinic (SCWC) in Norway provides care for pregnant women with substance abuse problems. Treatment and support are provided without replacement therapy. Methods We performed a neuropsychological screening of 40 children aged four to 11 years whose ...

  18. Design and methods of the evaluation of an HPV-based cervical cancer screening strategy in Mexico: the Morelos HPV study Diseño y métodos de la evaluación del uso de la prueba de virus de papiloma humano para tamizaje de cáncer cervical en México: el estudio de VPH en Morelos

    OpenAIRE

    Yvonne Flores; Keerti Shah; Eduardo Lazcano; Mauricio Hernández; David Bishai; Daron G. Ferris; Attila Lörincz; Pilar Hernández; Jorge Salmerón

    2002-01-01

    Objective. The purpose of this paper is to describe the design and methodology of the Morelos HPV Study. The main objective of this study is to examine the use of two different methods for obtaining HPV DNA specimens, self-collected vaginal and clinician-collected cervical, to detect pre-invasive cervical lesions and cancer. Material and Methods. This study was conducted within the regular population-based framework of the Mexican Institute of Social Security (IMSS) cervical cancer screening ...

  19. On Screening Methods and Effectiveness of Cervical Cancer%浅谈子宫颈癌的筛查方法效果

    Institute of Scientific and Technical Information of China (English)

    张艳辉

    2014-01-01

    Screening methods and strategies of cervical cancer are to be discussed. Reasonable screening method should depend on multiple technologies, rational al ocation and optimization in accordance with local resources and population risk level. Specific plan is decided by costs and availability of al kinds of technologies. Screen with different uterine neck screening projects to monitor uterine neck conditions and lower morbidity of cervical cancer. Keep cervical cancer’s threat on women healthy and life low to the largest extent.%探讨子宫颈癌的筛查方法、筛查策略。合理的筛查方案应该涉及多种技术的组合,按照地区资源条件和人群风险度进行优化配置,具体方案由各种技术的成本及可获得性决定。采用不同的宫颈筛查项目进行人群筛查,以监测宫颈状况,降低宫颈癌发病率,最大限度地降低子宫颈癌对妇女生命和健康的威胁。

  20. Economic evaluation of three populational screening strategies for cervical cancer in the county of Valles Occidental: CRICERVA clinical trial

    Directory of Open Access Journals (Sweden)

    Bonet Josep M

    2011-10-01

    Full Text Available Abstract Background A high percentage of cervical cancer cases have not undergone cytological tests within 10 years prior to diagnosis. Different population interventions could improve coverage in the public system, although costs will also increase. The aim of this study was to compare the effectiveness and the costs of three types of population interventions to increase the number of female participants in the screening programmes for cancer of the cervix carried out by Primary Care in four basic health care areas. Methods/Design A cost-effectiveness analysis will be performed from the perspective of public health system including women from 30 to 70 years of age (n = 20,994 with incorrect screening criteria from four basic health care areas in the Valles Occidental, Barcelona, Spain. The patients will be randomly distributed into the control group and the three intervention groups (IG1: invitation letter to participate in the screening; IG2: invitation letter and informative leaflet; IG3: invitation letter, informative leaflet and a phone call reminder and followed for three years. Clinical effectiveness will be measured by the number of HPV, epithelial lesions and cancer of cervix cases detected. The number of deaths avoided will be secondary measures of effectiveness. The temporal horizon of the analysis will be the life expectancy of the female population in the study. Costs and effectiveness will be discounted at 3%. In addition, univariate and multivariate sensitivity analysis will be carried out. Discussion IG3 is expected to be more cost-effective intervention than IG1 and IG2, with greater detection of HPV infections, epithelial lesions and cancer than other strategies, albeit at a greater cost. Trial Registration Clinical Trials.gov Identifier NCT01373723

  1. Comparison of conventional Papanicolaou smear and SurePath® liquid-based cytology in the Copenhagen population screening programme for cervical cancer

    DEFF Research Database (Denmark)

    Kirschner, Benny; Simonsen, Kåre; Junge, Jette

    2006-01-01

    OBJECTIVE: To compare diagnostic performance of conventional Papanicolaou smear with SurePath liquid-based cytology in a population screening programme. METHODS: A retrospective comparison was performed on data from two 18-month periods of the screening programme for cervical cancer...... in the municipality of Copenhagen with conventional Papanicolaou technique (n = 82,116) and liquid-based cytology (n = 84,414). RESULTS: After the conversion to liquid-based cytology the percentage of unsatisfactory samples decreased from 2.3% to 0.3% (P ...-based technique. CONCLUSIONS: This study showed the number of unsatisfactory samples to be significantly reduced with the liquid-based technique. The data suggest that there is an increased detection rate of cervical precancerous lesions with liquid-based cytology, but the number of false positive tests is still...

  2. Histology verification demonstrates that biospectroscopy analysis of cervical cytology identifies underlying disease more accurately than conventional screening: removing the confounder of discordance.

    Directory of Open Access Journals (Sweden)

    Ketan Gajjar

    Full Text Available BACKGROUND: Subjective visual assessment of cervical cytology is flawed, and this can manifest itself by inter- and intra-observer variability resulting ultimately in the degree of discordance in the grading categorisation of samples in screening vs. representative histology. Biospectroscopy methods have been suggested as sensor-based tools that can deliver objective assessments of cytology. However, studies to date have been apparently flawed by a corresponding lack of diagnostic efficiency when samples have previously been classed using cytology screening. This raises the question as to whether categorisation of cervical cytology based on imperfect conventional screening reduces the diagnostic accuracy of biospectroscopy approaches; are these latter methods more accurate and diagnose underlying disease? The purpose of this study was to compare the objective accuracy of infrared (IR spectroscopy of cervical cytology samples using conventional cytology vs. histology-based categorisation. METHODS: Within a typical clinical setting, a total of n = 322 liquid-based cytology samples were collected immediately before biopsy. Of these, it was possible to acquire subsequent histology for n = 154. Cytology samples were categorised according to conventional screening methods and subsequently interrogated employing attenuated total reflection Fourier-transform IR (ATR-FTIR spectroscopy. IR spectra were pre-processed and analysed using linear discriminant analysis. Dunn's test was applied to identify the differences in spectra. Within the diagnostic categories, histology allowed us to determine the comparative efficiency of conventional screening vs. biospectroscopy to correctly identify either true atypia or underlying disease. RESULTS: Conventional cytology-based screening results in poor sensitivity and specificity. IR spectra derived from cervical cytology do not appear to discriminate in a diagnostic fashion when categories were based on

  3. Preventing premature deaths from breast and cervical cancer among underserved women in the United States: insights gained from a national cancer screening program.

    Science.gov (United States)

    White, Mary C; Wong, Faye L

    2015-05-01

    This commentary highlights some of the valuable insights gained from a special collection of papers that utilized data from the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and appear in this special issue. The data and experiences of the NBCCEDP can inform the identification of new opportunities and directions for meeting the cancer screening needs of underserved women in a complex and changing health care environment.

  4. Computer-aided screening system for cervical precancerous cells based on field emission scanning electron microscopy and energy dispersive x-ray images and spectra

    Science.gov (United States)

    Jusman, Yessi; Ng, Siew-Cheok; Hasikin, Khairunnisa; Kurnia, Rahmadi; Osman, Noor Azuan Bin Abu; Teoh, Kean Hooi

    2016-10-01

    The capability of field emission scanning electron microscopy and energy dispersive x-ray spectroscopy (FE-SEM/EDX) to scan material structures at the microlevel and characterize the material with its elemental properties has inspired this research, which has developed an FE-SEM/EDX-based cervical cancer screening system. The developed computer-aided screening system consisted of two parts, which were the automatic features of extraction and classification. For the automatic features extraction algorithm, the image and spectra of cervical cells features extraction algorithm for extracting the discriminant features of FE-SEM/EDX data was introduced. The system automatically extracted two types of features based on FE-SEM/EDX images and FE-SEM/EDX spectra. Textural features were extracted from the FE-SEM/EDX image using a gray level co-occurrence matrix technique, while the FE-SEM/EDX spectra features were calculated based on peak heights and corrected area under the peaks using an algorithm. A discriminant analysis technique was employed to predict the cervical precancerous stage into three classes: normal, low-grade intraepithelial squamous lesion (LSIL), and high-grade intraepithelial squamous lesion (HSIL). The capability of the developed screening system was tested using 700 FE-SEM/EDX spectra (300 normal, 200 LSIL, and 200 HSIL cases). The accuracy, sensitivity, and specificity performances were 98.2%, 99.0%, and 98.0%, respectively.

  5. Recommendations for cervical cancer screening programs in developing countries: the need for equity and technological development Recomendaciones a programas de detección oportuna de cáncer cervical en países en desarrollo: necesidad de equidad y desarrollo tecnológico

    OpenAIRE

    2003-01-01

    The cervical cancer screening programs (CCSP) have not been very efficient in the developing countries. This explains the need to foster changes on policies, standards, quality control mechanisms, evaluation and integration of new screening alternatives considered as low and high cost, as well as to regulate colposcopy practices and the foundation of HPV laboratories. Cervical cancer (CC) is a disease most frequently found in poverty-stricken communities and reflecting a problem of equity at ...

  6. Evaluation of primary HPV-DNA testing in relation to visual inspection methods for cervical cancer screening in rural China: an epidemiologic and cost-effectiveness modelling study

    Directory of Open Access Journals (Sweden)

    Kang Yoon-Jung

    2011-06-01

    Full Text Available Abstract Background A new lower-cost rapid-throughput human papillomavirus (HPV test (careHPV, Qiagen, Gaithersburg, USA has been shown to have high sensitivity for the detection of high grade cervical intraepithelial neoplasia. Methods We assessed the outcomes and cost-effectiveness of careHPV screening in rural China, compared to visual inspection with acetic acid, when used alone (VIA or in combination with Lugol's iodine (VIA/VILI. Using data on sexual behaviour, test accuracy, diagnostic practices and costs from studies performed in rural China, we estimated the cost-effectiveness ratio (CER and associated lifetime outcomes for once-lifetime and twice-lifetime screening strategies, and for routine screening at 5-yearly, 10-yearly and IARC-recommended intervals. The optimal age range for once-lifetime screening was also assessed. Results For all strategies, the relative ordering of test technologies in reducing cervical cancer incidence and mortality was VIA (least effective; VIA/VILI; careHPV@1.0 pg/ml and careHPV@0.5 pg/ml (most effective. For once-lifetime strategies, maximum effectiveness was achieved if screening occurred between 35-50 years. Assuming a participation rate of ~70%, once-lifetime screening at age 35 years would reduce cancer mortality by 8% (for VIA to 12% (for careHPV@0.5 over the long term, with a CER of US$557 (for VIA to $959 (for careHPV@1.0 per life year saved (LYS compared to no intervention; referenced to a 2008 GDP per capita in Shanxi Province of $2,975. Correspondingly, regular screening with an age-standardised participation rate of 62% (which has been shown to be achievable in this setting would reduce cervical cancer mortality by 19-28% (for 10-yearly screening to 43-54% (using IARC-recommended intervals, with corresponding CERs ranging from $665 (for 10-yearly VIA to $2,269 (for IARC-recommended intervals using careHPV@1.0 per LYS. Conclusions This modelled analysis suggests that primary careHPV screening

  7. Real-time colorimetric detection of DNA methylation of the PAX1 gene in cervical scrapings for cervical cancer screening with thiol-labeled PCR primers and gold nanoparticles

    Directory of Open Access Journals (Sweden)

    Huang J

    2016-10-01

    proposed method showed that the areas under the receiver operating characteristic curve (AUCs of PAX1 were 0.833, 0.742, and 0.739 for the detection of cervical intraepithelial neoplasms grade 2 and worse lesions (CIN2+, cervical intraepithelial neoplasms grade 3 and worse lesions (CIN3+, and squamous cell carcinoma, respectively. The sensitivity and specificity for detecting CIN2+ lesions were 0.941 and 0.600, respectively, with a cutoff value of 31.27%. The proposed method also showed superior sensitivity over qMSP methods for the detection of CIN2+ and CIN3+ (0.941 vs 0.824 and 1.000 vs 0.800, respectively. Furthermore, the novel method exhibited higher AUC (0.833 for the detection of CIN2+ than qMSP (0.807. Conclusion: The results of thiol-labeled AuNP method were clearly observed by the naked eyes without requiring any expensive equipment. Therefore, the thiol-labeled AuNP method could be a simple but efficient strategy for cervical cancer screening. Keywords: colorimetric detection, gold nanoparticles, DNA methylation, cervical cancer screening, UV-vis, high sensitivity, quantitative detection

  8. Improving cervical cancer screening in Mexico: results from the Morelos HPV Study Mejorando la detección oportuna del cáncer cervical en México: resultados del Estudio de VPH en Morelos

    Directory of Open Access Journals (Sweden)

    Yvonne Flores

    2003-01-01

    Full Text Available OBJECTIVE: The purpose of this paper is to describe some of the results of the Morelos HPV Study. The main objective of the Morelos HPV Study is to evaluate the use of human papillomavirus (HPV DNA testing, as compared to the Papanicolaou (Pap test, for cervical cancer (CC screening. MATERIAL AND METHODS: The Morelos HPV Study is currently being conducted in Mexico, to examine the possibility of using HPV testing for CC screening. The HPV testing of self-collected vaginal and clinician-collected cervical specimens was evaluated as part of this study. The acceptability of the HPV testing of self-collected specimens was compared to that of the Pap test. A cost-effectiveness analysis (CEA and cost-benefit analysis (CBA was also performed. RESULTS: The Morelos HPV Study results indicate that HPV testing has a greater sensitivity to detect cervical intraepithelial neoplasia (CIN 2/3 and CC than the Pap test. Our results also indicate an over-all lower acceptability of the Pap test as compared to the self-collected procedure. The results of the CEA and CBA indicate that screening women between the ages of 20-80 for CC using some type of HPV testing is always more cost-effective than screening for CC using the Pap test. CONCLUSIONS: Our results suggest that self- and clinician-collected HPV testing could be used in CC prevention programs, as an effective complement or substitute for the Pap test.OBJETIVO: Describir algunos de los resultados del Estudio de VPH en Morelos. El objetivo principal del Estudio de VPH en Morelos es evaluar el uso de la prueba del virus de papiloma humano (VPH, en relación con la prueba de Papanicolaou, para el tamizaje de cáncer cervical. MATERIAL Y MÉTODOS: El Estudio de VPH en Morelos actualmente se está llevando a cabo en México, para examinar la posibilidad de usar la prueba de VPH para la detección de cáncer cervical. Se evaluó el uso de la prueba de VPH en muestras auto-tomadas vaginales y en muestras cervicales

  9. Results of an Australian trial using SurePath liquid-based cervical cytology with FocalPoint computer-assisted screening technology.

