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Sample records for cervical screening cohort

  1. 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...

  2. 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.

  3. Primary cervical cancer screening with an HPV mRNA test: a prospective cohort study

    Science.gov (United States)

    Fismen, Silje; Gutteberg, Tore Jarl; Mortensen, Elin Synnøve; Skjeldestad, Finn Egil

    2016-01-01

    Objectives To assess the performance of a 5-type human papillomavirus (HPV) messenger RNA (mRNA) test in primary screening within the framework of the Norwegian population-based screening programme. Design Nationwide register-based cohort study. Setting In 2003–2004, general practitioners and gynaecologists recruited 18 852 women for participation in a primary screening study with a 5-type HPV mRNA test. Participants After excluding women with a history of abnormal smears and with cervical intraepithelial neoplasia grade 2 (CIN2+) before or until 3 months after screening, 11 220 women aged 25–69 years were eligible for study participation. The Norwegian Cancer Registry completed follow-up of CIN2+ through 31 December 2009. Interventions Follow-up according to the algorithm for cytology outcomes in the population-based Norwegian Cervical Cancer Screening Programme. Main outcome measures We estimated cumulative incidence of CIN grade 3 or worse (CIN3+) 72 months after the 5-type HPV mRNA test. Results 3.6% of the women were HPV mRNA-positive at baseline. The overall cumulative rate of CIN3+ was 1.3% (95% CI 1.1% to 1.5%) through 72 months of follow-up, 2.3% for women aged 25–33 years (n=3277) and 0.9% for women aged 34–69 years (n=7943). Cumulative CIN3+ rates by baseline status for HPV mRNA-positive and mRNA-negative women aged 25–33 years were 22.2% (95% CI 14.5% to 29.8%) and 0.9% (95% CI 0.4% to 1.4%), respectively, and 16.6% (95% CI 10.7% to 22.5%) and 0.5% (95% CI 0.4% to 0.7%), respectively, in women aged 34–69 years. Conclusions The present cumulative incidence of CIN3+ is similar to rates reported in screening studies via HPV DNA tests. Owing to differences in biological rationale and test characteristics, there is a trade-off between sensitivity and specificity that must be balanced when decisions on HPV tests in primary screening are taken. HPV mRNA testing may be used as primary screening for women aged 25–33 years and

  4. Risks of Cervical Cancer Screening

    Science.gov (United States)

    ... Treatment Cervical Cancer Prevention Cervical Cancer Screening Research Cervical Cancer Screening (PDQ®)–Patient Version What is screening? Screening ... These are called diagnostic tests . General Information About Cervical Cancer Key Points Cervical cancer is a disease in ...

  5. Evidence for cervical cancer mortality with screening program in Taiwan, 1981–2010: age-period-cohort model

    Directory of Open Access Journals (Sweden)

    Su Shih-Yung

    2013-01-01

    Full Text Available Abstract Background Cervical cancer is the most common cancer experienced by women worldwide; however, screening techniques are very effective for reducing the risk of death. The national cervical cancer screening program was implemented in Taiwan in 1995. The objective of this study was to examine and provide evidence of the cervical cancer mortality trends for the periods before and after the screening program was implemented. Methods Data from 1981 to 2010 of the causes of death registered were obtained from the Department of Health, Taiwan. Age-standardized mortality rates, age-specific rates, and age-period-cohort models that employed the sequential method were used to assess temporal changes that occurred between 1981 and 2010, with 1995 used as the separating year. Results The results showed that for both time periods of 1981 to 1995 and 1996 to 2010, age and period had significant effects, whereas the birth cohort effects were insignificant. For patients between 80 and 84 years of age, the mortality rate for 1981 to 1995 and 1996 to 2010 was 48.34 and 68.08. The cervical cancer mortality rate for 1996 to 2010 was 1.0 for patients between 75 and 79 years of age and 1.4 for patients between 80 and 84 years of age compared to that for 1981 to 1995. Regarding the period effect, the mortality trend decreased 2-fold from 1996 to 2010. Conclusions The results of this study indicate a decline in cervical cancer mortality trends after the screening program involving Papanicolaou tests was implemented in 1995. However, the positive effects of the screening program were not observed in elderly women because of treatment delays during the initial implementation of the screening program.

  6. 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 ...

  7. Cervical cancer - screening and prevention

    Science.gov (United States)

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

  8. Screening for Cervical Cancer

    Science.gov (United States)

    ... cervical cancer: • Cytology: This test, also called a Pap test or Pap smear, looks for abnormal changes in cells in ... women ages 21 to 65, screening with a Pap test every 3 years has the highest benefits ...

  9. Abnormal Cervical Cancer Screening Test Results

    Science.gov (United States)

    ... AQ FREQUENTLY ASKED QUESTIONS FAQ187 GYNECOLOGIC PROBLEMS Abnormal Cervical Cancer Screening Test Results • What is cervical cancer screening? • What causes abnormal cervical cancer screening test ...

  10. 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...

  11. 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...

  12. 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.

  13. Cervical cancer screening in the Faroe Islands

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...

  14. Cervical screening: Frequently asked questions (FAQs)

    OpenAIRE

    Public Health Agency

    2012-01-01

    Testing for high-risk human papillomavirus (HR-HPV) as triage and test of cure was introduced into the Northern Ireland Cervical Screening Programme on Monday 28 January 2013. This policy change will significantly alter the screening pathway for women with a mild dyskaryosis or borderline smear result. The link between HR-HPV infection and the development of cervical cancer has now been clearly established, with almost 100% of cervical cancers containing HPV DNA. Women with no evidence of HR-...

  15. Cervical cancer : incidence, screening and prognosis among immigrant women in Sweden

    OpenAIRE

    Azerkan, Fatima

    2013-01-01

    Immigrant studies may help further our understanding of the aetiology of cervical cancer and improve its prevention. The overall aim of this thesis is to study the risk of cervical cancer among immigrant women in Sweden, their cervical screening attendance and their prognosis after cervical cancer diagnosis. Quantitative cohort study designs using data from population-based registers were carried out and analysed using Poisson regression and Cox proportional hazard models. A quantitative expl...

  16. Human papillomavirus testing in cervical cancer screening.

    Science.gov (United States)

    Castle, Philip E; Cremer, Miriam

    2013-06-01

    Human papillomavirus (HPV) testing is more reliable and sensitive but less specific than Papanicolaou (Pap) testing/cervical cytology for the detection of cervical precancer and cancer. HPV-negative women are at lower risk of cervical cancer than Pap-negative women. In high-resource settings, HPV testing can be used to make cervical cancer prevention programs more efficient by focusing clinical attention on women who have HPV. In lower-resource settings, where Pap testing has not been sustained or widespread, new, lower-cost HPV tests may make cervical cancer screening feasible. PMID:23732037

  17. Genotypic distribution of human papillomavirus (HPV) and cervical cytology findings in 5906 Thai women undergoing cervical cancer screening programs

    OpenAIRE

    Kantathavorn, Nuttavut; Mahidol, Chulabhorn; Sritana, Narongrit; Sricharunrat, Thaniya; Phoolcharoen, Natacha; Auewarakul, Chirayu; Teerayathanakul, Narongchai; Taepisitpong, Chantanee; Saeloo, Siriporn; Sornsamdang, Gaidganok; Udomchaiprasertkul, Wandee; Krongthong, Waraphorn; Arnamwong, Arpaporn

    2015-01-01

    Background Cervical cancer is the major cause of morbidity and mortality in Thai women. Nevertheless, the preventive strategy such as HPV vaccination program has not been implemented at the national level. This study explored the HPV prevalence and genotypic distribution in a large cohort of Thai women. Methods A hospital-based cervical cancer screening program at Chulabhorn Hospital, Bangkok and a population-based screening program at a rural Pathum Thani Province were conducted using liquid...

  18. Cervical cancer - screening and prevention

    Science.gov (United States)

    Cervical cancer is cancer that starts in the cervix. The cervix is the lower part of the uterus ( ... can do to decrease your chance of having cervical cancer. Also, tests done by your health care provider ...

  19. 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.

  20. 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.

  1. Cervical Cancer Screening and Perceived Information Needs

    Science.gov (United States)

    Whynes, David K.; Clarke, Katherine; Philips, Zoe; Avis, Mark

    2005-01-01

    Purpose: To identify women's sources of information about cervical cancer screening, information which women report receiving during Pap consultations, information they would like to receive, and the relationships between perceived information needs, personal characteristics and information sources. Design/methodology/approach: Logistic regression…

  2. Nanomechanical clues from morphologically normal cervical squamous cells could improve cervical cancer screening

    Science.gov (United States)

    Geng, Li; Feng, Jiantao; Sun, Quanmei; Liu, Jing; Hua, Wenda; Li, Jing; Ao, Zhuo; You, Ke; Guo, Yanli; Liao, Fulong; Zhang, Youyi; Guo, Hongyan; Han, Jinsong; Xiong, Guangwu; Zhang, Lufang; Han, Dong

    2015-09-01

    Applying an atomic force microscope, we performed a nanomechanical analysis of morphologically normal cervical squamous cells (MNSCs) which are commonly used in cervical screening. Results showed that nanomechanical parameters of MNSCs correlate well with cervical malignancy, and may have potential in cancer screening to provide early diagnosis.Applying an atomic force microscope, we performed a nanomechanical analysis of morphologically normal cervical squamous cells (MNSCs) which are commonly used in cervical screening. Results showed that nanomechanical parameters of MNSCs correlate well with cervical malignancy, and may have potential in cancer screening to provide early diagnosis. Electronic supplementary information (ESI) available. See DOI: 10.1039/c5nr03662c

  3. Promoting Quality of Cervical Cancer Screening and Treatment in India

    OpenAIRE

    Krishnan, S.; Madsen, E.; Porterfield, D.; Varghese, B.

    2015-01-01

    Cervical cancer screening is highly cost effective, feasible, and culturally acceptable in higher and lower income settings across the world. According to the World Health Organization and the World Economic Forum, screening for cervical cancer is an evidence-based best buy prevention intervention (1). However, to be effective in reducing cervical cancer incidence and mortality, screenin...

  4. 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.

  5. 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.

  6. Optoelectronic image processing for cervical cancer screening

    Science.gov (United States)

    Narayanswamy, Ramkumar; Sharpe, John P.; Johnson, Kristina M.