    Science.gov (United States)

    Bowditch, Ron C; Clarke, Joanne M; Baird, Phillip J; Greenberg, Merle L

    2012-12-01

    BD FocalPoint GS™ computer-assisted screening of BD SurePath® liquid-based cervical cytology slides (SP + FP) was compared with screening an accompanying conventional cervical Papanicolaou (Pap) smear (CON) in a split sample trial of 2,198 routine specimens. The rate of unsatisfactory specimens in the SP + FP arm was 0.2% compared with 4.1% in the conventional Pap smear, a significant reduction. There was no statistically significant difference between SP + FP and CON for the detection of histologically confirmed high-grade (HG) lesions in the routine split sample specimens (n = 9). To further test the sensitivity of SP + FP for HG lesions, 38 SurePath slides from confirmed HG cases, without an accompanying CON, were interpolated among the routine smears. In every one of the 47 confirmed HG cases, either HG cells were present in the microscope fields selected by FocalPointGS™ for review by the screening cytologist (46 of 47), or full screening of the slide was indicated by the FocalPointGS™ (1 of 47), confirming the effectiveness of SP + FP technology for primary screening. In a small number of cases, the screening cytologist did not recognize the abnormality even though on review HG cells were present in fields selected by FocalPointGS™. The overall detection rate was 93% for HG squamous lesions; 89% for known HG endocervical glandular lesions; and 91% for known endometrial carcinoma. In conclusion, the SP + FP detected 100% of HG abnormalities in the trial set; significantly reduced the rate of unsatisfactory specimens; and improved the overall screening rate of detection of HG abnormalities particularly of glandular lesions when compared with other screening technologies.

  10. Risk of preterm birth after treatment for cervical intraepithelial neoplasia among women attending colposcopy in England: retrospective-prospective cohort study

    Science.gov (United States)

    Castanon, Alejandra; Brocklehurst, Peter; Evans, Heather; Peebles, Donald; Singh, Naveena; Walker, Patrick; Patnick, Julietta

    2012-01-01

    Objective To explore the association between preterm delivery and treatment at colposcopy. Design Retrospective-prospective cohort study using record linkage. Setting 12 National Health Service hospitals in England. Participants Women who had a cervical histology sample taken between 1987 and 2009. These women were linked by hospital episode statistics to hospital obstetric records between 1998 and 2009 for the whole of England to identify singleton live births between 20-43 gestational weeks before or after cervical histology. Main outcome measures Proportion of preterm births (<37 weeks); the relative risk for the strength of association between preterm births and treatment for cervical intraepithelial neoplasia. Results 18 441 singleton births occurred: 4176 before histology and 14 265 after histology. Of the singleton births after histology, 9.0% (n=1284) were preterm compared with 6.7% of all births in England over the same period (excess risk 2.3 per 100 births, 95% confidence interval 1.8% to 2.8%). Among first births after histology, the adjusted relative risk associated with previous treatment was 1.19 (95% confidence interval 1.01 to 1.41); among first births before histology the relative risk associated with subsequent treatment was 1.47 (1.05 to 2.05). Combining these, the relative risk associated with treatment adjusted for timing relative to histology was 0.91 (0.66 to 1.26) corresponding to an absolute difference of −0.25 (−2.61 to 2.11) per 100 singleton births. Among 372 women who gave birth both before and after treatment, there were 30 preterm births after treatment and 32 before treatment (relative risk 0.94, 0.62 to 1.43). Conclusion The risk of preterm delivery in women treated by colposcopy in England was substantially less than that in many other studies, predominantly from Nordic countries. The increased risk may be a consequence of confounding and not caused by treatment. Although this study is reassuring for large loop excision of

  11. Determinants of Cervical Cancer Screening Accuracy for Visual Inspection with Acetic Acid (VIA) and Lugol’s Iodine (VILI) Performed by Nurse and Physician

    Science.gov (United States)

    Raifu, Amidu O.; El-Zein, Mariam; Sangwa-Lugoma, Ghislain; Ramanakumar, Agnihotram; Walter, Stephen D.

    2017-01-01

    Background Visual inspection with acetic acid (VIA) and Lugol’s iodine (VILI) are used to screen women for cervical cancer in low-resource settings. Little is known about correlates of their diagnostic accuracy by healthcare provider. We examined determinants of VIA and VILI screening accuracy by examiner in a cross-sectional screening study of 1528 women aged 30 years or older in a suburb of Kinshasa, Democratic Republic of Congo. Methods We used a logistic regression model for sensitivity and specificity to estimate the diagnostic accuracy of VIA and VILI, independently performed by nurse and physician, as a function of sociodemographic and reproductive health characteristics. Results Nurses rated tests as positive more often than physicians (36.3% vs 30.2% for VIA, 26.2% vs 25.2% for VILI). Women’s age was the most important determinant of performance. It was inversely associated with sensitivity (nurse’s VIA: p<0.001, nurse’s VILI: p = 0.018, physician’s VIA: p = 0.005, physician’s VILI: p = 0.006) but positively associated with specificity (all four combinations: p<0.001). Increasing parity adversely affected sensitivity and specificity, but the effects on sensitivity were significant for nurses only. The screening performance of physician’s assessment was significantly better than the nurse’s (difference in sensitivity: VIA = 13%, VILI = 16%; difference in specificity: VIA = 6%, VILI = 1%). Conclusions Age and parity influence the performance of visual tests for cervical cancer screening. Proper training of local healthcare providers in the conduct of these tests should take into account these factors for improved performance of VIA and VILI in detecting cervical precancerous lesions among women in limited-resource settings. PMID:28107486

  12. Evaluation of an array-based method for human papillomavirus detection and genotyping in comparison with conventional methods used in cervical cancer screening.

    Science.gov (United States)

    García-Sierra, Nerea; Martró, Elisa; Castellà, Eva; Llatjós, Mariona; Tarrats, Antoni; Bascuñana, Elisabet; Díaz, Rosana; Carrasco, María; Sirera, Guillem; Matas, Lurdes; Ausina, Vicente

    2009-07-01

    Cervical cancer is the second-most prevalent cancer in young women around the world. Infection with human papillomavirus (HPV), especially high-risk HPV types (HR-HPV), is necessary for the development of this cancer. HPV-DNA detection is increasingly being used in cervical cancer screening programs, together with the Papanicolau smear test. We evaluated the usefulness of introducing this new array-based HPV genotyping method (i.e., Clinical Arrays Papillomavirus Humano) in the cervical cancer screening algorithm in our center. The results obtained using this method were compared to those obtained by the hybrid capture II high-risk HPV DNA test (HC-II) and Papanicolau in a selected group of 408 women. The array-based assay was performed in women that were HC-II positive or presented cytological alterations. Among 246 array-positive patients, 123 (50%) presented infection with >or=2 types, and HR-HPV types were detected in 206 (83.7%), mainly HPV-16 (24.0%). Up to 132 (33.2%) specimens were classified as ASCUS (for atypical squamous cells of undetermined significance), and only 48 (36.4%) of them were HPV-DNA positive by either assay; however, 78.7% of these cases were caused by HR-HPV types. The agreement between both HPV-DNA detection techniques was fairly good (n = 367). Screening with Papanicolau smear and HC-II tests, followed by HPV detection and genotyping, provided an optimal identification of women at risk for the development of cervical cancer. Furthermore, with the identification of specific genotypes, either in single or multiple infections, a better prediction of disease progression was achieved. The array method also made allowed us to determine the possible contribution of the available vaccines in our setting.

  13. Preventing cervical cancer globally.

    Science.gov (United States)

    Schmeler, Kathleen M

    2012-11-01

    Cervical cancer is one of the leading causes of cancer and cancer-related deaths among women worldwide. More than 85% of cases and deaths occur in the developing world where the availability of effective screening is limited. In this issue of the journal, Pierce and colleagues (beginning on page 1273) describe a novel technique using a high-resolution microendoscope (HRME) to diagnose cervical dysplasia. This perspective reviews the limitations of existing cervical cancer screening methods currently in use in low-resource settings and the potential for HRME imaging to contribute to cervical cancer prevention in the developing world.

  14. The 836 Cases of Cervical Cancer Screening Lesions Result Analysis%宫颈癌前期病变筛查836例结果分析

    Institute of Scientific and Technical Information of China (English)

    杨惠新

    2012-01-01

    Objective:To summarize and analyze the results of precancerous lesion screening for cervical caner and provide evidence for cervical caner prevention.Methods:The characteristics such as age,education level,birth history and cervical laceration,episiotomy of the 836 participants were reviewed,the results of LCT and histopathologic diagnosis were compared,and the LCT results of foreign female labors and local females were also compared and analyzed.Results:The positive rate of LCT was 10.77%,the accuracy was 89.89%.The proportions of history of birth,episiotomy and cervical laceration in LCT positive participants were statistically significantly higher than in the LCT negative participants (P<0.05).Positive rate of LCT in foreign female labors was statistically higher than in local females (P<0.05). Conclusion:LCT is a ideal screening tool for cervical cancer in this area,gynecologic health care education should be enhanced in foreign female labors to improve the activity and compliance for participating the cervical cancer screening.%目的:总结分析宫颈癌前期病变LCT筛查结果,为本地区宫颈癌预防提供依据.方法:回顾调查836例参加宫颈癌前期病变LCT筛查妇女的年龄、文化程度、分娩史和宫颈撕裂、会阴切除术等病史,对比分析LCT检查及其与组织病理学诊断结果,对比分析外来务工妇女与本地妇女参加检查情况和检查结果.结果:LCT阳性率为10.77%,准确率为89.89%.LCT阳性者,有分娩、会阴切开术、宫颈撕裂史比例高于LCT阴性者,差异具有统计学意义(P<0.05).外来务工妇女LCT检出率高于本地居民,差异具有统计学意义(P<0.05).结论:LCT是本地区较为理想的宫颈癌筛查方法;应大力加强外来务工妇女妇科保健宣传力度,提高其参加宫颈癌筛查的主动性和依从性.

  15. A comparative study of cervical smears in an urban Hospital in India and a population-based screening program in Mauritius

    Directory of Open Access Journals (Sweden)

    Mulay Kaustubh

    2009-01-01

    Full Text Available Objective: To study cervical smear abnormalities in urban women in India and women in Mauritius and to compare the results in the two groups. Study Design: An analysis of 6010 cervical smears taken as part of routine check-ups in an urban hospital was done and an analysis of 10,000 cervical smears taken from women participating in a National Cancer Screening Program in Mauritius was done. Emphasis was put on cervical epithelial cell abnormalities and the results in the two populations are compared with that of similar studies in other parts of the world. Results: Non specific inflammation formed 19.6% and 25.34% of the smears in the Indian and Mauritian groups, respectively (with specific infection forming 6.05% and 15.08%. The epithelial abnormalities constituted 1.392% of the Indian group and 0.47% of the Mauritian group. The difference was statistically significant in the atypical squamous cells of uncertain significance (ASCUS and atypical glandular cells of uncertain significance (AGUS group. Conclusions: The prevalence of low-grade squamous intraepithelial lesions (LSIL and high-grade squamous intraepithelial lesions (HSIL is similar to that in the developed world.

  16. Prioritizing prevention: culture, context, and cervical cancer screening among Vietnamese American women.

    Science.gov (United States)

    Gregg, Jessica; Nguyen-Truong, Connie K Y; Wang, Pei-ru; Kobus, Amy

    2011-12-01

    Few studies have investigated what Vietnamese American women believe about the Pap smear or how those beliefs might influence behavior. Thirty-one Vietnamese American women recruited through snowball sampling were interviewed about their beliefs regarding the Pap smear. Interviews were qualitatively analyzed using a theoretically informed, inductive approach. The women interviewed emphasized the importance of primary prevention of disease through culturally-informed personal health regimens. They were also largely unfamiliar with the Pap smear, but believed that gynecological exams in general were effective and necessary for disease detection. Finally, when access to gynecological care was difficult, women's faith in their own preventive behaviors helped alleviate their concerns over lack of care. While culturally associated beliefs do not simply "cause" Vietnamese American women to seek or avoid Pap smears, they do influence screening behaviors to a greater or lesser degree, depending on other contextual variables.

  17. HPV for cervical cancer screening (HPV FOCAL): Complete Round 1 results of a randomized trial comparing HPV-based primary screening to liquid-based cytology for cervical cancer.

    Science.gov (United States)

    Ogilvie, Gina S; Krajden, Mel; van Niekerk, Dirk; Smith, Laurie W; Cook, Darrel; Ceballos, Kathy; Lee, Marette; Gentile, Laura; Gondara, Lovedeep; Elwood-Martin, Ruth; Peacock, Stuart; Stuart, Gavin; Franco, Eduardo L; Coldman, Andrew J

    2017-01-15

    Complete Round 1 data (baseline and 12-month follow-up) for HPV FOCAL, a randomized trial establishing the efficacy of HPV DNA testing with cytology triage as a primary screen for cervical cancer are presented. Women were randomized to one of three arms: Control arm - Baseline liquid-based cytology (LBC) with ASCUS results triaged with HPV testing; Intervention and Safety arms - Baseline HPV with LBC triage for HPV positives. Results are presented for 15,744 women allocated to the HPV (intervention and safety combined) and 9,408 to the control arms. For all age cohorts, the CIN3+ detection rate was higher in the HPV (7.5/1,000; 95%CI: 6.2, 8.9) compared to the control arm (4.6/1,000; 95%CI: 3.4, 6.2). The CIN2+ detection rates were also significantly higher in the HPV (16.5/1,000; 95%CI: 14.6, 18.6) vs. the control arm (10.1/1,000; 95%CI: 8.3, 12.4). In women ≥35 years, the overall detection rates for CIN2+ and CIN3+ were higher in the HPV vs. the control arm (CIN2+:10.0/1,000 vs. 5.2/1,000; CIN3+: 4.2/1,000 vs. 2.2/1,000 respectively, with a statistically significant difference for CIN2+). HPV testing detected significantly more CIN2+ in women 25-29 compared to LBC (63.7/1,000; 95%CI: 51.9, 78.0 vs. 32.4/1,000; 95%CI: 22.3, 46.8). HPV testing resulted in significantly higher colposcopy referral rates for all age cohorts (HPV: 58.9/1,000; 95%CI: 55.4, 62.7 vs.

  18. Geographic Disparities in Cervical Cancer Mortality: What Are the Roles of Risk Factor Prevalence, Screening, and Use of Recommended Treatment?

    Science.gov (United States)

    Yabroff, K. Robin; Lawrence, William F.; King, Jason C.; Mangan, Patricia; Washington, Kathleen Shakira; Yi, Bin; Kerner, Jon F.; Mandelblatt, Jeanne S.

    2005-01-01

    Despite advances in early detection and prevention of cervical cancer, women living in rural areas, and particularly in Appalachia, the rural South, the Texas-Mexico border, and the central valley of California, have had consistently higher rates of cervical cancer mortality than their counterparts in other areas during the past several decades.…

  19. A Mixed Method Research to Identify Perceived Reasons and Solutions for Low Uptake of Cervical Cancer Screening in Urban Families of Bhopal Region

    Directory of Open Access Journals (Sweden)

    Nancy Jain

    2016-01-01

    Full Text Available Low uptake of cervical cancer screening is not a matter of poor coverage of health care facilities only. We wish to identify the perceived reasons behind low uptake of screening in Bhopal region and also possible solutions for an urban setting. In a mixed research, through a series of focused group discussions, we wished to do thematic interpretation of the perceptions towards cervical cancer screening by deductive content analysis of FGD and also to obtain a free list of perceived causes and solutions with Smith’s saliency score and perform cluster analysis by pile sorting. We found that the perceived reasons could be grouped into three themes which were (1 information gap leading to fear of unknown, (2 casual attitude, and (3 resource constrains and affordability issues. For the perceived solutions there were 11 codes which could be grouped into two groups; these were increasing awareness and vaccination. Free list of perceived reasons and solutions has also been generated. No single solution can be suggested but a comprehensive approach with awareness campaigns, personalized encouragements, affordable and friendly health care with subsidized vaccination, and screening facilities are expected to increase awareness and acceptability and thus reduce burden of disease in the long run.

  20. Cost-effectiveness analysis of cervical cancer prevention based on a rapid human papillomavirus screening test in a high-risk region of China.

    Science.gov (United States)

    Levin, Carol E; Sellors, John; Shi, Ju-Fang; Ma, Li; Qiao, You-lin; Ortendahl, Jesse; O'Shea, Meredith K H; Goldie, Sue J

    2010-09-01

    This study assessed the cost-effectiveness of a new, rapid human papillomavirus (HPV)-DNA screening test for cervical cancer prevention in the high-risk region of Shanxi, China. Using micro-costing methods, we estimated the resources needed to implement preventive strategies using cervical cytology or HPV-DNA testing, including the Hybrid Capture 2 (hc2) test (QIAGEN Corp., Gaithersburg, MD) and the rapid HPV-DNA careHPV test (QIAGEN). Data were used in a previously published model and empirically calibrated to country-specific epidemiological data. Strategies differed by initial test, targeted age, frequency of screening, number of clinic visits required (1, 2 or 3) and service delivery setting (national, county and township levels). Outcomes included lifetime risk of cancer, years of life saved (YLS), lifetime costs and incremental cost-effectiveness ratios (cost per YLS). For all screening frequencies, the most efficient strategy used 2-visit rapid HPV-DNA testing at the county level, including screening and diagnostics in the first visit, and treatment in the second visit. Screening at ages 35, 40 and 45 reduced cancer risk by 50% among women compliant with all 3 screening rounds, and was US$ 150 per YLS, compared with this same strategy applied twice per lifetime. This would be considered very cost-effective evaluated against China's per-capita gross domestic product (US$ 1,702). By enhancing the linkage between screening and treatment through a reduced number of visits, rapid HPV-DNA testing 3 times per lifetime is more effective than traditional cytology, and is likely to be cost-effective in high-risk regions of China.

  1. Acceptability and Accuracy of Cervical Cancer Screening Using a Self-Collected Tampon for HPV Messenger-RNA Testing among HIV-Infected Women in South Africa.

    Directory of Open Access Journals (Sweden)

    Paul C Adamson

    Full Text Available HIV increases women's risk for high-risk human papillomavirus (hrHPV infection and invasive cervical cancer. South Africa has a high HIV prevalence but low cervical cancer screening coverage. Self-collection of cervical specimens and hrHPV testing, including hrHPV messenger-RNA (mRNA testing, are methods aimed at increasing screening rates. However, data are limited on the acceptability and accuracy of tampon-based self-collection for hrHPV mRNA testing in HIV-infected women.We recruited 325 HIV-infected women seeking care at a government HIV clinic in Pretoria, South Africa. A clinician performed a pelvic examination and obtained an endocervical specimen. Study participants performed self-collection using a tampon. Both clinician- and self-collected specimens were tested for hrHPV mRNA. Acceptability of both collection methods was assessed, the prevalence of hrHPV mRNA in our study population was estimated, test positivity of the two collection methods were compared, and test agreement was assessed by calculating the κ-statistic, sensitivity, and specificity.Over 90% of women reported no difficulties self-collecting specimens and 82% were willing to perform the tampon-collection at home. Based on clinician-collection specimens, the prevalence of hrHPV mRNA in our study population was 36.7% (95% CI: 31.4%- 42.0%. There was no difference in test positivity between clinician-collection, 36.7%, and tampon-collection, 43.5% (p-value = 0.08. Using clinician-collection as the reference test, the sensitivity and specificity for hrHPV mRNA of tampon-collection were 77.4% (95% CI: 69.8-85.0% and 77.8% (95% CI: 71.9-83.6%, respectively.Tampon-based self-collection is acceptable to women and has similar hrHPV mRNA positivity rates as clinician-collection, but has reduced sensitivity and specificity compared to clinician-collection. The hrHPV mRNA prevalence in our study population is high, but similar to other high-risk populations, and highlights the

  2. A Large Cross-Sectional Survey Investigating the Knowledge of Cervical Cancer Risk Aetiology and the Predictors of the Adherence to Cervical Cancer Screening Related to Mass Media Campaign

    Directory of Open Access Journals (Sweden)

    Corrado De Vito

    2014-01-01

    Full Text Available Objectives. The aims of this study were to compare the characteristics of women who got a Pap-test during the mass media campaign, carried out in an Italian region by broadcasts advertising, and two years later and to identify the determinants of knowledge of cervical cancer etiology and of the adherence to the mass media campaign. Methods. A cross-sectional survey was carried out through a self-administered questionnaire. Results. A total of 8570 randomly selected women were surveyed, 823 of these had a Pap-test during the mass media campaign period and 7747 two years later. Higher educational level, being not married, and living in urban areas were the main independent characteristics associated with a higher level of knowledge of cervical cancer etiology, although a previous treatment following a Pap smear abnormality was the strongest predictor (OR = 2.88; 95% CI: 2.43–3.41. During the campaign period women had the Pap-test more frequently as a consequence of the mass media campaign (OR = 8.28; 95% CI; 5.51–12.45. Conclusions. Mass media campaign is a useful tool to foster cervical screening compliance; however, its short-term effect suggests repeating it regularly.

  3. A randomized controlled trial of Human Papillomavirus (HPV testing for cervical cancer screening: trial design and preliminary results (HPV FOCAL Trial

    Directory of Open Access Journals (Sweden)

    Smith Laurie W

    2010-03-01

    Full Text Available Abstract Background In the HPV FOCAL trial, we will establish the efficacy of hr-HPV DNA testing as a stand-alone screening test followed by liquid based cytology (LBC triage of hr-HPV-positive women compared to LBC followed by hr-HPV triage with ≥ CIN3 as the outcome. Methods/Design HPV-FOCAL is a randomized, controlled, three-armed study over a four year period conducted in British Columbia. It will recruit 33,000 women aged 25-65 through the province's population based cervical cancer screening program. Control arm: LBC at entry and two years, and combined LBC and hr-HPV at four years among those with initial negative results and hr-HPV triage of ASCUS cases; Two Year Safety Check arm: hr-HPV at entry and LBC at two years in those with initial negative results with LBC triage of hr-HPV positives; Four Year Intervention Arm: hr-HPV at entry and combined hr-HPV and LBC at four years among those with initial negative results with LBC triage of hr-HPV positive cases Discussion To date, 6150 participants have a completed sample and epidemiologic questionnaire. Of the 2019 women enrolled in the control arm, 1908 (94.5% were cytology negative. Women aged 25-29 had the highest rates of HSIL (1.4%. In the safety arm 92.2% of women were hr-HPV negative, with the highest rate of hr-HPV positivity found in 25-29 year old women (23.5%. Similar results were obtained in the intervention arm HPV FOCAL is the first randomized trial in North America to examine hr-HPV testing as the primary screen for cervical cancer within a population-based cervical cancer screening program. Trial Registration International Standard Randomised Controlled Trial Number Register, ISRCTN79347302

  4. Cervical cancer screening among immigrant Hispanics: an analysis by country of origin.

    Science.gov (United States)

    Shelton, Rachel C; Jandorf, Lina; King, Sheba; Thelemaque, Linda; Erwin, Deborah O

    2012-08-01

    As the largest and most diverse ethnic minority population in the U.S., it is important to examine differences in and correlates of Pap test adherence among Hispanics by country of origin. The data for these analyses are baseline responses from a Randomized Controlled Trial. Bivariate and multivariable logistic regression models were conducted among Hispanic immigrant women who identified as Mexican, Puerto Rican, Dominican, or Central/South American (n = 1,305). There were significant differences in Pap test adherence: Dominicans (81.6%), Mexicans (77.5%), Central/South Americans (71.2%), and Puerto Ricans (69.3%). In multivariable analyses, there were different correlates of Pap test adherence for each country of origin. For example, marriage status (P = .0001) and younger age (P = .006) were positively associated with adherence among Mexican women. This research provides insight into the variability that exists among Hispanics and can help improve understanding of important determinants that may influence Pap test screening among diverse Hispanics.

  5. Effects of streamlining cervical cancer screening the Dutch way: consequences of changes in the Dutch KOPAC-based follow-up protocol and consensus-based limitation of equivocal cytology

    DEFF Research Database (Denmark)

    Briët, Martijn C; Berger, Thomas H D; van Ballegooijen, Marjolein;

    2010-01-01

    To analyze the impact of the 1995 revision of the Dutch cervical screening program guidelines (e.g., the introduction of more stringent criteria for cytologic diagnosis of atypical squamous cells of undetermined significance [ASCUS]) on the negative side effects of screening in Region West....

  6. Screening of pregnant women attending the antenatal care clinic of a tertiary hospital in eastern Saudi Arabia for Chlamydia trachomatis and Neisseria gonorrhoeae infections

    Directory of Open Access Journals (Sweden)

    Alzahrani Alhusain

    2010-01-01

    Full Text Available Inroduction: Of the "top ten" sexually transmitted infections, Chlamydia trachomatis and Neisseria gonorrhoeae are ranked second and fifth, respectively, worldwide. Aim: The aim of this study was to screen the pregnant women for C. trachomatis and N. gonorrhoeae infections and to detect antimicrobial resistance pattern of N. gonorrhoeae. Materials and Methods: This study was a prospective, hospital-based analysis of a random sample of pregnant women visiting the antenatal clinic of a tertiary hospital in eastern Saudi Arabia. Endocervical and high vaginal swabs were collected both from pregnant women and female patients attending gynecology clinic with lower genital tract infection (control group. C. trachomatis antigen was detected using enzyme-linked immunosorbent assay (ELISA. N. gonorrhoeae was detected by culture and identification of isolates, and antimicrobial susceptibility testing was performed. Statistical Package for Social Sciences (SPSS version 13.0 and Chi-square test were used for statistical analysis. Results: C. trachomatis antigen was detected in 10.5% (10/95 and 34.4% (35/102 of pregnant women and control group, respectively (P < 0.001. The isolation rate of N. gonorrhoeae among pregnant women was 0.0% compared to 7.8% (8/102 among the control group (P < 0.01. N. gonorrhoeae were resistant to penicillin (62.5%, tetracycline (50%, ampicillin (25%, amoxycillin-clavulinic acid (25% and ciprofloxacin (37.5%, while they were susceptible to cefepime, ceftriaxone, ceftazidime, spectinomycin, and cefuroxime. Conclusion: Screening of pregnant women for C. trachomatis infection should be included in the antenatal care in this area. The detection rate of both organisms among the control group highlights the importance of preventive strategies. Certain antibiotics previously used in treating gonorrhea are no longer effective.

  7. Exploiting biospectroscopy as a novel screening tool for cervical cancer: towards a framework to validate its accuracy in a routine clinical setting.

    LENUS (Irish Health Repository)

    Purandare, Nikhil C

    2013-11-01

    Biospectroscopy is an emerging field that harnesses the platform of physical sciences with computational analysis in order to shed novel insights on biological questions. An area where this approach seems to have potential is in screening or diagnostic clinical settings, where there is an urgent need for new approaches to objectively interrogate large numbers of samples in an objective fashion with acceptable levels of sensitivity and specificity. This review outlines the benefits of biospectroscopy in screening for precancer lesions of the cervix due to its ability to separate different grades of dysplasia. It evaluates the feasibility of introducing this technique into cervical screening programs on the basis of its ability to identify biomarkers of progression within derived spectra (\\'biochemical‑cell fingerprints\\').

  8. Exploiting biospectroscopy as a novel screening tool for cervical cancer: towards a framework to validate its accuracy in a routine clinical setting.

    Science.gov (United States)

    Purandare, Nikhil C; Trevisan, Júlio; Patel, Imran I; Gajjar, Ketan; Mitchell, Alana L; Theophilou, Georgios; Valasoulis, George; Martin, Mary; von Bünau, Günther; Kyrgiou, Maria; Paraskevaidis, Evangelos; Martin-Hirsch, Pierre L; Prendiville, Walter J; Martin, Francis L

    2013-11-01

    Biospectroscopy is an emerging field that harnesses the platform of physical sciences with computational analysis in order to shed novel insights on biological questions. An area where this approach seems to have potential is in screening or diagnostic clinical settings, where there is an urgent need for new approaches to objectively interrogate large numbers of samples in an objective fashion with acceptable levels of sensitivity and specificity. This review outlines the benefits of biospectroscopy in screening for precancer lesions of the cervix due to its ability to separate different grades of dysplasia. It evaluates the feasibility of introducing this technique into cervical screening programs on the basis of its ability to identify biomarkers of progression within derived spectra ('biochemical‑cell fingerprints').

  9. Study to assess the acceptability and feasibility of cervical cancer screening using visual inspection with acetic acid and treatment of precancerous lesions using cryotherapy in low resource settings

    Directory of Open Access Journals (Sweden)

    Tosha M. Sheth

    2014-06-01

    Full Text Available Background: Objective of current study was to assess the acceptability and feasibility of cervical cancer screening using VIA, and treatment of precancerous lesions using cryotherapy in low resource settings Methods: 526 women from three primary health centers of Shinor taluka (population based approach and 250 women of Medical College, Vadodara (facility based approach were sensitized and screened for cervical cancer. Visual Inspection with Acetic acid (VIA was performed as the screening test. In the population based approach, VIA positive women were referred to a Community Health Centre (CHC for colposcopy and biopsy. Ablative treatment in the form of cryotherapy was offered. Patients requiring higher forms of treatment were referred to medical college, Vadodara. In the facility based approach, VIA positive women underwent colposcopy. Guided biopsy was performed in those with positive lesions on colposcopy. Cryotherapy was offered in the same sitting. Those not suitable for cryotherapy were offered loop electrosurgical excision procedure. Women found to have invasive cancer were offered definitive management. Results: VIA positivity rate was 18.8% in the population based approach and 27.2% in the facility based approach.58.8% women in the population based approach and 77.77% women in the facility based approach were treated with cryotherapy on the same day as screening and none reported any severe side effects. Dropout rate in the community approach was 32.32% whereas in the facility it was 0.4%. Conclusions: VIA and cryotherapy procedures were well tolerated by all screened women. This project has shown that the and ldquo;screen and treat and rdquo; approach can be successfully implemented in the existing health setup. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 615-621

  10. The Significance of High-Risk Human Papillomavirus to Cervical Cancer Screening%高危型人类乳头瘤病毒对子宫颈癌筛查的意义

    Institute of Scientific and Technical Information of China (English)

    郑蓉; 孙丽芳

    2011-01-01

    Persistent high-risk human papillomavirus (HR-HPV) infection is a necessary condition for the occurrence of cervical cancer. In this paper, the authors discussed whether HR-HPV infection screening should be included into conventional cervical cancer screening. Based on the analysis of 2 505 cases of cervical cancer screening in our hospital, it is shown that for women with good economic condition or potentially suffering high risk of cervical cancer, primary cervical cancer screening combining TCT and HR-HPV screening will lead to clinical benefits in excess of cost benefits.%高危型人类乳头瘤病毒(HR- HPV)感染是宫颈癌发生的必要条件,本文就是否将HR- HPV纳入宫颈癌筛查进行探讨.通过对我院行宫颈癌筛查的2 505例患者资料分析,结果显示对于经济条件良好或有官颈癌高危因素的女性,细胞学检查(TCT)联合HR- HPV检测做为宫颈癌的初筛,其临床效益大于成本收益.