    1994-05-01

    Automation of the Pap-smear cervical screening method is highly desirable as it relieves tedium for the human operators, reduces cost and should increase accuracy and provide repeatability. We present here the design for a high-throughput optoelectronic system which forms the first stage of a two stage system to automate pap-smear screening. We use a mathematical morphological technique called the hit-or-miss transform to identify the suspicious areas on a pap-smear slide. This algorithm is implemented using a VanderLugt architecture and a time-sequential ANDing smart pixel array.

  7. [Cervical cancer screening: past--present--future].

    Science.gov (United States)

    Breitenecker, G

    2009-12-01

    Despite the undisputed and impressive success which has been achieved since the 1960s by cervical cytology in the fight against cervical cancer and its precursor stages, during which the mortality rate in industrialized countries over the last 40 years has been reduced by two-thirds to three-quarters, a perfect and error-free screening procedure is still a long way off and will probably never be reached. There are two main reasons for this, the lack of adequate coverage and suboptimal quality and assessment of smears. Two screening procedures are in use Europe, an opportunistic and an organized system. Both systems have many advantages but also disadvantages. In organized programs the coverage is higher (up to 80%), although similar numbers are also achieved by non-organized programs over a 3-year cycle, even if they cannot be so exactly documented. The decision on which system is used depends on the health system of the country, public or non-public, and many other national circumstances. However, in both systems prerequisites for a satisfactory result is a high quality in the sampling technique, the processing and the assessment. Therefore, several guidelines have been introduced by state and medical societies for internal and external quality assurance. New technologies, such as thin-layer cytology or automation for replacement or support of conventional cytology liquid-based cytology proved not to be superior enough to justify the high costs of these systems. The recognition of the strong causal relationship between persistent infection with high-risk human papillomavirus (HPV) types and cervical cancer and its precursors has resulted in the development of comparably simple tests. Primary screening using HPV typing alone is not recommended in opportunistic screening due to the low specificity but high sensitivity because it leads to many clinically irrelevant results which place women under stress. In organized screening HPV testing is always and only possible

  8. 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

    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.......7% were not screened. We found a minimum of one abnormal test in 28 (10.8%) after subtotal hysterectomy and one after total hysterectomy. No cervical cancers were found. CONCLUSIONS: Adherence to cervical cancer screening after subtotal hysterectomy in a Danish population is suboptimal and some patients...... 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...

  9. 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...... nationwide population-based registers including information on AID diagnoses, immunosuppressant intake, cervical screening participation, and cervical cancer incidence. Standardized incidence ratios (SIR) were computed to compare the risk of cervical cancer in AID patients to that of the general population....... 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 of...

  10. Cervical screening programme: HPV triage and test of cure protocol

    OpenAIRE

    Public Health Agency

    2013-01-01

    Testing for high-risk human papillomavirus (HR-HPV) as triage and test of cure was introduced into the Northern Ireland Cervical Screening Programme on Monday 28 January 2013. This policy change will significantly alter the screening pathway for women with a mild dyskaryosis or borderline smear result. The link between HR-HPV infection and the development of cervical cancer has now been clearly established, with almost 100% of cervical cancers containing HPV DNA. Women with no evidence of HR-...

  11. The organization of cervical screening in general practice

    OpenAIRE

    Havelock, Christine; Edwards, Robert; Cuzick, Jack; Chamberlain, Jocelyn

    1988-01-01

    Well organized cervical screening in general practice can have considerable clinical and financial rewards. Yet in a randomized survey of general practitioners in the United Kingdom only 43% operated a system for cervical screening which allows previously untested women to be identified and invited for testing.

  12. 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.

  13. 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....

  14. 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....

  15. 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....

  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. Social Construction of Cervical Cancer Screening among Panamanian Women

    Science.gov (United States)

    Calvo, Arlene; Brown, Kelli McCormack; McDermott, Robert J.; Bryant, Carol A.; Coreil, Jeanine; Loseke, Donileen

    2012-01-01

    Background: Understanding how "health issues" are socially constructed may be useful for creating culturally relevant programs for Hispanic/Latino populations. Purpose: We explored the constructed meanings of cervical cancer and cervical cancer screening among Panamanian women, as well as socio-cultural factors that deter or encourage screening…

  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. Cervical acid phosphatase detection: A guide to abnormal cells in cytology smear screening for cervical cancer

    OpenAIRE

    Deb Prabal; Iyer Venkateswaran; Bhatla Neerja; Markovic O; Verma Kusum

    2008-01-01

    Background: Cervical acid phosphatase-Papanicolaou (CAP-PAP) test has recently been described for detection of acid phosphatase enzyme in abnormal squamous cells, and has been proposed as a biomarker-based technology for the screening of cervical cancer. Materials and Methods: Eighty-one consecutive cervical smears were subjected to routine Papanicolaou (Pap) staining as well as CAP-PAP, which combined cytochemical staining for acid phosphatase with modified Pap stain. Statistical evaluation ...

  1. 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...... infected with vaccine HPV-types at vaccination are well protected against CIN2+ from these HPV-types, but the vaccine does not protect against CIN2+ from other HPV-types and neither does it protect already HPV infected women. There is an increased risk of adverse obstetric outcomes following excisional...... treatment. CONCLUSIONS: The future of cervical cancer control may become a diversified strategy, one for non-vaccinated birth cohorts and another for vaccinated cohorts. It will take another 50 years before the non-vaccinated cohorts have passed the screening age. With the current uncertainty concerning the...

  2. 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.

  3. 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

  4. New Molecular Tools for Efficient Screening of Cervical Cancer

    OpenAIRE

    Magnus von Knebel Doeberitz

    2001-01-01

    Cytological screening using the Pap-smear led to a remarkable reduction of the mortality of cervical cancer. However, due to subjective test criteria it is hampered by poor inter- and intra-observer agreement. More reproducible assays are expected to improve the current screening and avoid unnecessary medical intervention and psychological distress for the affected women. Cervical cancer arises as consequence of persistent high risk papillomavirus (HR-HPV) infections. Expression of two viral ...

  5. Socioeconomic Disparities across Ethnicities: An Application to Cervical Cancer Screening

    OpenAIRE

    Walsh, B.; O'Neill, C

    2015-01-01

    Objectives: Our aim is to investigate socioeconomic disparities in cervical cancer screening utilization among and between ethnic groups in the United States. Study Design: Observational study. Methods: Data on 26,338 women aged 21 to 64 years were obtained from the 2007 to 2011 years of the Medical Expenditure Panel Survey. Data on cervical cancer screening utilization in the preceding 12 months and 3 years, and a range of sociodemographic characteristics were included. Analyses were...

  6. 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.

  7. 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

    2016-04-01

    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 < 0.0001). The exposed group was more likely to undergo ≥ 1 intervention (20.0 vs. 9.5%, p < 0.0001); specifically, admission for threatened preterm birth (3.8 vs. 1.8%, p = 0.04) and ≥ 2 cervical measurements (11.2 vs. 2.0%, p < 0.001). Other interventions were similar between groups (all p ≥ 0.06). Median 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

  8. New Screening Proposals: the Federal Joint Commission Defines the Parameters for Cervical Cancer Screening from 2018

    Science.gov (United States)

    Hillemanns, P.; Mallmann, P.; Beckmann, M. W.

    2016-01-01

    The Gynecology Oncology Working Group (AGO e. V.) unequivocally welcomes the decision taken by the German Federal Joint Commission (Gemeinsamer Bundesausschuss, G-BA) on March 19, 2015 regarding screening for cervical cancer. AGO is convinced that, in view of recent medical advances, this evidence-based decision will improve screening for cervical cancer. PMID:26941445

  9. 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 with a...... narrow definition of a (false-)positive test. The aim of this paper was to illustrate how the narrow definition affected the measured adverse effects of HPV DNA screening compared with cytology screening....

  10. '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. PMID:25282406

  11. Expenditure and resource utilisation for cervical screening in Australia

    Directory of Open Access Journals (Sweden)

    Lew Jie-Bin

    2012-12-01

    Full Text Available Abstract Background The National Cervical Screening Program in Australia currently recommends that women aged 18–69 years are screened with conventional cytology every 2 years. Publicly funded HPV vaccination was introduced in 2007, and partly as a consequence, a renewal of the screening program that includes a review of screening recommendations has recently been announced. This study aimed to provide a baseline for such a review by quantifying screening program resource utilisation and costs in 2010. Methods A detailed model of current cervical screening practice in Australia was constructed and we used data from the Victorian Cervical Cytology Registry to model age-specific compliance with screening and follow-up. We applied model-derived rate estimates to the 2010 Australian female population to calculate costs and numbers of colposcopies, biopsies, treatments for precancer and cervical cancers in that year, assuming that the numbers of these procedures were not yet substantially impacted by vaccination. Results The total cost of the screening program in 2010 (excluding administrative program overheads was estimated to be A$194.8M. We estimated that a total of 1.7 million primary screening smears costing $96.7M were conducted, a further 188,900 smears costing $10.9M were conducted to follow-up low grade abnormalities, 70,900 colposcopy and 34,100 histological evaluations together costing $21.2M were conducted, and about 18,900 treatments for precancerous lesions were performed (including retreatments, associated with a cost of $45.5M for treatment and post-treatment follow-up. We also estimated that $20.5M was spent on work-up and treatment for approximately 761 women diagnosed with invasive cervical cancer. Overall, an estimated $23 was spent in 2010 for each adult woman in Australia on cervical screening program-related activities. Conclusions Approximately half of the total cost of the screening program is spent on delivery of primary

  12. Cervical cancer screening in Belgium and overscreening of adolescents.

    Science.gov (United States)

    Van Kerrebroeck, Helena; Makar, Amin

    2016-03-01

    There has been a marked decrease in the incidence of cervical cancer thanks to cytological screening with the Pap smear test. In Belgium, this screening is rather opportunistic. Over 39% of Belgian women between 25 and 64 years of age are never or only rarely screened by cytological tests. Moreover, there is an excess use of Pap smears because of women who rely on their yearly cervical smear and because many Pap smears are obtained from women beyond the target age range of 25 to 64 years. Sexually active adolescents are increasingly being recognized as a population distinct from adult women. They are at a high risk of acquiring the human papillomavirus (HPV), but most infections and cervical intraepithelial lesions caused by HPV are efficiently cleared by the immune system. We present a description of cervical cancer screening in Belgium using the database of the National Health Insurance Institute (RIZIV/INAMI) and the Belgian Health Care Knowledge Centre (KCE). We describe why elimination of Pap testing in the adolescent population reduces costs and harms without increasing cervical cancer rates. Expectant management, education on the risk factors for cervical cancer and HPV persistence, and HPV vaccination are very important in adolescents and young adults. PMID:25812038