  11. Economic Evaluation of Screening Strategies Combined with HPV Vaccination of Preadolescent Girls for the Prevention of Cervical Cancer in Vientiane, Lao PDR

    Science.gov (United States)

    2016-01-01

    Background Several approaches to reduce the incidence of invasive cervical cancers exist. The approach adopted should take into account contextual factors that influence the cost-effectiveness of the available options. Objective To determine the cost-effectiveness of screening strategies combined with a vaccination program for 10-year old girls for cervical cancer prevention in Vientiane, Lao PDR. Methods A population-based dynamic compartment model was constructed. The interventions consisted of a 10-year old girl vaccination program only, or this program combined with screening strategies, i.e., visual inspection with acetic acid (VIA), cytology-based screening, rapid human papillomavirus (HPV) DNA testing, or combined VIA and cytology testing. Simulations were run over 100 years. In base-case scenario analyses, we assumed a 70% vaccination coverage with lifelong protection and a 50% screening coverage. The outcome of interest was the incremental cost per Disability-Adjusted Life Year (DALY) averted. Results In base-case scenarios, compared to the next best strategy, the model predicted that VIA screening of women aged 30–65 years old every three years, combined with vaccination, was the most attractive option, costing 2 544 international dollars (I$) per DALY averted. Meanwhile, rapid HPV DNA testing was predicted to be more attractive than cytology-based screening or its combination with VIA. Among cytology-based screening options, combined VIA with conventional cytology testing was predicted to be the most attractive option. Multi-way sensitivity analyses did not change the results. Compared to rapid HPV DNA testing, VIA had a probability of cost-effectiveness of 73%. Compared to the vaccination only option, the probability that a program consisting of screening women every five years would be cost-effective was around 60% and 80% if the willingness-to-pay threshold is fixed at one and three GDP per capita, respectively. Conclusions A VIA screening program

  12. Human papillomavirus testing in primary cervical screening and the cut-off level for hybrid capture 2 tests

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Bonde, Jesper; Njor, Sisse Helle;

    2011-01-01

    To determine the trade-off between the sensitivity and the specificity for high grade cervical intraepithelial neoplasia at hybrid capture 2 cut-off values above the standard = 1 relative light units/cut-off level (rlu/co)....

  13. Factors related to inadequate cervical cancer screening in two Brazilian state capitals Factores asociados al rastreo inadecuado del cáncer cervical en dos capitales brasileras Fatores associados ao rastreamento inadequado do câncer cervical em duas capitais brasileiras

    OpenAIRE

    2009-01-01

    OBJECTIVE:To analyze factors associated with cervical cancer screening failure. METHODS:Population-based cross-sectional study with self-weighted two-stage cluster sampling conducted in the cities of Fortaleza (Northeastern Brazil) and Rio de Janeiro (Southeastern Brazil) in 2002. Subjects were women aged 25-59 years in the last three years prior to the study. Data were analyzed through Poisson regression using a hierarchical model. RESULTS: The proportion of women who did not undergo the Pap...

  14. Analysis on cervical cancer screening results in Panyu district of Guangzhou city%广州市番禺区宫颈癌筛查结果分析

    Institute of Scientific and Technical Information of China (English)

    李艳; 范晓萍; 曾俐琴; 黄丽妮; 朱铭谊

    2013-01-01

    Objective:To explore the cervical cancer screening status in Panyu district of Guangzhou city from 2000 to 2011.Methods:Cervical cytologic test was conducted among the women of the right age in Panyu district,the individual information and medical records were recorded.Results:A total of 119 648 women received cervical cancer screening,the mean age was (40.60 ±3.50) years,the total positive rates was 9.92%,the positive screening rate in 2000 was 8.91%,then it increased to 12.02% in 2011,the proportion of women under 40 years old increased from 43.00% in 2000 to 50.58% in 2011,the positive rated among rural women and urban women were 12.76% and 7.42%,respectively; 119 women with cervical cancer were carried out,the prevalence rate was 9.95/10 000.Conclusion:The incidence rates of cervical diseases among women in the right age increase year by year,which become younger and younger.The incidence rates of cervical diseases in rural women are higher than those in urban women,cervical cancer screening should be popularized,and maternal health education and publicity should be enhanced.%目的:了解广州市番禺区2000年~2011年12年间全区妇女宫颈癌筛查情况.方法:对辖区适龄妇女进行宫颈细胞学检查,并记录个人信息及病史.结果:共完成宫颈癌筛查119 648例,受检时平均年龄(40.60±3.50)岁,总阳性率为9.92%,2000年筛查阳性率为8.91%,2011年增加至12.02%,其中40岁以下构成比从2000年的43.00%增加到2011年的50.58%,农村妇女阳性率12.76%,城镇妇女阳性率7.42%,筛查出宫颈癌119例,发病率为9.95/万.结论:适龄女性宫颈疾病发病率逐年增高,呈年轻化趋势,农村妇女发病率高于城镇妇女,应普及宫颈癌筛查,加强妇女卫生教育宣传.

  15. Analysis the effect of health education in the early screening of married women cervical cancer%健康教育对已婚妇女早期宫颈癌筛查的效果分析

    Institute of Scientific and Technical Information of China (English)

    马剑玲; 刘雪妮

    2013-01-01

    目的:了解已婚妇女对宫颈癌早期筛查认知情况,为正确开展宫颈癌早期筛查患者的健康教育提供依据.方法:对在我院妇产科门诊就诊接受宫颈癌筛查的患者同时进行宫颈癌相关知识宣传教育,应用自行设计的同卷评估干预效果.结果:已婚妇女对宫颈癌筛查认知程度较低.干预后患者宫颈癌相关性知识综合掌握情况和愿意接受宫颈癌筛查的患者明显提高.结论:开展多元素、多种形式的官颈癌筛查,有利于提高已婚妇女对宫颈癌筛查重要性的认识和宫颈癌筛查率,对早发现和早治疗宫颈癌具有重要意义.%Objective:To know the married women to cervical cancer early screening cognitive condition,for in cervical cancer early screening patients right of health education provides the basis.Methods:In obstetrics and gynecology clinical patients with cervical cancer screening accept the correlation between education and cervical cancer propaganda,the application of the self-designed questionnaire evaluation intervention effect.Results:The local married women cervical cancer screening of cognitive level was relatively low.After the intervention of cervical cancer patients with comprehensive knowledge and master the correlation between the neck cancer screening willing to accept the patients improved obviously.Conclusion:Multi-element,various forms of neck cancer screening the nursing intervention,to improve the region of married women cervical cancer screening and recognition of the importance of cervical cancer screening rate,There is important meaning to early detection and treatment cervical cancer.

  16. Mucopurulent cervicitis: a clinical entity?

    OpenAIRE

    Willmott, F E

    1988-01-01

    Of 297 women attending a sexually transmitted disease clinic who were examined for the presence of mucopurulent cervicitis, 96 (32%) satisfied the diagnostic criteria. Mucopurulent cervicitis was strongly associated with the isolation of Chlamydia trachomatis and Neisseria gonorrhoeae. It was also associated with bacterial vaginosis, the use of oral contraceptives, and sexual contact with men who had non-gonococcal urethritis. Conversely, the presence of opaque cervical secretions did not sho...

  17. 宫颈液基细胞学联合HPV检查在宫颈病变筛查中的评价%Evaluation of Liquid-based Cervical Cytology and HPV Examination in the Screening of Cervical Lesions

    Institute of Scientific and Technical Information of China (English)

    高洁; 方法; 战英杰

    2016-01-01

    Objective To research the application value of HPV combined with TCT in the screening of cervical lesions. Methods 424 cases of female patients diagnosed in the gynecology clinic of our hospital from January 2014 to December 2014 were selected as the research objects and were given HPV and TCT detection and pathologic biopsy vaginoscopy, and the methodology of screening of cervical lesions was evaluated through the single detection of cervical HPV and TCT and combined detection of the two using the pathological results as “gold standard”. Results Of 424 cases of female patients, 49.5% was HPV positive, and with the continuous progress of the degree of cervical disease, HPV positive rate also showed an increasing trend, TCT examination results of 424 cases: the positive rate of above-ASCUS lesions was 49.3%, ASC oc-curred to 105 cases, low-grade squamous intraepithelial lesion occurred to 69 cases, high-grade squamous intraepithelial lesion occurred to 34 cases, squamous-cell carcinoma occurred to 1 case, compared with those of the single examination, the sensitivity, Youden index and negative predictive value of the combined examination in the screening of above-CINI-were improved in varying degrees. Conclusion TCT combined with HPV detection is of an important clinical value to the screening of cervical lesions.%目的:研究人乳头瘤病毒(HPV)联合宫颈液基薄层细胞学(TCT)检测在宫颈病变筛检中的应用价值。方法整群选取2014年1—12月以424例妇科门诊就诊女性为研究对象,分别行HPV、TCT检测及阴道镜下病理活检,以病理学结果为“金标准”,对宫颈HPV及TCT的单独检测,以及二者联合检测对宫颈病变筛查的方法学评价。结果424例就诊女性患者49.5%为HPV阳性,且随着宫颈疾病病变程度不断进展,HPV阳性率也呈现升高趋势;424例TCT检查结果:宫颈不典型鳞状细胞(ASCUS)以上病变阳性率为49.3%,其中ASC105例,

  18. 不同检测方法在宫颈病变和早期宫颈癌筛查中的价值%The Screening Value of Different Detection Methods for Cervical Lesions and Early Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    张雯; 安红梅; 马丽莎; 邓继红

    2011-01-01

    目的:评价目前临床使用的几种筛查方法在宫颈病变和早期宫颈癌筛查中的价值,针对不同经济、文化及地理背景下的人群,探讨合理、经济、高灵敏度的筛查方案.方法:巴氏涂片、5%醋酸肉眼观察(VIA)、薄层液基细胞涂片法(TCT)结合TBS分类报告系统、HPV-DNA检测(HC-II)、阴道镜检查结合评分系统、镜下定点活检病理组织学检查合理联合应用.结果:1 594例病例进行活检,共检出CINⅡ及CINⅡ以上的宫颈病变65例,其中CINⅡ33例,CINⅢ 31例,浸润癌1例.HC-Ⅱ 诊断高度以上宫颈病变敏感度及约登指数最高分别为92.31%和0.81,TCT、VIA、阴道镜检查和巴氏涂片法诊断宫颈高度以上病变敏感度为中等敏感.HPV-DNA+TCT诊断宫颈高度以上病变敏感度、特异度和约登指数最高.结论:多技术联合互补检查可有效筛查宫颈癌前病变及宫颈癌,医务人员可根据患者的实际情况,为病员选择合适的筛查方案.推荐宫颈病变和早期宫颈癌筛查的最佳方案是同时进行TCT和HPV检测;次佳方案是传统巴氏涂片+HPV检测;一般方案:HPV检测+阴道镜检查;基础方案:巴氏涂片+VIA.%O b jectnve: To evaluate the clinical use of several screening methods for cervical lesions and early cervical cancer and to explore a reasonable choice of economical, high-sensitive screening piogran for the population with different economic, cultural and geographical background M e1hods: Pap smear, visual inspection of 5% acetic acid ( VIA) , thin layer liquid-based cytology smear( TCI) with TBS reporting system, HPV-DNA test( HC-Ⅱ), colposcopy combined scoring system, endoscopic sentinel bbpsy-histological diagnosis, and a reasonable combinatbn of the methods mentioned above were used h this study Results; Totally 1 594 cases undeiwent the biopsy with the results showing65 cases of C IN Ⅱ ormore severe than C IN Ⅱ ( hcluding33 cases of C IN Ⅱ ,31 cases ofCⅢ andl case

  19. 桐乡市宫颈癌筛查成本效益分析%Cost-benefit analysis on cervical cancer screening in Tongxiang city

    Institute of Scientific and Technical Information of China (English)

    钟钰平; 沈建生; 徐晓清; 董诀; 韩秋英; 徐敏娟

    2012-01-01

    Objective; To explore the effectiveness of cervical cancer screening projects. Methods; Cost - benefit analysis on cervical cancer screening projects was conducted in Tongxiang city from 2009 to 2011. Results; Among 20 000 respondents, 754 cases were found with positive cytological results, the positive detection rate was 1. 51%. Colposcopy was carried out in 731 cases, 386 cases received biopsy and pathological diagnosis, finally, 218 cases with cervical intraepithelial neoplasia (CIN) were diagnosed definitely, including 38 cases with CIN I , 101 cases with CIN II , and 79 cases with CIN Ⅲ; 7 cases were diagnosed as microinvasive carcinoma, and 2 cases were diagnosed as invasive carcinoma. It was estimated that 22 911. 60 Yuan were spend to save one person per year, which was lower than per capita GDP in Tongxiang city in 2010 (60 830 Yuan) , the benefit - cost ratio was 2. 65: 1. Conclusion: The current cervical cancer screening mode used in Tongxiang city has good economic benefit, which is worthy to be further spread as routine public health project.%目的:探讨宫颈癌筛查项目有效性.方法:对2009 ~ 2011年桐乡市宫颈癌筛查项目进行成本效益分析.结果:50 000例中,细胞学阳性754例,阳性检出率1.51%.731例行阴道镜检查,活体组织检查(活检)病理诊断386例,最后诊断CIN 218例(CIN I 38例,CINⅡ101例,CINⅢ79例),微小浸润癌7例,浸润癌2例.据估算挽救1个寿命年平均需花费22 911.60元,小于桐乡市2010年人均GDP60 830元,效益成本比2.65:1.结论:桐乡市现行宫颈癌筛查模式具有良好的经济效益,值得作为常规性公共卫生项目进一步推广.

  20. ROLE OF COLPOSCOPY USING MODIFIED REID’S INDEX IN SCREENING OF CERVICAL CANCER IN WOMEN WITH ABNORMAL CERVIX ON NAKED EYE EXAMINATION

    Directory of Open Access Journals (Sweden)

    Deshpande

    2014-01-01

    Full Text Available OBJECTIVE: To assess the validity of Colposcopy using Modified Reid's Index as a screening tool in cervical cancer in women with abnormal cervix on naked eye examination . METHODS: This observational study was carried out in Government medical college, Aurangabad from June 2011 to May 2013 . Total 392 women with abnormal cervix on naked eye examination of underwent colposcopy and diagnosis was made on the basis of Modified R eid’s Index. Colposcope directed biopsies were obtained from the abnormal areas. In women with normal colposcopic findings four quadrant biopsies from squamo - columnar junction were taken .Eight women were excluded from analysis owing to unsatisfactory colp oscopy. Results of colposcopy were validated by calculating sensitivity, specificity, positive predictive value, negative predictive value in diagnosing histopathologically confirmed lesions which served as gold standard. RESULTS: Overall sensitivity of colposcopy in all grades of lesions is around 90% or more, touching 100% in high order of histological lesions.Overall specificity is also high.It does have an excellent negative predictive value but comparatively lower positive predictive value especially in high order lesions with fair degree of accuracy in all grades of lesions in the hands of an experienced operator. CONCLUSION: Colposcopy using Modified Reid’s Index with high sensitivity and specificity is a good screening tool for cervical cancer

  1. Reliability of the CINtecTM p16INK4a immunocytochemical test in screening cervical precancerous lesions

    Directory of Open Access Journals (Sweden)

    Jović Milena

    2008-01-01

    Full Text Available Background/Aim. Overexpression of p16INK4a has been found to be linked with genomic integration of high-risk human papillomavirus (HPV and the developement of precancerous cervical intraepithelial lesions. The aim of this study was to examine is there a higher positive level of correlation between grade of histological dysplasia and p16INK4a level of expression in cervical smear, compared to results of Papanicolaou test. We also examined the correlation between HPV type, p16INK4a expression and Papanicolau test results. Methods. A total of 48 women with precanceorous cervical lesions and HPV cervicitis and 10 healthy women were enrolled in the study. Papanicolaou test, CINtecTM p16INK4a citological immunohistochemical test, polymerase chain reaction (PCR HPV 16, 18, 31, 33 analysis and histopathology of the lesion were performed in all the patients. Results. Comparing the results of Papanicoulaou test and the grade of histological dysplasia, low-grade squamous intraepithelial lesion (LSIL was confirmed in 38%, and high-grade squamous intraepithelial lesion (HSIL in 69.2% of the patients (p > 0.05. Significant positive correlation was found between p16 overexpression and grade of histological dysplasia (p = 0.000. Overexpression p16 was found in 70% of LSIL and 94.4% of HSIL. Positive correlation was found between p16 overexpression and grade of dysplasia in Papanicolaou test (p = 0.011. In 38% of LSIL and 15% of HSIL cases p16 was not expressed. The most frequently found HPV type in PCR analysis was HPV16. Analysing the results of p16 test according to HPV status and Papanicolaou test rather heterogenous results were obtained. Conclusion. In the patients with precancerous cervical lesions a higher level of correlation was found between the grade of histological dysplasia and p16INK4a level of expression in the cervical smear, compared to the results of Papanicolaou test.

  2. Analysis on liquid-based cytology test in the screening of cervical cancer%宫颈癌筛查中液基细胞学研究

    Institute of Scientific and Technical Information of China (English)

    王赫

    2009-01-01

    目的:评价液基细胞学(LPT)薄片制片对宫颈癌筛查的准确性.方法:对3 600例和2 200例受检者分别进行LPT制片和传统宫颈细胞涂片法进行宫颈癌筛查.细胞诊断采用TBS分级系统,阳性诊断包括意义不明的不典型鳞状上皮(ASCUS)以上病变.所有ASCUS以上病变的受检者全部在阴道镜下活检.结果:LPT薄片法和传统涂片法对ASCUS以上病变检出阳性率分别为10.5%和5.2%,两种检测方法的阳性率差异有统计学意义(P<0.01);两种制片方法的阳性结果与病理检查符合率比较:LPT薄片法检出SCC、HSIL、LSIL与阴道镜活检阳性符合率分别为100%、91%、82%,传统宫颈巴氏涂片法检出SCC、HSIL、LSIL与阴道镜活检阳性符合率分别为100%、60%、53%,两种方法比较差异有统计学意义(P<0.05).结论:LPT液基细胞学检查敏感性明显高于传统宫颈细胞涂片法,能大大提高检出率,尤其是对宫颈癌前筛查的患者.%Objective: To evaluate the accuracy of liquid-based cytology test in the screening of cervical cancer. Methods: 3 600 and 2 200 subjects were screened for cervical cancer by liquid-based cytology test and traditional cervical cells smears, respectively. Cell diagnosis adopted TBS-group system, positive diagnosis included above-ASCUS pathological changes. All the subjects of above-ASCUS pathological changes were examined under colposcopo. Results: The detection rates of above-ASCUS pathological changes identified by liq-uid-based cytology test and traditional smears were 10. 5% and 5.2 %, respectively (P < 0. 01) . The coincidence rates of SCC, HSIL and LSIL detected by liquid-based cytology test and biopsy under eolposcepe were 100%, 91% and 82%, respectively, while the coinci-dence rates detected by traditional cervical cells smears and biopsy under colposcope were 100%, 60% and 53%, respectively (P <0. 05)Conclusion: The sensitivity and detection rate of liquid-based cytology test are higher than those

  3. Diagnosis Value Analysis of Gynecological Screening to Early Cervical Cancer%妇科普查对早期宫颈癌的筛查诊断价值分析

    Institute of Scientific and Technical Information of China (English)

    张丹

    2016-01-01

    目的::妇科普查对早期宫颈癌的筛查诊断价值进行评价分析,为今后的临床诊断工作提供有价值的参考信息。方法:收集2012年1月~2014年12月间在某中心接受妇科疾病筛查的受试者资料进行研究。结果:接受宫颈筛查者5298名,检出妇科疾病者检出率为31.67%,其中宫颈病变检出率为10.65%,检出宫颈癌检出率为0.35%。结论:妇科普查对早期宫颈癌筛查具有重要意义,可为临床宫颈癌早期诊断提供可靠的参考依据,值得关注。%Objective:To analyze diagnostic value of gynecological screening to early cervical cancer and provide valuable information for future reference clinical diagnosis.Methods:To study the data of subj ects re-ceived gynecological diseases screening in a Community Health from January 2012 to December 2012.Re-sults:During this period,5298 patients received cervical screening,the detection rate was 31.67%,the de-tection rate of cervical lesions was 10.65%,the detection rate of cervical cancer was 0.35%.Conclusion:The gynecological screening is important for early cervical cancer screening,it can provide a reliable reference for the early diagnosis of cervical cancer and deserves attention.

  4. Cancer screening status in Korea, 2011: results from the Korean National Cancer Screening Survey.

    Science.gov (United States)

    Park, Boyoung; Choi, Kui Son; Lee, Yoon Young; Jun, Jae Kwan; Seo, Hong Gwan

    2012-01-01

    This study was conducted to determine the use of screening for stomach, liver, colorectal, breast, and cervical cancers, which are included in the Korean National Cancer Screening Programme. In 2011 the National Cancer Centre in Korea conducted a nationwide, population-based, cross-sectional interview survey using multi-stage random sampling. Participants included 4,100 cancer-free men 40 years and over of age and women over 30 years of age. The lifetime screening rates for stomach, liver, colorectal, breast, and cervical cancers were 76.2%, 54.3%, 56.1%, 79.0%, and, 74.8%, respectively. The rates of recommended screening for stomach, liver, colorectal, breast, and cervical cancers were 64.6%, 22.9%, 35.3%, 60.4%, and 62.4%, respectively. More than 70% of all screening was attributed to organised cancer screening programmes. The main reason given for non attendance was 'no symptoms'. A greater effort is needed to increase screening rates, especially for liver and colorectal cancers.

  5. A Qualitative Evaluation of a Faith-Based Breast and Cervical Cancer Screening Intervention for African American Women

    Science.gov (United States)

    Matthews, Alicia K.; Berrios, Nerida; Darnell, Julie S.; Calhoun, Elizabeth

    2006-01-01

    This article presents a formative evaluation of a CDC Racial and Ethnic Approaches to Community Health (REACH) 2010 faith-based breast and cervical cancer early detection and prevention intervention for African American women living in urban communities. Focus groups were conducted with a sample of women (N = 94) recruited from each church…

  6. Validity and reliability of using a self-lavaging device for cytology and HPV testing for cervical cancer screening: findings from a pilot study.

    Directory of Open Access Journals (Sweden)

    Heidi E Jones

    Full Text Available Self-sampling could increase cervical cancer screening uptake. While methods have been identified for human papillomavirus (HPV testing, to date, self-sampling has not provided adequate specimens for cytology. We piloted the validity and reliability of using a self-lavaging device for cervical cytology and HPV testing. We enrolled 198 women in New York City in 2008-2009 from three ambulatory clinics where they received cervical cancer screening. All were asked to use the Delphi Screener™ to self-lavage 1-3 months after clinician-collected index cytological smear (100 normal; 98 abnormal. Women with abnormal cytology results from either specimen underwent colposcopy; 10 women with normal results from both specimens also underwent colposcopy. We calculated sensitivity of self-collected cytology to detect histologically confirmed high grade lesions (cervical intraepithelial neoplasia, CIN, 2+; specificity for histology-negative (CIN 1 or lower, paired cytology negative, or a third cytology negative; and kappa for paired results. One hundred and ninety-seven (99.5% women self-collected a lavage. Seventy-five percent had moderate to excellent cellularity, two specimens were unsatisfactory for cytology. Seven of 167 (4% women with definitive results had CIN2+; one had normal and six abnormal cytology results with the self-lavage (sensitivity = 86%, 95% Confidence Interval, CI: 42, 100. The kappa for paired cytology was low (0.36; 95% CI: 0.25, 0.47 primarily due to clinician specimens with atypical squamous cells of undetermined significance (ASC-US and low grade squamous intraepithelial lesion (LSIL coded as normal using Screener specimens. However, three cases of HSIL were coded as ASC-US and one as normal using Screener specimens. Seventy-three women had paired high-risk HPV tests with a kappa of 0.66 (95% CI: 0.49, 0.84. Based on these preliminary findings, a larger study to estimate the performance of the Screener for co-testing cytology and

  7. 薄层液基细胞学在宫颈癌及其癌前病变筛查中的价值%The value of Thin prep cytology test in cervical precancerous lesions and cervical cancer screening

    Institute of Scientific and Technical Information of China (English)

    雷静; 万霖; 李惠新; 蒋瑛; 李瑞萍

    2011-01-01

    Objective: To evaluate the detecting technology of thin layers of liquid base cytology (TCT) on the diagnosis of precancerous lesions of uterine cervix and the clinical value, accuracy of the cervical cancer screening. Methods: To collect and analysis 7340 patients who were did examine of TCT in gynecological clinic line of our hospital from May, 2009 ~ November, 2010. Take cytology diagnosed ASC - US and higher as positive results, and the positive results do pathohistological. Take histological diagnosis as gold standard. Results: Thin prep cytology test specimens of SCC, and satisfaction LSIL accuracy HSIL, respectively, 76.8% 97.3%, 100%. Conclusion: TCT combination diagnostic systems of TBS are ideal method of current diagnosis precancerous lesions of uterine cervix (CIN) and cervical cancer screening. Also it can be used as an indicator for cervical cancer detecting. There is some risk of precancerous lesions of young In ASC-US patients.%目的:评价薄层液基细胞学(Thin prep cytology test,TCT)检测技术对宫颈癌前病变的诊断和宫颈癌筛查的准确性及临床价值.方法:收集分析2009年5月~2010年11月在我院妇科门诊行TCT检查的受检者7340例,以细胞学诊断为未明确意义的不典型鳞状上皮细胞(ASC-US)及以上者为阳性结果,并对阳性结果行病理组织学诊断,以组织学诊断作为金标准.结果:液基细胞学标本满意度高,对SCC、HSIL、LSIL的准确率分别为76.8%、97.3%、100%.结论:TCT结合TBS诊断系统是目前诊断宫颈癌前病变和筛查宫颈癌的理想方法 [1],同时也可以作为一项宫颈癌术后随访的检测指标 [2].ASC-US患者中存在部分年轻的高危癌前病变者.

  8. Human papillomavirus prevalence and type-distribution, cervical cancer screening practices and current status of vaccination implementation in Russian Federation, the Western countries of the former Soviet Union, Caucasus region and Central Asia.

    Science.gov (United States)

    Rogovskaya, Svetlana I; Shabalova, Irina P; Mikheeva, Irina V; Minkina, Galina N; Podzolkova, Nataly M; Shipulina, Olga Y; Sultanov, Said N; Kosenko, Iren A; Brotons, Maria; Buttmann, Nina; Dartell, Myassa; Arbyn, Marc; Syrjänen, Stina; Poljak, Mario

    2013-12-31

    Limited data are available on the burden of human papillomavirus (HPV) and its associated diseases in the Russian Federation, the Western Countries of the former Soviet Union (Belarus, Republic of Moldova, Ukraine), the Caucasus region and Central Asia (Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan). Both the incidence and mortality rate of cervical cancer are higher in these countries than in most Western European countries. In this article, we review available data on HPV prevalence and type distribution in women with normal cytology, women from the general population, cervical precancerous lesions and cervical cancer, as well as data on national policies of cervical cancer screening and HPV vaccination initiatives in these countries. Based on scarce data from the 12 countries, the high-risk HPV (hrHPV) prevalence among 5226 women with normal cytology ranged from 0.0% to 48.4%. In women with low-grade cervical lesions, the hrHPV prevalence among 1062 women varied from 29.2% to 100%. HrHPV infection in 565 women with high-grade cervical lesions ranged from 77.2% to 100% and in 464 invasive cervical cancer samples from 89.8% to 100%. HPV16 was the most commonly detected hrHPV genotype in all categories. As the HPV genotype distribution in cervical diseases seems to be similar to that found in Western Europe the implementation of HPV testing in screening programs might be beneficial. Opportunistic screening programs, the lack of efficient call-recall systems, low coverage, and the absence of quality assured cytology with centralized screening registry are major reasons for low success rates of cervical cancer programs in many of the countries. Finally, HPV vaccination is currently not widely implemented in most of the twelve countries mainly due to pricing, availability, and limited awareness among public and health care providers. Country-specific research, organized nationwide screening programs, registries and well

  9. Test characteristics of visual inspection with 4% acetic acid (VIA) and Lugol's iodine (VILI) in cervical cancer screening in Kerala, India.

    Science.gov (United States)

    Sankaranarayanan, Rengaswamy; Wesley, Ramani; Thara, Somanathan; Dhakad, Namrata; Chandralekha, Bharathykutty; Sebastian, Paul; Chithrathara, K; Parkin, Donald Maxwell; Nair, Madhavan Krishnan

    2003-09-01

    Simple and inexpensive methods based on visual examination of the cervix are currently being investigated as alternative methods of cervical screening. The test characteristics of visual inspection with 4% acetic acid (VIA), and Lugol's iodine (VILI) and conventional cytology were investigated in a cross-sectional study involving 4,444 women aged 25 to 65 years in Kerala, India. While detection of any acetowhite area constituted a low-threshold positive VIA, detection of well-defined, opaque acetowhite lesions close to or touching the squamocolumnar junction constituted a high-threshold positive VIA test. Detection of definite yellow iodine nonuptake areas in the transformation zone close to or touching the squamocolumnar junction constituted a positive VILI test. Cytology was considered positive if reported as atypia or worse lesions. All screened women were evaluated by colposcopy and biopsies were directed in 1,644 women (37.0%), which allowed the direct estimation of sensitivity, specificity and predictive values. The reference diagnosis was based on a combination of histology and/or colposcopy. True disease status was defined as CIN 2 and worse lesions. A total of 149 (3.4%) women had CIN 2 or worse lesions. The sensitivities of low-threshold VIA, high-threshold VIA, VILI and cytology to detect CIN 2 or worse disease were 88.6%, 82.6%, 87.2% and 81.9%, respectively; the corresponding specificities were 78.0%, 86.5%, 84.7% and 87.8%. Our results indicate that VIA and VILI are suitable alternate screening tests to cytology for detecting cervical neoplasia in low-resource settings.