  13. New Molecular Tools for Efficient Screening of Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Magnus von Knebel Doeberitz

    2001-01-01

    Full Text Available Cytological screening using the Pap-smear led to a remarkable reduction of the mortality of cervical cancer. However, due to subjective test criteria it is hampered by poor inter- and intra-observer agreement. More reproducible assays are expected to improve the current screening and avoid unnecessary medical intervention and psychological distress for the affected women. Cervical cancer arises as consequence of persistent high risk papillomavirus (HR-HPV infections. Expression of two viral oncogenes, E6 and E7, in epithelial stem cells is required to initiate and maintain cervical carcinogenesis and results in significant overexpression of the cellular p16INK4a protein. Since this protein is not expressed in normal cervical squamous epithelia, screening for p16INK4a over-expressing cells allows to specifically identify dysplastic lesions, and significantly reduces the inter-observer disagreement of the conventional cytological or histological tests. Progression of preneoplastic lesions to invasive cancers is associated with extensive recombination of viral and cellular genomes which can be monitored by detection of papillomavirus oncogene transcripts (APOT assay derived from integrated viral genome copies. Detection of integrated type oncogene transcripts points to far advanced dysplasia or invasive cancers and thus represents a progression marker for cervical lesions. These new assays discussed here will help to improve current limitations in cervical cancer screening, diagnosis, and therapy control.

  14. Human papillomavirus testing and genotyping in cervical screening

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Lynge, Elsebeth; Bonde, Jesper

    2011-01-01

    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...

  15. Cervical screening: your results explained (English and 11 translations)

    OpenAIRE

    Public Health Agency

    2015-01-01

    Testing for high-risk human papillomavirus (HR-HPV) as triage and test of cure was introduced into the Northern Ireland Cervical Screening Programme on Monday 28 January 2013. This policy change will significantly alter the screening pathway for women with a mild dyskaryosis or borderline smear result.

  16. Cervical screening: the colposcopy examination (English and 11 translations)

    OpenAIRE

    Public Health Agency

    2015-01-01

    Testing for high-risk human papillomavirus (HR-HPV) as triage and test of cure was introduced into the Northern Ireland Cervical Screening Programme on Monday 28 January 2013. This policy change will significantly alter the screening pathway for women with a mild dyskaryosis or borderline smear result.

  17. 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

  18. 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...

  19. Impact of invitation and reminder letters on cervical cancer screening participation rates in an organized screening program.

    Science.gov (United States)

    Tavasoli, Simon M; Pefoyo, Anna J Kone; Hader, Joanne; Lee, Alex; Kupets, Rachel

    2016-07-01

    Study's Objective was to explore the impact of invitation and reminder letters on cervical cancer screening participation among eligible Ontario women 30 to 69years of age. A cross-sectional study was used to describe factors and screening patterns for 1,150,783 eligible women. A cohort design was used to compare the impact of invitation and reminder letters on Pap uptake comparing women who received the intervention (n=99,278) with a historical non-intervention group (n=130,181). Factors that might influence screening participation were included as covariates in a multivariable logistic regression models. Overall, 26.7% of women who had a Pap test 3 to 5years prior and 9.8% of women with no Pap test in the previous 5years were screened within 9months after the intervention. On cohort analysis, 14.1% of women in the intervention group and 8.5% of women in the non-intervention group were screened within 9months. Being mailed an invitation letter was associated with greater likelihood of screening (OR=1.8, CI 1.7-1.8). Controlling for covariates, the letter intervention was associated with 9month screening for both women with a Pap test 3 to 5years prior (AOR=1.7, CI 1.6-1.8) and those with no Pap test in the previous 5years (AOR=1.8, CI 1.7-1.9). There was a significant effect of all covariates on the participation. The invitation and reminder letter strategy increased cervical cancer screening participation. Additional strategies that could encourage eligible women to participate and/or removing barriers to screening for eligible women may be necessary. PMID:27143497

  20. [Cigarette smoking among women attending cervical cancer screening program].

    Science.gov (United States)

    Walentowicz-Sadłecka, Małgorzata; Sadłecki, Paweł; Marszałek, Andrzej; Grabiec, Marek

    2012-01-01

    Cervical cancer is recognized as tobacco-related malignancy. HPV vaccination and introducing screening protocols were found as the best way to decrease cervical cancer related mortality. Besides the cytological screening programs of the uterine cervix smear, nowadays co-factors of carcinogenesis are taken into consideration, also. The aim of our study was to analyse data included in questionnaire of 310 women who underwent cytological examination wi thin cervical cancer screening program in our Department in 2011. There were no differences found between studied groups on rate of oral contraceptive or hormonal therapy use, as well as age and tobacco smoking. However, taking into account education and smoking, there was a significant correlation observed. Patients with higher education level smoked less often. The special attention should be paid to promote smoking cessation in the group of women who finished education on elementary level. PMID:23421059

  1. 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...

  2. 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.

  3. Exploration of knowledge of cervical cancer and cervical cancer screening amongst HIV-positive women

    Directory of Open Access Journals (Sweden)

    Johanna E. Maree

    2014-10-01

    Full Text Available Background: Although preventable, cervical cancer, an AIDS-related disease, is the second most common cancer amongst South African women and the most common cancer amongst black women. Objective: The objective of the study was to determine what women being treated for HIV and AIDS at a specific healthcare centre in Johannesburg knew about cervical cancer and cervical screening. Method: A survey design was used, with data gathered by means of a self-administered questionnaire. Convenience sampling selected 315 women to participate (n = 315. Descriptive statistics were used to analyse the data and chi-square testing found associations between categorical variables. Results: The majority of respondents (78.7%; n = 248 indicated that they had heard of cervical cancer and 62.9% (n = 198 knew about the Pap smear, with nurses and doctors being the primary source of information. Of the women who knew about the Pap smear, less than one-third had had a smear done, the main reason being fear of the procedure. Conclusion: The study provided evidence that women attending the specific HIV clinic were more knowledgeable about cervical cancer and screening than those of unknown HIV status involved in previous studies. Knowledge was still at a low level, especially when their exceptionally high risk was taken into account. Once again it was found that having knowledge did not necessarily mean having had a Pap smear, which remains a huge challenge in the prevention of cervical cancer.

  4. Cervical cancer screening: on the way to a shift from cytology to full molecular screening.

    Science.gov (United States)

    Dijkstra, M G; Snijders, P J F; Arbyn, M; Rijkaart, D C; Berkhof, J; Meijer, C J L M

    2014-05-01

    Cytology-based nation-wide cervical screening has led to a substantial reduction of the incidence of cervical cancer in western countries. However, the sensitivity of cytology for the detection of high-grade precursor lesions or cervical cancer is limited; therefore, repeated testing is necessary to achieve program effectiveness. Additionally, adenocarcinomas and its precursors are often missed by cytology. Consequently, there is a need for a better screening test. The insight that infection with high-risk human papillomavirus (hrHPV) is the causal agent of cervical cancer and its precursors has led to the development of molecular tests for the detection of hrHPV. Strong evidence now supports the use of hrHPV testing in the prevention of cervical cancer. In this review, we will discuss the arguments in favor of, and concerns on aspects of implementation of hrHPV testing in primary cervical cancer screening, such as the age to start hrHPV-based screening, ways to increase screening attendance, requirements for candidate hrHPV tests to be used, and triage algorithms for screen-positive women. PMID:24445150

  5. 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

    , nationality, level of education, and use of health care. Associations with non-participation in screening were determined with logistic regression. RESULTS: Main predictors of non-participation were limited or no contact with dental services (odds ratio (OR)=2.36), general practitioners (OR=1.75), and high......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...... age (OR=1.98). Other important factors for non-participation were primary school education only (OR=1.53), not being married (OR=1.49), and foreign nationality (OR=1.32). CONCLUSION: A 2-1.5-fold difference in non-participation in cervical screening in Denmark was found across various population sub...

  6. Quality control in screening programs for cervical cancer

    International Nuclear Information System (INIS)

    The malignancy of the cervix is one of the few locations avoidable cancers, if detected before it progresses to the infiltration. The most efficient way of early detection is through a screening program to provide women undertaking a regular and quality Pap smear. If this test results abnormal, the program offers easier access to specialized care, effective treatment, and follow-up. The objective of this article is to present usefulness of methods for quality control used in screening programs for cervical cancer to detect their inadequacies. Here are some factors and conditions that must be considered in each of the steps to take, for a cervical cancer screening program to be successful and to meet the objectives proposed in reducing mortality due to this cause. This document contains some useful indexes calculated to ensure quality throughout the process. There should be the measurement of quality throughout the screening process that allows collecting of reliable data as well as correcting deficiencies

  7. Overcoming Barriers to Cervical Cancer Screening Among Asian American Women

    OpenAIRE

    Fang, Carolyn Y.; Ma, Grace X.; Tan, Yin

    2011-01-01

    Significant disparities in cervical cancer incidence and mortality exist among ethnic minority women, and in particular, among Asian American women. These disparities have been attributed primarily to differences in screening rates across ethnic/racial groups. Asian American women have one of the lowest rates of screening compared to other ethnic/racial groups. Yet Asian Americans, who comprise one of the fastest growing populations in the United States, have received the least attention in c...

  8. Mortality of non-participants in cervical screening

    DEFF Research Database (Denmark)

    Dugué, Pierre-Antoine; Lynge, Elsebeth; Rebolj, Matejka

    2014-01-01

    -participants had a HR of 2.09 (95% CI: 2.05-2.14) compared to regular participants. The HR for human papillomavirus (HPV)-related cancers other than cervical cancer was 3.80 (95% CI: 2.67-5.41). Younger women, whose coverage rates were higher, had higher all-cause mortality HRs. Women screened more frequently than...

  9. Cervical screening in England: the past, present, and future.

    Science.gov (United States)

    Albrow, Rebecca; Kitchener, Henry; Gupta, Nalini; Desai, Mina

    2012-04-25

    Cervical screening in England commenced in a disorganized fashion in 1964. The flaws of this approach became apparent in the mid-1980s and led to the inception of the National Health Service Cervical Screening Programme (NHSCSP). The main features of this program are its population-based registry, accessibility to all women within the screening age range, its systematic process of call and recall, national coordination, and quality assurance. Its success is in part based on its ability to evolve as evidence necessitates, and throughout the period of 2000-2010, it embarked upon a series of developments involving liquid-based cytology, which also provided the means to conduct reflex high-risk human papillomavirus (HR-HPV) testing and the potential to automate the screening process. As a result of evidence acquired since 2000, the NHSCSP is currently based on a system of primary cytology with HPV triage for low-grade abnormalities combined with cytology plus a HR-HPV "test of cure" for women who have received treatment for cervical intraepithelial neoplasia. Future challenges for the program will involve finding solutions to increasing screening uptake among women HPV primary screening. PMID:22367883

  10. Outcomes in cervical screening using various cytology technologies

    DEFF Research Database (Denmark)

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

    2013-01-01

    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...... 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 of...... 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...

  11. Electrical Bioimpedance Analysis: A New Method in Cervical Cancer Screening

    OpenAIRE

    Lopamudra Das; Soumen Das; Jyotirmoy Chatterjee

    2015-01-01

    Cervical cancer is the second most common female cancer worldwide and a disease of concern due to its high rate of incidence of about 500,000 women annually and is responsible for about 280,000 deaths in a year. The mortality and morbidity of cervical cancer are reduced through mass screening via Pap smear, but this technique suffers from very high false negativity of around 30% to 40% and hence the sensitivity of this technique is not more than 60%. Electrical bioimpedance study employing cy...

  12. 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.

  13. Breast density and outcome of mammography screening: a cohort study

    DEFF Research Database (Denmark)

    Olsen, A H; Bihrmann, K; Jensen, M-B;

    2009-01-01

    The purpose of this study was to investigate the effect of breast density on breast cancer (BC) mortality in a mammography screening programme. The cohort included 48 052 women participating in mammography screening in Copenhagen, Denmark, where biennial screening is offered to women aged 50...

  14. Screening for Chlamydia is acceptable and feasible during Cervical Screening in General Practice.

    Science.gov (United States)

    Hassan, S J; Dunphy, E; Navin, E; Marron, L; Fitzsimmons, C; Loy, A; O'Shea, B

    2016-01-01

    The incidence of Chlamydia trachomatis (CT) & Neisseria gonorrhoeae (NG) are rising in Ireland. Both are often undiagnosed and may cause infertility amongst other complications. CT/NG screening is not routinely offered during cervical cancer screening. This study aimed to ascertain the feasibility and acceptability of screening for CT/NG at time of smear and to measure the diagnostic yield. Screening was offered to women aged 25-40 years attending four participating general practices as part of Cervical Check. A retrospective review of the three months preceding the study period, indicated that out of 138 smears, CT/NG testing was performed in 10 (7%) of cases. 236 (93%) patients consented to screening for CT/NG. The detection rate for Chlamydia was 6 (2.4%), with no positive results for NG. Feedback from patients was positive. Interestingly, 42 (18%) of participants who completed the questionnaire believed STI screening was already part of the routine smear. PMID:26904785

  15. 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.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    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......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......, and histological diagnosis of positive cases of both tests. METHODS: A cross-sectional study of 934 asymptomatic women living in Khartoum, Sudan, was conducted during 2009-2010. A semi-structured questionnaire containing socio-economic and reproductive variables was used to collect data from each participant...

  17. 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

  18. Women’s perceived susceptibility to and utilisation of cervical cancer screening services in Malawi

    Directory of Open Access Journals (Sweden)

    Melanie Y. Hami

    2014-10-01

    Full Text Available Background: Malawi provides cervical cancer screening services free of charge at some public health facilities. Few women make use of these cancer screening services in Malawi and many women continue to be diagnosed with cervical cancer only during the late inoperable stages of the condition. Objectives: The purpose of this study was to discover whether the perceived susceptibility to cervical cancer, amongst Malawian women aged 42 and older, influenced their intentions to utilise the available free cervical cancer screening services. Method: A quantitative, cross-sectional descriptive study design was adopted. Structured interviews were conducted with 381 women who visited 3 health centres in the Blantyre District of Malawi. Results: A statistically-significant association existed between women’s intentions to be screened for cervical cancer and their knowledge about cervical cancer (X² = 8.9; df = 1; p = 0.003 and with having heard about HPV infection (X² = 4.2; df = 1; p = 0.041 at the 5% significance level. Cervical cancer screening services are provided free of charge in government health institutions in Malawi. Nevertheless, low perceived susceptibility to cervical cancer amongst women, aged 42 and older, might contribute to limited utilisation of cervical screening services, explaining why 80% of cervical cancer patients in Malawi were diagnosed during the late inoperable stages. Conclusion: Malawian women lacked awareness regarding their susceptibility to cervical cancer and required information about the available cervical cancer screening services. Malawi’s women, aged 42 and older, must be informed about the advantages of cervical cancer screening and about the importance of effective treatment if an early diagnosis has been made. Women aged 42 and older rarely attend antenatal, post-natal, well baby or family-planning clinics, where health education about cervical cancer screening is often provided. Consequently, these women

  19. 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.

  20. Morphological feature detection for cervical cancer screening

    Science.gov (United States)

    Narayanswamy, Ramkumar; Sharpe, John P.; Duke, Heather J.; Stewart, Rosemary J.; Johnson, Kristina M.

    1995-03-01

    An optoelectronic system has been designed to pre-screen pap-smear slides and detect the suspicious cells using the hit/miss transform. Computer simulation of the algorithm tested on 184 pap-smear images detected 95% of the suspicious region as suspect while tagging just 5% of the normal regions as suspect. An optoelectronic implementation of the hit/miss transform using a 4f Vander-Lugt correlator architecture is proposed and demonstrated with experimental results.

  1. Which high-risk HPV assays fulfil criteria for use in primary cervical cancer screening?

    Science.gov (United States)

    Arbyn, M; Snijders, P J F; Meijer, C J L M; Berkhof, J; Cuschieri, K; Kocjan, B J; Poljak, M

    2015-09-01

    Several countries are in the process of switching to high-risk human papillomavirus (hrHPV) testing for cervical cancer screening. Given the multitude of available tests, validated assays which assure high-quality screening need to be identified. A systematic review was conducted to answer the question which hrHPV tests fulfil the criteria defined by an international expert team in 2009, based on reproducibility and relative sensitivity and specificity compared to Hybrid Capture-2 or GP5+/6+ PCR-enzyme immunoassay. These latter two hrHPV DNA assays were validated in large randomized trials and cohorts with a follow-up duration of 8 years or more. Eligible studies citing the 2009 guideline were retrieved from Scopus (http://www.scopus.com) and from a meta-analysis assessing the relative accuracy of new hrHPV assays versus the standard comparator tests to detect high-grade cervical intraepithelial neoplasia or cancer in primary screening. The cobas 4800 HPV test and Abbott RealTime High Risk HPV test were consistently validated in two and three studies, respectively, whereas the PapilloCheck HPV-screening test, BD Onclarity HPV assay and the HPV-Risk assay were validated each in one study. Other tests which partially fulfil the 2009 guidelines are the following: Cervista HPV HR Test, GP5+/6+ PCR-LMNX, an in-house E6/E7 RT quantitative PCR and MALDI-TOF (matrix-assisted laser desorption-ionization time-of-flight). The APTIMA HPV assay targeting E6/E7 mRNA of hrHPV was also fully validated. However, the cross-sectional equivalency criteria of the 2009 guidelines were set up for HPV DNA assays. Demonstration of a low risk of CIN3+ after a negative APTIMA test over a longer period is awaited to inform us about its utility in cervical cancer screening at 5-year or longer intervals. PMID:25936581

  2. 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. PMID:26608273

  3. Mass Media Campaign Improves Cervical Screening across All Socio-Economic Groups

    Science.gov (United States)

    Anderson, Jenny O.; Mullins, Robyn M.; Siahpush, Mohammad; Spittal, Matthew J.; Wakefield, Melanie

    2009-01-01

    Low socio-economic status (SES) has been associated with lower cervical screening rates. Mass media is one known strategy that can increase cervical screening participation. This study sought to determine whether a mass media campaign conducted in Victoria, Australia, in 2005 was effective in encouraging women across all SES groups to screen. Data…

  4. 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. PMID:25957285

  5. Electrical Bioimpedance Analysis: A New Method in Cervical Cancer Screening

    Directory of Open Access Journals (Sweden)

    Lopamudra Das

    2015-01-01

    Full Text Available Cervical cancer is the second most common female cancer worldwide and a disease of concern due to its high rate of incidence of about 500,000 women annually and is responsible for about 280,000 deaths in a year. The mortality and morbidity of cervical cancer are reduced through mass screening via Pap smear, but this technique suffers from very high false negativity of around 30% to 40% and hence the sensitivity of this technique is not more than 60%. Electrical bioimpedance study employing cytosensors over a frequency range offers instantaneous and quantitative means to monitor cellular events and is an upcoming technique in real time to classify cells as normal and abnormal ones. This technology is exploited for label-free detection of diseases by identifying and measuring nonbiological parameters of the cell which may carry the disease signature.

  6. 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. PMID:24787379

  7. Patients with cervical cancer: why did screening not prevent these cases?

    NARCIS (Netherlands)

    Bie, R.P. de; Vergers-Spooren, H.C.; Massuger, L.F.A.G.; Siebers, A.G.; Salet-van der Pol, M.R.; Vedder, J.E.M.; Melchers, W.J.G.; Bulten, J.; Bekkers, R.L.M.