  10. Intervention of awareness on opportunistic screening for cervical cancer in married women in Zhaoqing area%肇庆地区已婚妇女对宫颈癌机会性筛查认知度干预研究

    Institute of Scientific and Technical Information of China (English)

    李永翠; 丁敏芳; 刘志容; 梁莉; 何连珠

    2011-01-01

    Objective To comprehend awareness on opportunistic screening for cervical cancer in married women,and to provide support for health education on opportunistic screening for cervical cancer.Methods A survey on awareness of cervical cancer screening was conducted in 740 married women by self-designed questionnaires in our gynecology clinic.Nursing intervention of health education was performed and the effect was assessed before and after intervention.Results The awareness rate of cervical cancer screening(32.57%)was low in married women.High cost was one of the main factors of difficulty in cervical cancer screening,especially in rural patients.Conclusions Multi-element and various forms of cognitive intervention for cervical cancer screening is beneficial for improving married women's awareness on and the rate of cervical cancer screening and is of significance in the early detection and treatment of cervical cancer.%目的 了解肇庆地区已婚妇女对宫颈癌机会性筛查认知情况,为正确开展宫颈癌机会性筛查患者的健康教育工作提供依据.方法 采用自行设计的调查表,对740例在我院妇科门诊就诊已婚妇女进行宫颈癌筛查认知情况的问卷调查.并给予健康教育护理干预措施,对干预前后进行效果评价.结果本地区已婚妇女对宫颈癌筛查认知程度较低,为32.57%(241/740),干预后患者认知程度有明显提高,为59.05%(437/740).其中费用高是开展宫颈癌筛查难的主要因素之一,农村患者尤为明显.结论 开展多元素、多种形式的宫颈癌筛查认知干预,有利于提高已婚妇女对宫颈癌筛查重要性的认识和宫颈癌筛查率,对早发现和早治疗宫颈癌具有重要意义.

  11. 农村妇女宫颈糜烂样改变者对宫颈癌前期筛查的认知、态度、行为及相关因素分析%Awareness, Attitudes and Behaviors of Cervical Cancer Screening in Rural Women with Cervical Erosion and Related Factors Analysis

    Institute of Scientific and Technical Information of China (English)

    孙娇; 王瑞; 任岩峰

    2016-01-01

    目的:调查农村妇女宫颈糜烂样改变者对宫颈癌前筛查的认知、态度和行为状况。方法:选择2015年3月25日至9月25日下乡生殖健康普查中,具有宫颈糜烂样改变者妇女700例为调查对象,自行设计调查问卷,统计问卷结果。结果:686例宫颈糜烂样改变者妇女对宫颈癌前筛查的认知、态度、行为状况调查结果存在一定的差异性,其认知程度与文化程度、职业、家庭收入呈正相关,年龄越小或年龄越大者对其认知越差,其态度与对癌前筛查的了解程度呈正相关,对其行为具有一定影响。结论:农村妇女宫颈糜烂样改变者对宫颈癌前筛查的认知、态度和行为状况可相互影响。因此,加强对宫颈糜烂样改变正确认知、宫颈癌防控意识的知识普及和宣教,对提高自我保健意识和加强预防工作至关重要。%Objective:To analysis awareness,attitudes and behavior conditions of cervical cancer screening in rural women with cervical erosion. Methods:From Mar 25, 2015 to Sep 25, 2015, 700 rural women with cervical erosion were checked-out in reproductive health survey. Self-designed questionnaire was used. Results:Awareness, attitudes, behaviors situation of cervical cancer screening existed some differences in 686 rural women with cervical erosion. Cognition was correlated positively with cultural level, occupation, household income. Awareness of younger or older person was poorer, their attitudes and understanding was positively correlated with the precancerous screening. Conclusions:Awareness of rural women with cervical erosion on cervical cancer screening can affect health attitudes and behavior. So, the strengthening of the awareness of cervical erosion and cervical cancer screening can essentially improve prevention efforts.

  12. 宫颈液基细胞学检查与高危型HPV检测早期筛查宫颈癌前病变的对比分析%Comparative study of liquid-based cervical cytology and high-risk HPV testing on ear-ly screening for cervical precancerous lesions

    Institute of Scientific and Technical Information of China (English)

    刘志红; 邹艳芬

    2016-01-01

    Objective:To study the effect of cervical cytology liquid-based and high-risk HPV screening for early detection of cervical lesions before. Methods:From March 2013 to March 2014 to select cervical screening 700 cases as subjects. Using high-risk HPV testing and liquid-based cervical cytology screening to test early cervical lesions. Results:In 700 cases with high-risk HPV-positive in 47 cases. HPV16 type was the most,accounting for 48. 94 percent,followed by HPV18,accounting for 21. 28%. Liquid-based cytology in cervical smear abnormalities in patients with 40 cases. LSIL accounted for 2. 71%,HSIL accounted for 0. 57%. TCT method combined high-risk HPV,LSIL and HSIL were 2. 32% and 0. 54%,and TCT was 0. 45% and 0. 19%. Conclusion:High-risk HPV tes-ting can improve the accuracy of cervical cancer screening,combined with liquid-based cervical cytology high-risk HPV testing can improve the success rate of screening for cervical precancerous lesions.%目的:对比研究宫颈液基细胞学检查与高危型HPV检测早期筛查宫颈癌前病变.方法:选取2013年3月到2014年3月接受宫颈病理变化筛选检查的700例患者作为研究对象.采用高危型HPV检查和宫颈液基细胞检查进行早期宫颈癌前病变筛查.结果:在700例患者中,高危型HPV检查结果阳性有47例.其中HPV16型最多,占48.94%,其次是HPV18型,占21.28%.在宫颈液基细胞学检查中涂片异常病人有40例.其中LSIL占2.71%,HSIL占0.57%.高危HPV联合TCT方法,LSIL和HSIL分别是2.32%和0.54%;而TCT则是0.45%和0.19%.结论:高危型HPV检查能够提高宫颈癌前筛查的准确率,宫颈液基细胞检查联合高危HPV检查能够提高宫颈癌前病变筛查成功率.

  13. Methylation analysis and HPV genotyping of self-collected cervical samples from women not responding to screening invitation and review of the literature

    Science.gov (United States)

    Del Mistro, Annarosa; Frayle, Helena; Rizzi, Martina; Fantin, Gianpiero; Ferro, Antonio; Angeletti, Paolo Matteo; Giorgi Rossi, Paolo; Altobelli, Emma

    2017-01-01

    Aim of the study To assess the feasibility of partial HPV genotyping and methylation analysis of CADM1, MAL, and miR124-2 genes as triage tests in assaying self-collected cervical samples positive for high-risk HPV on primary screening, and to review the literature regarding host cellular gene methylation analysis of self-collected cervical samples. Material and methods Women residing in North-East Italy who had failed to respond to the invitation to participate in an organized population-based program were invited to provide a self-sample. Their stored baseline (self-collected) and follow-up (clinician-collected) cervical samples were included in the study. DNA was extracted from HPV-positive (Qiagen’s Hybrid Capture 2, HC2) samples. Partial genotyping with separate detection of HPV types 16 and 18 was performed with a hybrid capture-based method and a quantitative PCR assay. Methylation was assayed with a quantitative methylation-specific PCR. Results High-risk HPV infection was detected in 48% of baseline and 71% of follow-up HC2-positive samples. Methylation was demonstrated respectively in 15% and 23.5% of baseline and follow-up samples and chiefly involved a single gene (miR124-2). Invalid quantitative PCR results were recorded in 5% of self-collected samples. The specificity of miR124-1, MAL, and CADM1 methylation was 84%, 94%, and 98%, respectively, and the specificity of the three markers combined was 84%. Sensitivity was not estimated due to the lack of CIN2+ samples. The systematic review showed that different methylation assays yield different accuracy values. Conclusion Self-collected samples are suitable for methylation assays included in reflex triage testing. The reproducibility and accuracy of the methylation tests described in the literature should be improved. PMID:28263992

  14. Biomarkers for cervical cancer screening: the role of p16(INK4a) to highlight transforming HPV infections.

    Science.gov (United States)

    von Knebel Doeberitz, Magnus; Reuschenbach, Miriam; Schmidt, Dietmar; Bergeron, Christine

    2012-04-01

    Biomarkers indicating the initiation of neoplastic transformation processes in human papillomavirus (HPV)-infected epithelial cells are moving into the focus of cancer prevention research, particularly for anogenital cancer, including cancer of the uterine cervix. Based on the in-depth understanding of the molecular events leading to neoplastic transformation of HPV-infected human cells, the cyclin-dependent kinase inhibitor p16(INK4a) turned out to be substantially overexpressed in virtually all HPV-transformed cells. This finding opened novel avenues in diagnostic histopathology to substantially improve the diagnostic accuracy of cervical cancer and its precursor lesions. Furthermore, it provides a novel technical platform to substantially improve the accuracy of cytology-based cancer early-detection programs. Here, we review the molecular background and the current evidence for the clinical utility of the p16(INK4a) biomarker for HPV-related cancers, and cervical cancer prevention in particular.

  15. Framing preventive care messaging and cervical cancer screening in a health-insured population in South Africa: Implications for population-based communication?

    Science.gov (United States)

    Adonis, Leegale; Paramanund, Jithen; Basu, Debashis; Luiz, John

    2016-02-17

    The impact of health message framing on cervical cancer screening uptake is poorly understood.We undertook a prospective randomized control study between August 2013 and February 2014 within a health-insuered population. The study consisted of 748 females, aged 21-65 years who had not had a Pap smear in the previous 3 years and were randomly selected to receive either a loss-framed, gain-framed, or neutral health message (control) regarding cervical cancer screening via email. Pap smear uptake was determined from medical claims data. The median age was 43 years (interquartile range: 26-60 years). Overall Pap smear screening rate was found to be 8.36 percent (confidence interval: 8.08%-8.64%). Screening rate in the control group was 9.58 percent (confidence interval: 9.29%-9.87%), 5.71 percent (confidence interval: 5.48%-6.98%) in the gain-framed group, and 8.53 percent (confidence interval: 8.24%-8.81%) in the loss-framed group. Statistically there was no difference between the screening rates of the groups (p = 0.75). Females were 43 percent (odds ratio = 0.57) less likely to have a Pap smear if exposed to a gain-framed message, compared to a neutral-framed message; however, this finding was non-significant (p = 0.13). When receiving a loss-framed message, females were only 23 percent (odds ratio = 0.87) less likely to have a Pap smear compared to a neutral-framed message, also not significant (p = 0.69). In addition, further age stratification revealed no differences in Pap smear uptake between different age groups. These findings indicate that Pap smear uptake in this health-insured population is low, with no difference in exposure to differently framed health messages when emailed. Framing of health messages may not be a significant consideration when constructing population-based communication through emails.

  16. A cost-utility analysis of adding a bivalent or quadrivalent HPV vaccine to the Irish cervical screening programme.

    LENUS (Irish Health Repository)

    Dee, Anne

    2010-04-01

    Cervical cancer is a leading cause of death worldwide, and in Ireland it is the ninth most commonly diagnosed cancer in women. Almost 100% of these cancers are caused by human papillomavirus (HPV) infection. Two newly developed vaccines against HPV infection have become available. This study is a cost-utility analysis of the HPV vaccine in Ireland, and it compares the cost-effectiveness profiles of the two vaccines.

  17. Prevalence and significance of psammoma bodies in cervicovaginal smears in a cervical cancer screening program with emphasis on a case of primary bilateral ovarian psammocarcinoma

    Directory of Open Access Journals (Sweden)

    Pusiol Teresa

    2008-04-01

    Full Text Available Abstract Background The purpose of our study was to determine the prevalence and significance of psammoma bodies (PBs in the cervicovaginal smears of the screening population of Trento district (Italy, with the description of the cytological presentation of an asymptomatic bilateral ovarian psammocarcinoma. Methods From 1993 to 2006, women with PBs detected on consecutively screened cervical smears were identified from the computerized pathology database of Rovereto Hospital. The follow-up period was set from the time of cytological diagnosis to May 31st, 2007. Clinical information was obtained from retrospective review of women's medical records. The source of PBs was identified with adequate diagnostic procedures. Results PBs were found in six of the 201,231 Papanicolaou screening smears (0.0029%. Benign conditions (intrauterine device, inclusion ovarian cysts and ovarian cystoadenofibroma with PBs were found in four patients. In two cases, PBs were associated with malignant cells; a bilateral ovarian malignancy was diagnosed in both cases, a serous adenocarcinoma and a psammocarcinoma. Conclusion PBs in the cervicovaginal smears are a rare finding, associated more often with benign conditions than with malignancies. Moreover, to our knowledge, our case of primary ovarian psammocarcinoma is the first report in which the presence of malignant cells and PBs in the cervicovaginal and endometrial smears represents the first manifestation of disease.