    2011-01-01

    OBJECTIVE: The objective of the study was to assess the screening history of women with cervical cancer and review normal cervical smears 5 years preceding the diagnosis. STUDY DESIGN: Cytological and histological results of 401 women treated for invasive cervical cancer between 1991 and 2008 at the

  8. 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…

  9. 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. PMID:24863746

  10. Development and Validation of the Assessment of Health Literacy in Breast and Cervical Cancer Screening

    OpenAIRE

    Han, Hae-Ra; Huh, Boyun; Kim, Miyong T.; Kim, Jiyun; Nguyen, Tam

    2014-01-01

    For many people limited health literacy is a major barrier to effective preventive health behavior such as cancer screening, yet a comprehensive health literacy measure that is specific to breast and cervical cancer screening is not readily available. The purpose of this paper is to describe the development and testing of a new instrument to measure health literacy in the context of breast and cervical cancer screening, the Assessment of Health Literacy in Cancer Screening (AHL-C). The AHL-C ...

  11. 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....

  12. Cervical and Breast Cancer-Screening Knowledge of Women with Developmental Disabilities

    Science.gov (United States)

    Parish, Susan L.; Swaine, Jamie G.; Luken, Karen; Rose, Roderick A.; Dababnah, Sarah

    2012-01-01

    Women with developmental disabilities are significantly less likely than women without disabilities to receive cervical and breast cancer screening according to clinical guidelines. The reasons for this gap are not understood. The present study examined the extent of women's knowledge about cervical and breast cancer screening, with the intention…

  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. Barriers and Motivators Related to Cervical and Breast Cancer Screening

    Directory of Open Access Journals (Sweden)

    M Bokaee

    2004-10-01

    Full Text Available Introduction: modern knowledge could protect against cancer for individuals in community with early stage and premalignat state. Screening of cancer is best instrument for early detection of malignancy. Between women’s cancers breast and cervical cancer have more incidence and mortality than other cancers . But could be prevented by simple and cheep screening programs. Despite specific statistics in Iran evidence shows that women’s participation in screening program is poor , so cancers are diagnosed in advanced stage. The purpose of this study was to identify major barriers and motivators for breast and cervical screening . Methods: This survey was a descriptive study in which 400 women participated in health and treatment centers in Yazd. Sampling method was done in two simple and random stages. Data was collected by inventory and questionnaire . Then data were analyzed by SPSS soft ware . Results: Findings showed that 80% of them never refereed to a health provider for clinical breast exam (C B E and only 3% of them did regularly C B E . 46% of them had never done pap smear and only 14.5 % of them did regularly pap smear. The findings showed that major motivators were as follow: advice of health’s personnel , using of contraceptive methods , and awareness of media. Also the major barriers were as follow : Not having knowledge of these exams , not having knowledge of the existence of these centers of education and practice , not having precious health problems , fear of examination , Embarrassment of examination and health providers not to teach them . to consider the most important barriers were propounded which showed that health education role to eliminate barriers for referring women for screening . Discussion: Based on the results of this sample , screening was the least expected . considering barriers and motivators observed it was revealed that health education was required for prevention of common women’s cancers. Also

  15. Breast and cervical cancer screening in Great Britain: Dynamic interrelated processes.

    Science.gov (United States)

    Labeit, Alexander; Peinemann, Frank

    2015-12-01

    No previous analysis has investigated the determinants of screening uptake for breast and cervical cancer screening for possible spillover effects from one type of screening examination to the other type of screening examination with a dynamic bivariate panel probit model. For our analysis, we used a dynamic random effects bivariate panel probit model with initial conditions (Wooldridge-type estimator) and dependent variables were the participation of breast and cervical cancer screening in the recent year. The balanced panel sample consisted of 844 women from the British Household Panel Survey (BHPS) from the time period 1992 to 2008. Our analysis showed the high relevance of past screening behaviour and the importance of state dependency for the same and the other type of cancer screening examinations even after controlling for covariates and unobserved heterogeneity. The uptake for breast and cervical cancer screening was higher when the same screening examination was done one or three years earlier. This result is in accordance with the medical screening programmes in Great Britain. With regard to breast and cervical cancer screening positive spillover effects existed between screening examinations in the third order lags. Women with a previous visit to a general practitioner and individuals in the recommended age groups had a higher uptake for breast and cervical cancer screening. Other socioeconomic and health related variables had non-uniform results in both screening examinations. Promoting the uptake of one female prevention activity could also enhance the uptake of the other prevention activity. PMID:26487452

  16. 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...... sense to determine the indicators also for the true at-risk populations. We described the frequency of total hysterectomy in Denmark and its impact on the calculated incidence of cervical cancer and the screening coverage. MATERIAL AND METHODS: With data from five Danish population-based registries......, the incidence rate of cervical cancer and the screening coverage for women aged 23-64 years on 31 December 2010 were calculated with and without adjustments for hysterectomies undertaken for reasons other than cervical cancer. They were calculated as the number of cases divided by 1) the total number of woman...

  17. Using probabilistic record linkage methods to identify Australian Indigenous women on the Queensland Pap Smear Register: the National Indigenous Cervical Screening Project

    Science.gov (United States)

    Diaz, Abbey; Baade, Peter; Garvey, Gail; Cunningham, Joan; Brotherton, Julia M L; Canfell, Karen; Valery, Patricia C; O'Connell, Dianne L; Taylor, Catherine; Moore, Suzanne P; Condon, John R

    2016-01-01

    Objective To evaluate the feasibility and reliability of record linkage of existing population-based data sets to determine Indigenous status among women receiving Pap smears. This method may allow for the first ever population measure of Australian Indigenous women's cervical screening participation rates. Setting/participants A linked data set of women aged 20–69 in the Queensland Pap Smear Register (PSR; 1999–2011) and Queensland Cancer Registry (QCR; 1997–2010) formed the Initial Study Cohort. Two extracts (1995–2011) were taken from Queensland public hospitals data (Queensland Hospital Admitted Patient Data Collection, QHAPDC) for women, aged 20–69, who had ever been identified as Indigenous (extract 1) and had a diagnosis or procedure code relating to cervical cancer (extract 2). The Initial Study Cohort was linked to extract 1, and women with cervical cancer in the initial cohort were linked to extract 2. Outcome measures The proportion of women in the Initial Cohort who linked with the extracts (true -pairs) is reported, as well as the proportion of potential pairs that required clerical review. After assigning Indigenous status from QHAPDC to the PSR, the proportion of women identified as Indigenous was calculated using 4 algorithms, and compared. Results There were 28 872 women (2.1%) from the Initial Study Cohort who matched to an ever Indigenous record in extract 1 (n=76 831). Women with cervical cancer in the Initial Study Cohort linked to 1385 (71%) records in extract 2. The proportion of Indigenous women ranged from 2.00% to 2.08% when using different algorithms to define Indigenous status. The Final Study Cohort included 1 372 823 women (PSR n=1 374 401; QCR n=1955), and 5 062 118 records. Conclusions Indigenous status in Queensland cervical screening data was successfully ascertained through record linkage, allowing for the crucial assessment of the current cervical screening programme for Indigenous women. Our study

  18. New concepts on risk factors of HPV and novel screening strategies for cervical cancer precursors.

    Science.gov (United States)

    Syrjänen, K

    2008-01-01

    During the past several years, this author has been engaged in coordinating two major multicentre trials testing optional screening tools for cervical cancer (CC) in low-resource settings both in East Europe and in Latin America. These international trials include the NIS (New Independent States of the former Soviet Union) cohort (n = 3,187 women) and the LAMS (Latin American Screening) study (n = 12,114 women). In both studies, a sizeable cohort of women (887 and 1,011, respectively) have been prospectively followed-up to assess the natural history of high-risk human papillomavirus (HR-HPV) infections and the role of implicated risk factors as potential predictors of disease outcome (acquisition, persistence and clearance). In this communication some of the key observations recently reported from the NIS and LAMS studies will be discussed, with special emphasis on i) risk factors that are still controversial (i.e., oral contraception; OC, and smoking) or not previously studied (drug addiction), on ii) reproductive factors as potential cofactors of HPV infections in cervical carcinogenesis (i.e., age at menarche, menopause), and finally on iii) the performance of different screening strategies among young and older women. Although closely related to these topics, a detailed discussion on the dynamics of HPV infections (acquisition, persistence, clearance) and their predictive factors falls outside the scope of this communication, because they have been extensively discussed in a series of original reports and in a recent review of the author in this journal. The NIS cohort failed to establish OC as a risk factor of CC. In all future studies, the strong confounding effects from the lifestyle behavioural factors must be taken into account, while interpreting the data on OCs as potential risk factors of CC. Similarly, it now seems that the increased risk (if any) of CC among smokers seems to be attributed to the increased acquisition of HR-HPV infections, of which the

  19. 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...... cytologies. During the different calendar intervals throughout the study period between 29-46% of WLWH followed the HIV cervical screening guidelines. Adjusted OR's of attendance to the general population screening program for WLWH aged 30, 40 and 50 years, compared to controls, were 0.69 (95% CI: 0...

  20. Screening for cervical cancer: new alternatives and research

    Directory of Open Access Journals (Sweden)

    Lörincz Attila T

    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

  1. Knowledge and attitude towards cervical cancer screening among female students and staff in a tertiary institution in the Niger Delta

    Directory of Open Access Journals (Sweden)

    Owoeye I.O.G

    2013-01-01

    Full Text Available Background: Cervical cancer is a largely preventable disease. In western countries, the incidence of and mortality associated with cervical cancer has reduced substantially following the introduction of effective cervical screening programmes. This is in contrast to what is obtained in Africa including Nigeria where cervical screening is rudimentary or non- existent. Aim: This study seeks to assess the knowledge, level of perception and the attitude of female staff and students of Niger Delta University, Nigeria, towards cervical cancer screening. Methods: A questionnaire was used for data collection. The questions were made to capture the objectives of the study. Results: Most of the respondents 278 (72% were aware of cervical cancer, while only 182 (50.6% were aware of cervical cancer screening. Pap smear was the most popular screening test mentioned by respondents 100 (41.2%, while some respondents (8.5% of staff and 16.3% of students wrongly believed that blood test is used for cervical cancer screening. There is a significant association between awareness and practice of cervical cancer screening amongst staff and students (X2 = 29.4, P=0.00. Conclusion: The study shows that awareness of cervical cancer screening was higher amongst students than staff of Niger Delta University. Uptake was low in both staff and students. There was an association between awareness and practice of cervical cancer screening amongst respondents. Overall, a greater proportion of the staff respondents had little or no knowledge of cervical cancer screening.

  2. 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

  3. Sociodemographic gradients in breast and cervical cancer screening in Korea: the Korean National Cancer Screening Survey (KNCSS 2005-2009

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    Jun Jae

    2011-06-01

    Full Text Available Abstract Background Cancer screening rates in Korea for five cancer types have increased steadily since 2002. With regard to the life-time cancer screening rates in 2009 according to cancer sites, the second highest was breast cancer (78.1% and the third highest was cervical cancer (76.1%. Despite overall increases in the screening rate, disparities in breast and cervical cancer screening, based on sociodemographic characteristics, still exist. Methods Data from 4,139 women aged 40 to74 years from the 2005 to 2009 Korea National Cancer Screening Survey were used to analyze the relationship between sociodemographic characteristics and receiving mammograms and Pap smears. The main outcome measures were ever having had a mammogram and ever having had a Pap smear. Using these items of information, we classified women into those who had had both types of screening, only one screening type, and neither screening type. We used logistic regression to investigate relationships between screening history and sociodemographic characteristics of the women. Results Being married, having a higher education, a rural residence, and private health insurance were significantly associated with higher rates of breast and cervical cancer screening after adjusting for age and sociodemographic factors. Household income was not significantly associated with mammograms or Pap smears after adjusting for age and sociodemographic factors. Conclusions Disparities in breast and cervical cancer screening associated with low sociodemographic status persist in Korea.

  4. Cervical cancer screening: knowledge, health perception and attendance rate among Hong Kong Chinese women

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    Sharron SK Leung

    2010-07-01

    Full Text Available Sharron SK Leung1, Ivy Leung21School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong; 2Quality Healthcare Medical Services, Hong KongPurpose: Cervical cancer screening has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. However, cervical screening attendance rates are still far from satisfactory in many countries. Strategies, health promotion and education programs need to be developed with clear evidence of the causes and factors relating to the low attendance rate. The study aims to assess the prediction of cervical screening attendance rate by Chinese women’s knowledge about cervical cancer and cervical screening as well as their perception of health.Patients and methods: A survey with self-reported questionnaires was conducted on 385 Chinese women recruited from a community clinic in Hong Kong. Participants were Chinese women, Hong Kong residents, aged 18–65 years, able to read Chinese or English, and were not pregnant.Results: Women aged 37 years or less, with at least tertiary education, who perceived having control over their own health and had better knowledge on risk factors, were more likely to attend cervical cancer screening. Many participants had adequate general knowledge but were unable to identify correct answers on the risk factors.Conclusion: Health promotion efforts need to focus on increasing women’s knowledge on risk factors and enhancing their perceived health control by providing more information on the link between screening and early detection with lower incidence rates and mortality from cervical cancer.Keywords: cervical screening attendance, cervical cancer, health perception and knowledge, perceived health control, Chinese

  5. 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......, only 47.3% of Malaysian women have been screened. Several factors may have contributed to this. No national call-recall system has been established. Women are informed about cervical screening primarily through mass media rather than being individually invited. Smears are free of charge if taken in...

  6. An Educational Training on Cervical Cancer Screening Program for Rural Healthcare Providers in India

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    Rita Caroline Isaac

    2014-03-01

    Full Text Available Conventional, cytology based Cervical cancer screening programmes used in the developed world is often not practical in developing countries. Training of health care work force on a feasible, low-tech, screening methods is urgently needed in low resource settings. Twenty providers including doctors and nurses participated in a 2-days training workshop organized by a Community Health Center in rural South India. The pre-post-training assessment showed significant improvement in knowledge about cervical cancer, ‘low tech’ screening, treatment options and counseling among the participants.  Twenty volunteers screened at the workshop, 2 women (10% tested positive and one had CINIII lesion and the other had cervical cancer stage IIIB. After the training, the participants felt confident about their ability to counsel and screen women for cervical cancer.

  7. 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. PMID:24698810

  8. Knowledge, attitudes and practices on cervical cancer screening among the medical workers of Mulago Hospital, Uganda

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    Weiderpass Elisabete

    2006-03-01

    Full Text Available Abstract Background Cervical cancer is the commonest cancer of women in Uganda. Over 80% of women diagnosed in Mulago national referral and teaching hospital, the biggest hospital in Uganda, have advanced disease. Pap smear screening, on opportunistic rather than systematic basis, is offered free in the gynaecological outpatients clinic and the postnatal/family planning clinics. Medical students in the third and final clerkships are expected to learn the techniques of screening. Objectives of this study were to describe knowledge on cervical cancer, attitudes and practices towards cervical cancer screening among the medical workers of Mulago hospital. Methods In a descriptive cross-sectional study, a weighted sample of 310 medical workers including nurses, doctors and final year medical students were interviewed using a self-administered questionnaire. We measured knowledge about cervical cancer: (risk factors, eligibility for screening and screening techniques, attitudes towards cervical cancer screening and practices regarding screening. Results Response rate was 92% (285. Of these, 93% considered cancer of the cervix a public health problem and knowledge about Pap smear was 83% among respondents. Less than 40% knew risk factors for cervical cancer, eligibility for and screening interval. Of the female respondents, 65% didn't feel susceptible to cervical cancer and 81% had never been screened. Of the male respondents, only 26% had partners who had ever been screened. Only 14% of the final year medical students felt skilled enough to use a vaginal speculum and 87% had never performed a pap smear. Conclusion Despite knowledge of the gravity of cervical cancer and prevention by screening using a Pap smear, attitudes and practices towards screening were negative. The medical workers who should be responsible for opportunistic screening of women they care for are not keen on getting screened themselves. There is need to explain/understand the cause

  9. Knowledge, Attitudes, and Practices for Cervical Cancer Screening Among the Bhutanese Refugee Community in Omaha, Nebraska

    OpenAIRE

    Haworth, Rebecca J.; Margalit, Ruth; Ross, Christine; Nepal, Tikka; Soliman, Amr S.

    2014-01-01

    Cervical cancer is the second most common cause of cancer mortality among women with the vast majority of patients in developing countries. Bhutanese refugees in the United States are from South Central Asia, the 4th leading region of the world for cervical cancer incidence. Over the past few years, Bhutanese refugees have increased significantly in Nebraska. This study evaluates current knowledge of cervical cancer and screening practices among the Bhutanese refugee women in Omaha, Nebraska....

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

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

    2012-01-01

    Treatment of cervical intraepithelial neoplasia (CIN) detectable at screening has helped reduce the incidence of cervical cancer, but has also led to overtreatment. The estimates of overtreatment have often focused on a particular grade of CIN or age group. The aim of this paper was to provide 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...... rates. We estimated the frequency of CIN treatment per prevented cervical cancer case by comparing the cumulative life-time risk of CIN treatment from 1996 onward, with the difference in the cumulative life-time risks of cervical cancer in the prescreening and the screening periods. Since 1996, more...

  11. Knowledge, attitudes, and practices regarding cervical cancer and screening among Ethiopian health care workers

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    Kress CM

    2015-07-01

    Full Text Available Catherine M Kress,1 Lisa Sharling,2 Ashli A Owen-Smith,3 Dawit Desalegn,4 Henry M Blumberg,2 Jennifer Goedken1 1Department of Gynecology and Obstetrics, 2Division of Infectious Diseases, Department of Medicine, 3Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA; 4Department of Gynecology and Obstetrics, Addis Ababa University School of Medicine, Addis Ababa, Ethiopia Background: Though cervical cancer incidence has dramatically decreased in resource rich regions due to the implementation of universal screening programs, it remains one of the most common cancers affecting women worldwide and has one of the highest mortality rates. The vast majority of cervical cancer-related deaths are among women that have never been screened. Prior to implementation of a screening program in Addis Ababa University-affiliated hospitals in Ethiopia, a survey was conducted to assess knowledge of cervical cancer etiology, risk factors, and screening, as well as attitudes and practices regarding cervical cancer screening among women’s health care providers.Methods: Between February and March 2012 an anonymous, self-administered survey to assess knowledge, attitudes, and practices related to cervical cancer and its prevention was distributed to 334 health care providers at three government hospitals in Addis Ababa, Ethiopia and three Family Guidance Association clinics in Awassa, Adama, and Bahir Dar. Data were analyzed using SPSS software and chi-square test was used to test differences in knowledge, attitudes, and practices across provider type.Results: Overall knowledge surrounding cervical cancer was high, although awareness of etiology and risk factors was low among nurses and midwives. Providers had no experience performing cervical cancer screening on a routine basis with <40% having performed any type of cervical cancer screening. Reported barriers to performing screening were lack of

  12. Using Intervention Mapping as a Participatory Strategy: Development of a Cervical Cancer Screening Intervention for Hispanic Women

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    Byrd, Theresa L.; Wilson, Katherine M.; Smith, Judith Lee; Heckert, Andrea; Orians, Carlyn E.; Vernon, Sally W.; Fernandez-Esquer, Maria E.; Fernandez, Maria E.

    2012-01-01

    Cervical cancer is preventable with treatment of precancerous lesions and treatable at early stages. Hispanics have higher rates of cervical cancer and lower rates of screening. "Ayndando a las Mujeres con Informaccion, Guia, y Amor para su Salud" (AMIGAS) is an intervention to increase cervical cancer screening in U.S. women of Mexican origin.…

  13. Factors associated with the uptake of cervical cancer screening among women in Portland, Jamaica

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    Butho Ncube

    2015-01-01

    Full Text Available Background: Cervical cancer is the second most common cancer among women worldwide and is the leading cause of deaths in developing countries. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, the uptake for cervical screening among Jamaican women remains low. Aims : This study was carried out to identify factors associated with Jamaican women′s decisions to screen for cervical cancer. Materials and Methods: Cross-sectional descriptive study of 403 women aged 19 years and older from Portland, Jamaica. An interviewer-administered questionnaire assessed the women′s cervical cancer screening history, as well as their knowledge, attitudes, and practices regarding the disease and screening. Results: Of the 403 women interviewed, 66% had a Papanicolaou (Pap smear and only 16% had a Pap test within the past year. Significant predicators of uptake of screening were being married, age, parity, discussing cancer with health provider, perception of consequences of not having a Pap smear, and knowing a person with cervical cancer. Women who did not know where to go for a Pap smear were 85% less likely to have been screened (prevalence odds ratio (POR: 0.15, 95% confidence interval (CI: 0.04, 0.52. Conclusions: This study showed suboptimal uptake of cervical cancer screening among Jamaican women. Multipronged approaches are needed to address barriers to screening, as well as identify and support conditions that encourage women′s use of reproductive health services, thereby reducing incidence and mortality rates from cervical cancer.