  18. 不同筛查方法对宫颈癌的诊断价值%Evaluation of Different Screening Methods in Diagnosis of Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    杨越波; 张宇; 唐虹

    2010-01-01

    Objective To retrospectivly analyze the value of Pap smear,liquid-based cells, colposcopy and colposcopic cervical biopsy in the diagnosis of cervical cancer. Methods 116 cases of cervical cancer were retrospectively analyzed, and the value of Pap smear,liquid-based cells ,colposcopy,and colposcopic cervical biopsy in the diagnosis of cervical cancer were investigated. Result 116 patients were pathologically diagnosed with cervical cancer before and after surgery. Pap smear was performed for 30 patients (25.9%) ,and 10 patients (33.3%) were detected with HSIL. Liquid-based cells was performed for47 patients (40.5%) ,and 25 patients (53.1%) were detected with HSIL. Colposcopy was performed for 99 patients (85.3%), and 75 patients (75.8 % ) were detected with HSIL or invasive cancer. Preoperative colposcopic biopsy was performed for 99 patients, and the pathological coincidence rate was 94.9%. There was no significant difference statistically between two cytology screening ( P > 0.05 ). There was significant difference statistically between liquid-based cells and colposcopy ( P < 0.01 ). There were significant differences statistically among liquid-based cells,colposcopy ,and colposcopic cervical biopsy ( P <0.01 ). Conclusion Cytology, colposcopy, colposcopic cervical biopsy could not be individually more complete and accurate detection of cervical cancer. Colposcopy,colposcopic biopsy than cytology had higher accurate rate of diagnosis of cervical cancer. A reasonable combination of multiple detection methods could improve the diagnostic accuracy of cervical cancer.%目的 探讨巴氏涂片、液基细胞、阴道镜检和阴道镜下活检在子宫颈癌诊断中的价值.方法 116例子宫颈癌患者资料进行回顾性分析,进一步探讨巴氏涂片、液基细胞、阴道镜检和阴道镜下活检在宫颈癌诊断中的价值.结果 116例患者均为术前术后组织病理确诊为宫颈癌.其中30例曾行巴氏涂片检查,占25.9%,

  19. HPV、TCT 及阴道镜对宫颈癌筛查的意义%Significance of HPV、TCT and Colposcopy for Cervical Cancer Screening

    Institute of Scientific and Technical Information of China (English)

    劳芝英

    2014-01-01

    Objective To investigate the clinical efficacy of HPV ,TCT and colposcopy in screening of early cervical le-sions clinical .Methods 1 260 cases of cervical cancer were detected by liquid-based cytology ( liquid-based thinlayer cytology test,TCT) ,high-risk human papilloma virus ( human papilloma virus ,HPV) DNA testing and colposcopy positioned under cervi-cal biopsy ,and cervical biopsy results confirmed standard histopathological evaluation HPV ,TCT and joint detection for early diag-nosis of cervical cancer effect .Results Liquid-based cytology test ( TCT) showed that there was no intraepithelial lesion or ma-lignant cells,normal and benign inflammation 1 037 cases,accounting for 82.30%;the remaining 223 cases occurred without a clear sense of atypical squamous cells ( ASCUS) ,low-grade squamous intraepithelial lesions ( LSIL) ,high-grade squamous intra-epithelial lesions (HSIL),squamous cell carcinoma (SCC),TCT showed positive detection rate of 17.70%.HPV-DNA testing found that 659 patients had 1 or more of the HPV infection ,HPV-DNA positive rate was 52.30%;For TCT combined with the highest and HPV-DNA genotyping sensitivity ,all indicators showed 262 patients had a positive indictor ,compared with a single TCT and HPV-DNA genotyping,the detection rate was significantly higher ,χ2 values was 71.610,40.971,P values was 0.000, 0.000 ratio.Conclusion The clinical use of HPV-DNA, liquid-based cytology and colposcopy for early screening of cervical cancer,is an efficient and feasible solution ,and the combined detection of cervical precancerous lesions can improve the detection rate and reduce the rate of misdiagnosis .Early screening for cervical cancer is important .%目的:探讨HPV、TCT联合阴道镜在筛查早期宫颈病变中的临床意义。方法本研究选取在门诊初次就诊接受宫颈癌筛查的患者1260例,通过液基细胞学检查(liquid-based thinlayer cytology test ,TCT)、高危型人类乳头状瘤病毒( human papilloma

  20. HPV基因分型检测在宫颈癌筛查中的应用%The Application of HPV Genotypes in Screening of Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    肖凤静; 苏明权; 杨柳; 马越云; 郝晓柯

    2012-01-01

    Objective: To explore the application value of HPV genotyped technology in screening of cervical cancer. Methods: Reverse dot blot hybridization was used to demonstrate the HPV genotypes, there were 23 genotypes including low-risk type and high-risk type. Results: In 98 samples, 38 cases were infected by HPV and the positive rate was 38.8%. The prevalence of HPV infection in the chronic cervicitis, CIN I, CIN II, CIN III and SCC was 30.4% (14/46), 15.4% (4/26), 71.4%(10/14), 75%(6/8) and 100% (4/4) respectively. The order of type-specific prevalence was HPV43, 11, 6, 31, 42 and 51 in the chronic cervicitis, HPV35, 16, 52, 53 and 59 in CIN I; HPV 16,6,11 and 51 in CIN II , HPV 16,18,31 and 53 in CIN III while the distribution order in SCC was HPV 1 6, followed by HPV52, 18, 33, 58, 59 and 66. Conclusions: Continuous HPV infection has a close relationship with cervical disease. Detection of HPV gene type provides great help for clinical screening, diagnosis, treatment and prognosis of cervical disease detection.%目的:探讨人乳头瘤病毒(human papilloma virus,HPV)基因分型技术在宫颈癌筛查中的临床应用价值.方法:采用反向斑点杂交法对HPV基因型进行分析,包括低危型(如6、11、42、43、44型等)和高危型(如16、18、31、33、35、MM4型等)共23个型别.结果:98例样本中检出HPV阳性者38例,23种基因型中共检出15种HPV型别,HPV总感染率38.8%(38/98).慢性宫颈炎患者中HPV感染率30.4% (14/46),检测到的HPV亚型主要是HPV43,11,6,42,31和51(其中HPV6,42,31,51检出率一致).CIN I患者HPV感染率15.4%(4/26),最常见的HPV亚型为HPV35,其次为HPV16,52,53和59(其中16,52,53,59检出率一致).CIN Ⅱ患者HPV感染率71.4%(10/14),以HPV16,6,11,51等亚型最常见.CINⅢ患者HPV感染率75%(6/8),HPV亚型以HPV16,18,31,53为主.SCC患者HPV阳性率为100%(4/4),HPV16检测率最高,其次为HPV52,18,33,58,59和66.结论:持续的HPV感染与宫颈疾病有着密切的关

  1. Cervical Cancer Screening System and Liquid Based Cytology Test in ervical Lesion Screening Study%宫颈癌筛查系统与液基细胞学检测在宫颈病变初筛中的研究

    Institute of Scientific and Technical Information of China (English)

    李霞; 黄俊霞

    2011-01-01

    目的:探讨宫颈癌筛查系统(TruScreen)与液基细胞学检测(TCT)在宫颈病变初筛中的应用价值.方法:对1 201例患者依次进行TruScreen、TCT及宫颈活检病理学检查,将其病理结果与TruScreen和TCT结果对照分析.结果:TruScreen、TCT阳性结果分别为316例和207例,病理学检查阳性结果为115例.TruScreen、TCT检测的敏感度分别为81.7%、71.3%,特异度分别为79.6%、88.5%,假阴性率分别为18.3%、28.7%,假阳性率分别为20.4%、11.5%.TruScreen检查敏感度略高于TCT,差异无统计学意义(P>0.05).结论:TruScreen的效果评价略优于TCT,具有较低的假阴性率及相对不高的假阳性率,有望成为我国宫颈病变初筛的独立方法.%Objective:To study the value of cervical cancer screening system and liquid based cytology test in detection of cervical lesions.Methods:Cervical cancer screening system,liquid based cytology test and pathological test were performed in a 1201 cases,and the results of the former two were compared with pathological outcomes.Results:A total of 316,207 and 115 cases were shown as positive according to cervical cancer screening system, liquid based cytology test and pathological test respectively indicating sensitivity of 81.7%,71.3%;specificity of 79.6%,88.5%;false negative rate of 18.3%,28.7%;and false positive rate of 20.4%,11.5% for cervical cancer screening system and liquid based cytology test.Sensitivity of cervical cancer screening system was slightly higher than that of the liquid based cytology test,while the difference was insignificant (P>0.05).Conclusion: Efficacy of cervical cancer screening system is better than that of liquid based cytology test. With low false negative rate and comparatively low false positive rate,it might be used alone as primary screening method for cervical lesions in China.

  2. Clinical and evolving features of women diagnosed with precancerous cervical lesions, screened and treated in the Amazon region of Brazil.

    Science.gov (United States)

    Prado, Patricia Rezende do; Koifman, Rosalina Jorge; Silva, Ilce Ferreira da

    2014-09-01

    The objective of the study was to determine the dynamics of precancerous lesions in women of a cohort treated for cervical intraepithelial neoplasia (CIN) and followed up over the next two years. The conditional probability of failure was calculated using the Kaplan-Meier method, and the raw and adjusted hazard ratios (HR) were determined using Cox regression with a p-value entry of history of more frequent pregnancies and a histological diagnosis of CIN II/III are directly correlated with risk of CIN treatment failure, whereas being in a stable relationship is inversely correlated with this risk.

  3. Research of cervical cytology screening in diagnosis of 370,000 cases with cervical lesion in Guangdong%广东地区37万例妇女子宫颈细胞学筛查子宫颈病变的研究

    Institute of Scientific and Technical Information of China (English)

    Baowen Zheng; Congde Chen; Anxiang Wei; Han Ran; Dong Liu; Wenling Yue; Huirong Zhou; Qingyi Zhu; Juming Su

    2009-01-01

    Objective:Analysis of the results of 37 million cases by using cervical liquid-based cytology screening.discussion the situation of cervical cancer and precancerous lesions in Guangdong province.Methods:From 2002 to 2006.using liquid-based thin-layer cytology (TCT)method screening cervical lesions within 371.929 women in Guangdong.Cytological diagnosis adopt TBS(the Bethesda system)Standard(TBS improved 2001 version of the diagnostic criteria),staastic positive rate by age and region respectively.Results:371,929 cases of gynecology cervical samples in Guangdong.331,251 cases were negative,accounted for 91.23%:cytology positive cases:32,548 cases were squamous intreepithelial lesions(8.96%),486 cases were glandular epithelial lesions(0.13%):grouped according to age:30 to 40-year-old positive rate was 9.13%,40 to 50-year-old positive rate was 9.60%.the latter had higher cytology positive rate;grouped according to region:the total samples in PRD areas were 304.951 cases,accounted for 81.99%,in which 24301 cases were positive(8.14%),in 66978 cases(18.01%)of NON-PRD regions,7645 cases were positive(11.87%),there were 1858 cases had biopsy/follow-up results from 2004t02005.and the rate was 2.88%.Conclusion:The cytological positive rate of cervical cancer and its pre-cancerous lesions was 9.09%in Guangdong(of which the rate of cytological diagnosis as precancerous lesions was 3.40%),30 to 50 age group had the high incidence of cervical cancer and its precursor lesions.and also the main stage of prevention for cervical cancer.Cytology positive rate was 11.87% in economic underdevelopment Non-Pead River Delta regions.much higher than the Pearl River Delta region.

  4. [Preventing cervical cancer].

    Science.gov (United States)

    Simon, P; Noël, J-C

    2015-09-01

    The incidence of cervical cancer has hopefully been dropping down in our industrialized countries since the introduction of both primary and secondary prevention. Nevertheless, it is still lethal in one out of two affected women though the introduction of cytological screening has dramatically reduced the mortality. Progressive diffusion of anti-HPV vaccination, the broadening of the viral types concerned, its association with existing screening measures and finally the introduction of viral detection as a screening tool must optimize the results already obtained.

  5. 2986例农村妇女宫颈癌筛查结果分析%Results of cervical cancer screening in 2986 rural women

    Institute of Scientific and Technical Information of China (English)

    丛涛; 李红颖; 刘丽丽; 臧永宏

    2016-01-01

    examination and liquid based cytology (TCT) examination.The occurrence of cervical disease and the risk factors of cervical erosion,cervical polyp,and carcinoma were were analyzed.Results 64.9% of the 2986 women had cervical abnormalities.The cervix abnormal rate was highest in 35~45 years old group,second highest in 46~55 years old group,and lowest in 56~65 years old group.Among the 1938 women with cervical abnormalities,81.1% were cervical erosion,15.4% cervical polyps,0.2% carcinoma in situ,and 3.3% cervical laceration.The abnormal rate of TCT was 2.1% among the 1938 women.The incidence of ASC-US was highest and that of HISL lowest.The incidence of cervical erosion in 35~45 years old,married people,income <1000 yuan,middle school and below,the number of sexual partner≥2,initial pregnancy age≤20 years old,pregnant times > 2 times,producing time > 2 times,or no regular census women were higher (P < 0.05).The incidence of cervical polyp in 35~45 years old,married and divorced,primary and less educated,income < 1000 yuan,the age of first sexual intercourse < 16 years old,the number of sexual partners ≥ 2,or initial pregnancy age < 20 women were higher (P < 0.05).The incidence of carcinoma in situ in the women whose first sexual intercourse age <16 years old or the number of sexual partners ≥2 was higher.Conclusions The correct method of contraception and education of premarital sexual knowledge should be strengthened in rural women to improve their self health awareness.Late marriage and childbearing and fewer children should be advocated.Attention should be paid on the screening for cervical diseases.Women having sexual life,early marriage or childbearing,abortion history,history of sexually transmitted disease,and multiple sexual partners should have regular census and have pathological biopsy or colposcopy when in need.

  6. Cancer Screening

    Directory of Open Access Journals (Sweden)

    Krishna Prasad

    2004-10-01

    Full Text Available Cancer screening is a means to detect cancer early with the goal of decreasing morbidity and mortality. At present, there is a reasonable consensus regarding screening for breast, cervical and colorectal cances and the role of screening is under trial in case of cancers of the lung,  ovaries and prostate. On the other hand, good screening tests are not available for some of the commonest cancers in India like the oral, pharyngeal, esophageal and stomach cancers.

  7. An analysis of cervical cancer screening data in Miyun county, Beijing%北京市密云县宫颈癌筛查资料分析

    Institute of Scientific and Technical Information of China (English)

    苏艳霞

    2011-01-01

    Objective To investage prevalences of cervical cancer and cervical intraepithelial neoplasia(CIN) among women in villages or towns in Miyun county, Beijing. Methods The screening data of cervical cancer of inhabitant women aged 25-65 years in 4 villages and 5 communities of downtowns in Miyun county were retrospectively analyzed. Results Totally, 20236 women were screened, including 14 433 women in villages and 5 923 women in towns. The positive rate of cervical cytologyical examination were 2. 49% (507/20 356 ). 219 women received HPV-DNA detection, among them, the high-rsk HPV (HR-HPV) infection rate in village women group was 69.37% (77/111 ), and that in town women group was 67.59% (73/108), there was no significant difference between the two women groups(x2 =0. 080, P > 0.05 ). The pathological results of colpoecopy and cervical biopsy showed that in village women group, positive rate of CIN Ⅱ was 36.66% (33/90), positive rate of CIN Ⅲ was 50.00% (45/90), and positive rate of cervical cancer was 3.33% (3/90), while in town women group, positive rate of CIN Ⅱ was 45.00% ( 36/80), positive rate of CIN Ⅲ was 45.00% (36/80) and positive rate of cervical cancer was 2.50% ( 2/80 ), there was no significant difference between the two women groups(x2 = 1. 220, 0. 424, 0. 103 respectively, all P > 0. 05 ). Conclusion In Miyun county, there are no significant differences between village women group and downtown women group in prevalences of cervical cancer and CIN.%目的 了解本地区农村和城镇妇女宫颈癌及癌前病变的患病情况.方法 回顾性分析2009年8月~2010年7月间,密云县妇幼保健院对县域内4个农村乡镇、5个社区的25~65岁户籍妇女进行宫颈癌普查的临床资料.结果 普查总数为20 356例,其中农村妇女14 433例、城镇妇女5 923例,细胞学检查阳性率为2.49%(507/20 356);进行HPV-DNA检测219例,农村组HR-HPV感染率为69.37%(77/111),

  8. 北京市大兴区宫颈癌筛查宫颈细胞学结果分析%Analysis of cervical cytology results in cervical cancer screening in Daxing District of Beijing

    Institute of Scientific and Technical Information of China (English)

    聂艳华; 于洪艳; 贾国华; 刘爽

    2015-01-01

    目的:了解北京市大兴区适龄妇女的生殖健康状况。方法对2013至2014年北京市大兴区35~64岁户籍妇女进行妇科及宫颈细胞学检查,记录个人基本信息、个人病史及检查结果。结果宫颈癌筛查39224人,进行传统巴氏细胞学检查的妇女共有25544人,阳性(未明确诊断意义的不典型鳞状上皮细胞及以上)检出率为2.22%。国产液基细胞学技术检查13680人,阳性检出率为2.84%。液基细胞学检查与巴氏涂片相比,不满意涂片率低,经比较差异有统计学意义(χ2=20.00,P<0.01)。液基细胞学检查在癌前病变和癌的阳性检出率均高于巴氏涂片,主要体现在未明确诊断意义的不典型鳞状上皮细胞、鳞状上皮内低度病变、鳞状上皮内高度病变的阳性检出率高,差异均有统计学意义(χ2值分别为6.78、6.68、5.83,均P<0.01)。在细胞学结果为鳞状上皮内高度病变的51人中,有1人被最终确诊为宫颈癌,并且有22人最终诊断为宫颈上皮内瘤变。在细胞学结果为鳞状细胞癌的2人中,均被最终确诊为宫颈癌。结论宫颈细胞学检查在早期发现和及时治疗宫颈癌及癌前病变中起到了非常重要的作用,但由于阅片人员有限及其能力水平的问题,使得细胞学阅片结果阳性率偏低。%Objective To investigate the reproductive health status of women in Daxing District of Beijing.Methods From 2013 to 2014 women aged 35-64 years old accepted cervical cytological and gynecological examination, and personal basic information, personal history and examination results were recorded.Results Totally 39 224 women received cervical cancer screening and a total of 25 544 people received traditional pap cytological examination.The positive detection rate ( ASC-US and above) was 2.22%.Domestic technology of liquid based cytology check was performed among 13 680 people with positive

  9. 宫颈细胞DNA倍体定量分析联合液基细胞学在宫颈癌早期筛查中的应用价值%Value of quantitative analysis is of DNA ploidy and cervical liquid-based cytology in the screening of ;cervical cancer and cervical intraepithelial neoplasm

    Institute of Scientific and Technical Information of China (English)

    宋志琴; 王蔼明

    2014-01-01

    Objective To evaluate the application of DNA ploidy detection and cervical liquid-based cytology in the screen methods of cervical cancer and cervical precancerous lesion. Methods 12 630 women were detected by DNA ploidy and cervical liquid-based cytology, and in which of 1 146 cases with DNA aneuploidy and (or) abnormal cervical liquid-based cytology were given cervical biopsy. Pathological diagnosis was taken as gold standard. The clinical significance of two methods in the screen of cervical lesion was analyzed. Results The positive rates of DNA ploidy was significantly higher than cervical liquid-based cytology. Cases which were observed that LSIL and all above decided by cervical liquid-based cytology, and cases with DNA heteroploid cell more than 3 were sent to fixed point biopsy, the sensitivity of 73.28%and the specificity of 76.50%were cervical liquid-based cytology, while the sensitivity of 89.14%and the specificity of 75.80%by quantitative DNA. Conclusion DNA imaging cytometry is better for screening cervical dysplasia and carcinoma of the uterine cervix than conventional cytology.%目的:探讨宫颈细胞DNA倍体检测联合液基细胞学在宫颈癌早期筛查中的应用价值。方法对12630例患者采用宫颈细胞DNA倍体定量检测与液基细胞学联合进行宫颈病变的早期筛查,对其中1146例宫颈细胞DNA倍体定量检测阳性和(或)宫颈液基细胞学阳性者行阴道镜检查并取活检,以病理诊断为金标准,评价两种方法在宫颈癌早期筛查中的作用与意义。结果(1)宫颈DNA异倍体细胞的检出率和宫颈液基细胞学的阳性率分别为13.68%和8.97%,有统计学差异(P<0.01);(2)随着DNA异倍体细胞数量的增加,液基细胞学的阳性率也相应增加,且宫颈病变的严重程度也增加,两种方法检测结果均阳性者与活检病理诊断有较高的符合率;(3)以1~2个倍体异常细胞为宫颈活检标准,发现

  10. Type-specific prevalence of human papillomavirus by cervical cytology among women in Brasov, Romania.

    Science.gov (United States)

    Moga, Marius Alexandru; Irimie, Marius; Oanta, Alexandru; Pascu, Alina; Burtea, Victoria

    2014-01-01

    The oncogenic role of human papillomavirus (HPV) in triggering cervical cancer, the second most common cancer in women worldwide, is well established. Romania ranks in first place in Europe in terms of the incidence of cervical cancer. Geographical widespread data on HPV type-distribution are essential for estimating the impact of HPV vaccines and cervical cancer screening programmes. In this study we aimed to identify the prevalence of HPV genotypes and to establish correlations with abnormal cervical cytology among the female population of Brasov County, Romania. A total of 1,000 women aged 17.3-57 years, attending routine cervical examination in the Obstetrics and Gynecology Hospital of Brasov, Romania, and undergoing both cytological examination and HPV genotyping were screened. Infection with 35 different HPV genotypes was detected in 39.6% of cytological specimens. Overall HPV infections were highest in young women under 25 years (p<0.0001), in which cervical cytological abnormalities also reached the highest prevalence. Patients infected by HPV-16 or HPV-18 showed the highest prevalence of cervical cytological abnormalities. Some 48.2% of women with abnormal cytology were infected with high-risk HPV types whereas less than 3% of them were infected only with low-risk HPV types. Our study showed that the prevalence of high-risk HPV infection among Romanian women is higher compared to other studies in other geographic areas. Thus, we consider that in areas where there is an increased prevalence of high-risk HPV infections, HPV genotyping should be performed in all women aged between 18 and 45 years, and Pap test should be performed every 6 months in women with high-risk HPV infection, even those with previous normal cervical cytology.

  11. 液基薄层细胞学检查用于宫颈疾病筛查的临床应用%ThinPrep Cervical Cytology in Clinical Applications for Disease Screening

    Institute of Scientific and Technical Information of China (English)

    崔泳

    2014-01-01

    Objective To discuss the clinical ThinPrep cytology in cervical disease screening.Methods A randomized extracted from January 2012 to December 2012 in our hospital gynecology clinic and hospital treatment of patients with cervical lesions, combined Bethesda 2001 reporting classification standards, using technology TCT producer, randomized patients with cervical lesions in these 60 cases of cervical cells School screening. And more cases of atypical squamous cervical histopathological examination.Results 60 patients were satisfied with the drawn smear:abnormal results detected atypical squamous eight cases,not excluding the height of five cases of atypical squamous lesions,low-grade squamous intraepithelial lesions in 2 cases, high-grade squamous intraepithelial lesions in one case,Histopathological results for intraepithelial lesion (≥LSIL)14 cases of pathological 87.5%.Conclusion ThinPrep cytology, early detection of precancerous cervical lesions and cervical cancer even change that clinical application in cervical disease screening.%目的:讨论液基薄层细胞学检查在宫颈疾病筛查中的临床应用。方法随机提取2012年1~12月在我院妇科门诊及住院就诊的宫颈病变患者,结合Bethesda2001报告分类标准,采用TCT制片技术,随机对这60例宫颈病变患者进行宫颈细胞学筛查。并对非典型鳞状上皮以上病例进行宫颈组织病理学检查。结果60例患者取材均为满意涂片:检出异常结果非典型鳞状上皮8例,不除外高度病变的非典型鳞状上皮5例,低度鳞状上皮内病变2例,高度鳞状上皮内病变1例。病理组织学结果为上皮内病变(≥LSIL)14例,病理符合率为87.5%。结论在宫颈疾病筛查中应用液基薄层细胞学检查,可早期发现宫颈病变和癌前病变甚至宫颈癌变,可临床推广应用。

  12. Analysis on screen results of cervical cancer for 2 739 women in fishing village and countryside%渔农村妇女2739人宫颈癌筛选结果的分析

    Institute of Scientific and Technical Information of China (English)

    周悠燕

    2011-01-01

    Objective To analysis the screen results of cervical cancer and improve prevention for women with cervical cancer in fishing village and countryside. Method Analyze the information on cervical cancer for 2739 women in fishing village and countryside. Analyze the relation between age, marriage, education level, medical insurance, economic conditions and positive screen result of cervical cancer. Result 51 of 2739 women show positive results. Women with older age, lower education level and poorer economic conditions tend to have a higher rate of positive result. Conclusion Enhancing health education for women with cervical cancer in fishing village and countryside can improve the early detection, early diagnosis and early treatment of cervical cancer.%目的 分析渔农村妇女宫颈癌筛选的结果,提出对策.方法 对渔农村妇女 2 739 人的宫颈癌筛选资料进行分析,了解渔农村妇女年龄、婚姻状况、文化程度、医疗保险及经济状况与宫颈癌筛选阳性之间关系.结果 2 739 人中,宫颈癌筛选阳性检出 51 人,年龄越大阳性检出率越高,文化程度越低、经济状况越差阳性检出率越高.结论 加强渔农村妇女保健及健康教育工作,促使宫颈癌早发现、早诊断、早治疗.

  13. [Breast and cervical cancer screening: beliefs and behaviors among the female population of the city of Liege (Belgium)].

    Science.gov (United States)

    Escoyez, B; Mairiaux, Ph

    2003-05-01

    Several surveys have shown that in Belgium the coverage of the female population for both breast and cervix cancers screening is too low and not evenly distributed in the target population. In order to highlight modifiable behavioural factors about cancer screening and to know the profile of women who exhibit an inadequate preventive behaviour, a postal survey has been conducted in the city of Liège. A self-administrated questionnaire was sent to a randomised sample of 1.000 women from two age groups (25-37 and 45-57 years); 444 women returned the questionnaire (response rate: 45.4%). The results show that the responders who do not comply with the recommendations for cancer screening are more often unemployed women with a low educational level, women who have a poor perception of their health, or women who are not regularly followed by a gynaecologist. Those women have more often poor knowledge and wrong beliefs about prevention, a negative perception of the curability of a cancer detected early and of the efficacy of screening tests. In spite of an overrepresentation of women with an university degree among the responders, it was also observed that more than 1 woman out of 4 in the 25-37 years age group is not convinced of the pap smear efficacy. In view of these results, the design of screening campaigns for cancer prevention has to involve specific efforts targeted at under-privileged subgroups within the female population.

  14. Prevalence of human papillomavirus cervical infection in an Italian asymptomatic population

    Directory of Open Access Journals (Sweden)

    Sirito Rodolfo

    2005-09-01

    Full Text Available Abstract Background In the last decade many studies have definitely shown that human papillomaviruses (HPVs are the major cause of cervical carcinogenesis and, in the last few years, HPV testing has been proposed as a new and more powerful tool for cervical cancer screening. This issue is now receiving considerable attention in scientific and non scientific press and HPV testing could be considered the most important change in this field since the introduction of cervical cytology. This paper reports our prevalence data of HPV infection collected in the '90s, while a follow up of these patients is ongoing. Methods For this study we used polymerase chain reaction (PCR to search HPV DNA sequences in cervical cell scrapings obtained from 503 asymptomatic women attending regular cervical cancer screening program in the city of Genova, Italy. All patients were also submitted to a self-administered, standardized, questionnaire regarding their life style and sexual activity. On the basis of the presence of HPV DNA sequences women were separated into two groups: "infected" and "non infected" and a statistical analysis of the factors potentially associated with the infection group membership was carried out. Results The infection rate was 15.9% and the most frequent viral type was HPV 16. Conclusion Our HPV positivity rate (15.9% was consistent to that reported by other studies on European populations.

  15. ANALYSIS OF THE SCREENING RESULTS OF CANCER BREAST CANCER AND CERVICAL CANCER IN RURAL WOMEN%农村女性乳腺癌和宫颈癌筛查结果分析

    Institute of Scientific and Technical Information of China (English)

    薛冬梅

    2016-01-01

    Objective To analyze the epidemiological characteristics of the rural female breast and cervical diseases .Methods 28208 rural women underwent rou‐tine breast and cervical cancer screening ,and the suspicious client underwent mammography or pathologi‐cal examination .Results The detection rate of breast cancer was 38 .99/100000 and the detection rate of cervical cancer w as 85 .08/100000 .Conclusion Breast and cervical cancer Screening can help to enhance ru‐ral w omen's health .%目的:分析农村女性乳腺和宫颈疾病流行病学特征,为疾病防治提供依据。方法组织28208名农村女性进行乳腺癌和宫颈癌常规筛查,对可疑受检者进行钼靶X线检查或病理检查。结果乳腺癌检出率为38.99/10万;宫颈癌检出率为85.08/10万。结论对乳腺癌和宫颈癌进行筛查有利于提升农村女性健康水平。

  16. Test of an Intervention to Improve Knowledge of Women with Intellectual Disabilities about Cervical and Breast Cancer Screening

    Science.gov (United States)

    Swaine, J. G.; Parish, S. L.; Luken, K.; Son, E.; Dickens, P.

    2014-01-01

    Background: There is a critical need for evidence-based health education interventions for women with intellectual disabilities (IDs) to promote receipt of preventive health screenings. Previous research has established "Women Be Healthy," an 8-week classroom-style intervention designed to teach women with IDs about breast and cervical…

  17. Investigating the role of healthcare centre accessibility on the decision to attend for screening for gestational diabetes mellitus in Ireland [presentation

    LENUS (Irish Health Repository)

    Cullinan, John

    2011-01-01

    Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy and is associated with several serious maternal and neonatal complications and conditions. Screening practices for GDM vary within and across European countries, with some offering universal screening to all pregnant women and others only to selective high risk groups. In Ireland, no single policy with respect to GDM screening is implemented nationally and a debate exists as to what form such a policy should take. Within this context, the Atlantic Diabetes in Pregnancy (ATLANTIC DIP) network was established in 2005 to provide robust information on pregnancy outcomes for women with diabetes. The network includes five healthcare centres along the Atlantic seaboard and provides testing for all pregnant women at 24-28 weeks using a 75g Oral Glucose Tolerance Test. The centres are linked using a clinical information system which allows for data to be captured within a central database, containing a comprehensive range of data on screening uptake rates, maternal characteristics, outcomes for mothers and infants, healthcare resource usage over the course of pregnancy, as well as the postal address of each individual. At present it contains observations on 9,043 pregnant women offered the screening, 5,218 (58%) of whom participated in testing.\\r\

  18. 75 FR 7282 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Science.gov (United States)

    2010-02-18

    ... HUMAN SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and... cervical cancer. The committee makes recommendations regarding national program goals and objectives... Force guidelines for breast and cervical cancer screening; Impact of the revised clinical...

  19. Comparison of two commercial assays for detection of human papillomavirus (HPV) in cervical scrape specimens: validation of the Roche AMPLICOR HPV test as a means to screen for HPV genotypes associated with a higher risk of cervical