  14. Predictors of cervical cancer screening adherence in the United States: a systematic review.

    Science.gov (United States)

    Limmer, Karen; LoBiondo-Wood, Geri; Dains, Joyce

    2014-01-01

    Cervical cancer incidence rates have decreased dramatically since the implementation of the Papanicolaou (Pap) smear. Nevertheless, the American Cancer Society (ACS) estimates for 2013 predicted more than 12,000 new cases of cervical cancer in the United States. Given that some subpopulations in the United States are at a higher risk for cervical cancer than others, efforts to increase screening adherence are warranted. Many studies have explored the demographics of underscreened women, but no systematic reviews of screening demographics in adult US women were identified in the past 10 years, after release of the 2002 ACS cervical cancer screening guidelines. Knowledge of adherence to these guidelines becomes important as new guidelines were developed and released in 2012. The purpose of this systematic review of relevant studies was to identify factors that predict the use of cervical cancer screening in US women. Variables found to be significantly associated with adherence to screening included education, financial status, acculturation, psychosocial issues, and marital status. Using this information, nurse practitioners and other providers can target specific at-risk populations to increase screening by educating women about the need for cervical cancer screening and ensuring access to methods for prevention and early detection of the disease. PMID:25032031

  15. 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...... insufficient, with only two of 21 countries and territories having achieved coverage of cervical cancer screening above 40%. Ten of 21 countries and territories had included HPV vaccination in their immunization schedule, but only two countries reported coverage of HPV vaccination above 60% among the targeted...... population. Key barriers to the introduction and continuation of HPV vaccination were reported to be: (i) Lack of sustainable financing for HPV vaccine programs; (ii) Lack of visible government endorsement; (iii) Critical public perception of the value and safety of the HPV vaccine; and (iv) Lack of clear...

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

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    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

  17. Integrated cervical smear screening using liquid based cytology and bioimpedance analysis

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    Lopamudra Das

    2014-01-01

    Conclusion: The integration of bioimpedance observation along with the proposed low-cost monolayer technology could increase the efficiency of the cervical screening to a greater extent thereby reducing the rates of faulty diagnosis.

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

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    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...... the ages of 25--59 who lived in the sampled streets were invited to a cervical cancer screening; 804 women accepted and 313 rejected the invitation. Information on demographic characteristics and knowledge of cervical cancer were obtained through structured questionnaire interviews. RESULTS: Women aged 35...... to accept screening in comparison with women who had five or more children (ORs 3.21). Finally, knowledge of cervical cancer and awareness of the existing screening program were also associated with increased acceptance rates (ORs of 5.90 and 4.20). CONCLUSION: There are identifiable subgroups where...

  19. Knowledge, Attitudes and Practices Regarding Cervical Cancer and Screening among Haitian Health Care Workers

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    Leilah Zahedi

    2014-11-01

    Full Text Available It is estimated that Haiti has the highest incidence of cervical cancer in the Western Hemisphere. There are currently no sustainable and affordable cervical cancer screening programs in Haiti. The current status of screening services and knowledge of health care professionals was assessed through a Knowledge, Attitudes, and Practices survey on cervical cancer screening and prevention. It was distributed to Project Medishare for Haiti health care workers (n = 27 in the Central Plateau. The majority (22/27 of participants stated pre-cancerous cells could be detected through screening, however, only four had ever performed a pap smear. All of the participants felt a screening program should be started in their area. Our data establishes that knowledge is fairly lacking among healthcare workers and there is an opportunity to train them in simple, cost effective “screen-and-treat” programs that could have a great impact on the overall health of the population.

  20. Knowledge, attitudes and practices regarding cervical cancer and screening among Haitian health care workers.

    Science.gov (United States)

    Zahedi, Leilah; Sizemore, Emma; Malcolm, Stuart; Grossniklaus, Emily; Nwosu, Oguchi

    2014-11-01

    It is estimated that Haiti has the highest incidence of cervical cancer in the Western Hemisphere. There are currently no sustainable and affordable cervical cancer screening programs in Haiti. The current status of screening services and knowledge of health care professionals was assessed through a Knowledge, Attitudes, and Practices survey on cervical cancer screening and prevention. It was distributed to Project Medishare for Haiti health care workers (n = 27) in the Central Plateau. The majority (22/27) of participants stated pre-cancerous cells could be detected through screening, however, only four had ever performed a pap smear. All of the participants felt a screening program should be started in their area. Our data establishes that knowledge is fairly lacking among healthcare workers and there is an opportunity to train them in simple, cost effective "screen-and-treat" programs that could have a great impact on the overall health of the population. PMID:25390794

  1. Barriers to cervical cancer screening among ethnic minority women: a qualitative study

    OpenAIRE

    Marlow, L; Waller, J.; Wardle, J.

    2015-01-01

    Background Ethnic minority women are less likely to attend cervical screening. Aim To explore self-perceived barriers to cervical screening attendance among ethnic minority women compared to white British women. Design Qualitative interview study. Setting Community groups in ethnically diverse London boroughs. Methods Interviews were carried out with 43 women from a range of ethnic minority backgrounds (Indian, Pakistani, Bangladeshi, Caribbean, African, Black British, Black other, White othe...

  2. Cervical Cancer Screening: Attitudes and Behaviors of Young Asian American Women

    OpenAIRE

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

    2011-01-01

    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 w...

  3. 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. PMID:26031906

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

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    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

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

    Science.gov (United States)

    2016-01-01

    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.

  6. 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. PMID:27617239

  7. Women's knowledge about cervical cancer risk factors, screening, and reasons for non-participation in cervical cancer screening programme in Estonia

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    Anttila Ahti

    2011-09-01

    Full Text Available Abstract Background The attendance rate in Estonian cervical cancer screening programme is too low therefore the programme is hardly effective. A cross-sectional population based survey was performed to identify awareness of cervical cancer risk factors, reasons why women do not want to participate in cervical screening programme and wishes for better organisation of the programme. Method An anonymous questionnaire with a covering letter and a prepaid envelope was sent together with the screening invitation to 2942 randomly selected women. Results are based on the analysis of 1054 (36% returned questionnaires. Results Main reasons for non-participation in the national screening programme were a recent visit to a gynaecologist (42.3%, fear to give a Pap-smear (14.3%, long appointment queues (12.9% and unsuitable reception hours (11.8%. Fear to give a Pap-smear was higher among women aged 30 and 35 than 50 and 55 (RR 1.46; 95% CI: 0.82-2.59 and women with one or no deliveries (RR 1.56, 95% CI: 0.94-2.58. In general, awareness of cervical cancer risk factors is poor and it does not depend on socio-demographic factors. Awareness of screening was higher among Estonians than Russians (RR 1.64, 95% CI: 1.46-1.86. Most women prefer to receive information about screening from personally mailed invitation letters (74.8%. Conclusions Women need more information about cervical cancer risk factors and the screening programme. They prefer personally addressed information sharing. Minority groups should be addressed in their own language. A better collaboration with service providers and discouraging smears outside the programme are also required.

  8. Knowledge, attitudes, and practices for cervical cancer screening among the Bhutanese refugee community in Omaha, Nebraska.

    Science.gov (United States)

    Haworth, Rebecca J; Margalit, Ruth; Ross, Christine; Nepal, Tikka; Soliman, Amr S

    2014-10-01

    Cervical cancer is the second most common cause of cancer mortality among women with the vast majority of patients in developing countries. Bhutanese refugees in the United States are from South Central Asia, the 4th leading region of the world for cervical cancer incidence. Over the past few years, Bhutanese refugees have increased significantly in Nebraska. This study evaluates current knowledge of cervical cancer and screening practices among the Bhutanese refugee women in Omaha, Nebraska. The study aimed to investigate cervical cancer and screening knowledge and perceptions about the susceptibility and severity of cervical cancer and perceived benefits and barriers to screening. Self-administered questionnaires and focus groups based on the Health Belief Model were conducted among 42 healthy women from the Bhutanese refugee community in Omaha. The study revealed a significant lack of knowledge in this community regarding cervical cancer and screening practices, with only 22.2 % reporting ever hearing of a Pap test and 13.9 % reporting ever having one. Only 33.3 % of women were in agreement with their own perceived susceptibility to cervical cancer. Women who reported ever hearing about the Pap test tended to believe more strongly about curability of the disease if discovered early than women who never heard about the test (71.4 vs. 45.0 %, for the two groups. respectively). Refugee populations in the United States are in need for tailored cancer education programs especially when being resettled from countries with high risk for cancer. PMID:25060231

  9. Cost-effectiveness of adding vaccination with the AS04-adjuvanted human papillomavirus 16/18 vaccine to cervical cancer screening in Hungary

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    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.

  10. Health literacy and meeting breast and cervical cancer screening guidelines among Asians and whites in California

    OpenAIRE

    Sentell, Tetine; Braun, Kathryn L; Davis, James; Davis, Terry

    2015-01-01

    Objectives Empirical evidence regarding cancer screening and health literacy is mixed. Cancer is the leading cause of death in Asian Americans, yet screening rates are notably low. Using a population-based sample, we determined if health literacy: (1) was associated with breast and cervical cancer screening, and (2) helped to explain Asian cancer screening disparities. Methods We analyzed the 2007 California Health Interview Survey for Asian (Japanese, Chinese, Filipino, Korean, Vietnamese, o...

  11. 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.

  12. Understanding Cervical Cancer Screening Intentions Among Latinas Using An Expanded Theory of Planned Behavior Model

    Science.gov (United States)

    Roncancio, Angelica M.; Ward, Kristy K.; Fernandez, Maria E.

    2016-01-01

    We examined the utility of an expanded Theory of Planned Behavior (TPB) model in predicting cervical cancer screening intentions among Latinas. The model included acculturation and past cervical cancer screening behavior along with attitude, subjective norms, and perceived behavioral control. This cross-sectional study included a sample of 206 Latinas who responded to a self-administered survey. Structural equation modeling was employed to test the expanded TPB model. Acculturation (p= .025) and past screening behavior (p= .001) along with attitude (p= .019), subjective norms (p= .028), and perceived behavioral control (p= .014) predicted the intention to be screened for cervical cancer. Our findings suggest that the TPB is a useful model for understanding cervical cancer screening intentions among Latinas when both past behavior and culture are included. This highlights the importance of culture on behavior and indicates a need to develop culturally sensitive, theory-based interventions to encourage screening and reduce cervical cancer-related health disparities in Latinas. PMID:23930898

  13. 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.

  14. 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:…

  15. The problem of false-positive human papillomavirus DNA tests in cervical screening

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Pribac, Igor; Frederiksen, Maria Eiholm;

    2013-01-01

    Human Papillomavirus (HPV) testing has been extensively studied in randomized controlled trials of primary cervical screening. Based on encouraging results concerning its high detection rates and a high negative predictive value for high-grade cervical intraepithelial neoplasia (CIN), HPV testing...... will probably replace cytology in future primary cervical screening. However, HPV testing is associated with more frequent false-positive tests compared to cytology. False-positive tests are defined as positive screening tests which are not subsequently confirmed with high-grade CIN. Several authors...... have claimed that the frequency of false-positive HPV tests could be reduced if an additional test was used to decide on referral for colposcopy of HPV-positive women. Data from the trials, however, do not support this claim. In fact, when compared to standard cytology screening and triage procedures...

  16. Perception of cervical cancer screening among Japanese university students who have never had a pap smear: a qualitative study.

    Science.gov (United States)

    Oshima, Sumiko; Maezawa, Masaji

    2013-01-01

    This study aimed to explore attitudes towards cervical cancer screening among Japanese university students who had never had a Pap smear. Four focus-group discussions, each with 15 female university students, took place in November and December 2009. Discussions were recorded and transcripts were analyzed to extract attitudes of young women towards cervical cancer screening. The four themes that emerged were: i) a low sense of reality about cervical cancer; ii) a lack of knowledge about both cervical cancer and Pap smears; iii) a lack of motivation to get screened, and iv) a reluctance to visit the gynecologist. Participants who were interested in undergoing screening for cervical cancer cited the influence of conversations with friends and family, a diagnosis of cancer within their family, and relevant information from the media. The results indicate the importance of getting young women more interested in cervical cancer screening and overcoming their tendency to avoid visiting a gynecologist. PMID:23991995

  17. Cervical cancer screening in immigrant women in Italy: a survey on participation, cytology and histology results.

    Science.gov (United States)

    Campari, Cinzia; Fedato, Chiara; Iossa, Anna; Petrelli, Alessio; Zorzi, Manuel; Anghinoni, Emanuela; Bietta, Carla; Brachini, Angela; Brezzi, Silvia; Cogo, Carla; Giordano, Livia; Giorgi, Daniela; Palazzi, Mauro; Petrella, Marco; Schivardi, Maria R; Visioli, Carmen B; Giorgi Rossi, Paolo

    2016-07-01

    Cervical cancer screening programmes in Italy actively invite all 25-64-year-old resident women for the Pap test every 3 years irrespective of their citizenship. Immigrant women come from countries where screening is absent or poorly implemented and the prevalence of human papillomavirus is often high. These women therefore have significant risk factors for cervical cancer. The Italian Group for Cervical Cancer Screening promoted a survey of all the screening programmes on the participation and the positivity and detection rates in Italian and foreign women in 2009-2011. Aggregated data for participation, cytology results, compliance with colposcopy and histology results were collected, distinguishing between women born in Italy and abroad. All comparisons were age adjusted. Forty-eight programmes out of 120 participated in the immigrant survey, with 3 147 428 invited and 1 427 412 screened Italian women and 516 291 invited and 205 948 screened foreign women. Foreign women had a slightly lower participation rate compared with Italians (39.9 vs. 45.4%), whereas compliance with colposcopy was similar (90%). Foreigners showed a higher risk of pathological findings than Italians: cytology positivity [relative risk (RR)=1.25, 95% confidence interval (CI) 1.24-1.27] and detection rate for cervical intraepithelial neoplasia grade 2 (CIN2) (RR=1.39, 95% CI 1.31-1.47), CIN3 (RR=2.07, 95% CI 1.96-2.18) and cancer (RR=2.68, 95% CI 2.24-3.22). The ratio between cancer and CIN was higher in immigrants (0.06 vs. 0.04, P<0.01). Foreign women had a higher risk of cervical precancer and cancer. Because of their high risk and because opportunistic screening does not cover this often disadvantaged group, achieving high participation in screening programmes for foreigners is critical to further reducing the cervical cancer burden in Italy. PMID:26207563

  18. Integrated cervical smear screening using liquid based cytology and bioimpedance analysis

    OpenAIRE

    Das, Lopamudra; Sarkar, Tandra; Ashok K Maiti; Naskar, Sukla; Das, Soumen; Chatterjee, Jyotirmoy

    2014-01-01

    Objective: To minimize the false negativity in cervical cancer screening with Papanicolaou (Pap) test, there is a need to explore novel cytological technique and identification of unique and important cellular features from the perspectives of morphological as well as biophysical properties. Materials and Methods: The present study explores the feasibility of low-cost cervical monolayer techniques in extracting cyto-pathological features to classify normal and abnormal conditions. The cervica...

  19. Integrated cervical smear screening using liquid based cytology and bioimpedance analysis

    OpenAIRE

    Lopamudra Das; Tandra Sarkar; Maiti, Ashok K.; Sukla Naskar; Soumen Das; Jyotirmoy Chatterjee

    2014-01-01

    Objective: To minimize the false negativity in cervical cancer screening with Papanicolaou (Pap) test, there is a need to explore novel cytological technique and identification of unique and important cellular features from the perspectives of morphological as well as biophysical properties. Materials and Methods: The present study explores the feasibility of low-cost cervical monolayer techniques in extracting cyto-pathological features to classify normal and abnormal conditions. The cer...

  20. Invitation to cervical cancer screening does increase participation in Germany: Results from the MARZY study.

    Science.gov (United States)

    Radde, Kathrin; Gottschalk, Andrea; Bussas, Ulrike; Schülein, Stefanie; Schriefer, Dirk; Seifert, Ulrike; Neumann, Anne; Kaiser, Melanie; Blettner, Maria; Klug, Stefanie J

    2016-09-01

    The effect of different invitation models on participation in cervical cancer screening (CCS) was investigated in a randomized population-based cohort study in Germany. Participants were randomly selected via population registries and randomized into intervention Arm A (invitation letter) and Arm B (invitation letter and information brochure) or control Arm C (no invitation). The intervention and control arms were compared with regard to 3-year participation and the two invitation models were compared between intervention arms. Of the 7,758 eligible women aged 30-65 years, living in the city of Mainz and in the rural region of Mainz-Bingen, 5,265 were included in the analysis. Differences in proportions of women attending CCS were investigated and logistic regression was performed to analyze various factors influencing participation. In the intervention group, 91.8% participated in CCS compared to 85.3% in the control group (p education, migrant women and older women. No difference in participation was found between the intervention Arm A and Arm B. An accompanying information brochure did not motivate more women to undergo CCS. However, a written invitation statistically significantly increased participation in CCS in Germany. PMID:27083776

  1. 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. PMID:25355525

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

    OpenAIRE

    Raúl Murillo; Carolina Wiesner; Ricardo Cendales; Marion Piñeros; Sandra Tovar

    2011-01-01

    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 screenin...

  3. Access to cancer screening in people with learning disabilities in the UK: cohort study in the health improvement network, a primary care research database.

    Directory of Open Access Journals (Sweden)

    David P J Osborn

    Full Text Available To assess whether people with learning disability in the UK have poorer access to cancer screening.Four cohort studies comparing people with and without learning disability, within the recommended age ranges for cancer screening in the UK. We used Poisson regression to determine relative incidence rates of cancer screening.The Health Improvement Network, a UK primary care database with over 450 General practices.Individuals with a recorded diagnosis of learning disability including general diagnostic terms, specific syndromes, chromosomal abnormalities and autism in their General Practitioner computerised notes. For each type of cancer screening, a comparison cohort of up to six people without learning disability was selected for each person with a learning disability, using stratified sampling on age within GP practice.Incidence rate ratios for receiving 1 a cervical smear test, 2 a mammogram, 3 a faecal occult blood test and 4 a prostate specific antigen test.Relative rates of screening for all four cancers were significantly lower for people with learning disability. The adjusted incidence rate ratios (95% confidence intervals were Cervical smears: Number eligible with learning disability = 6,254; IRR = 0.54 (0.52-0.56. Mammograms: Number eligible with learning disability = 2,956; IRR = 0.76 (0.72-0.81; Prostate Specific Antigen: Number eligible = 3,520; IRR = 0.87 (0.80-0.96 and Faecal Occult Blood Number eligible = 6,566; 0.86 (0.78-0.94. Differences in screening rates were less pronounced in more socially deprived areas. Disparities in cervical screening rates narrowed over time, but were 45% lower in 2008/9, those for breast cancer screening appeared to widen and were 35% lower in 2009.Despite recent incentives, people with learning disability in the UK are significantly less likely to receive screening tests for cancer that those without learning disability. Other methods for reducing inequalities in access to cancer screening should be

  4. 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......Denmark has a higher incidence of cervical cancer than other Nordic countries, although all Danish women (aged 23–65) are screened regularly to identify possible cervical dysplasia or asymptomatic invasive cancer. Annually 40 000 women receives an abnormal or inadequate test result and a follow...... 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...

  5. Predictive Capability of HPV and Pap Tests in Screening for Cervical Cancer over a Three-Year Follow-up.

    Science.gov (United States)

    Girianelli, Vania Reis; Thuler, Luiz Claudio Santos; Azevedo E Silva, Gulnar

    2016-03-01

    Purpose To compare the predictive capability of HPV and Pap smear tests for screening pre-cancerous lesions of the cervix over a three-year follow-up, in a population of users of the Brazilian National Health System (SUS). Methods This is a retrospective cohort study of 2,032 women with satisfactory results for Pap smear and HPV tests using second-generation hybrid capture, made in a previous study. We followed them for 36 months with data obtained from medical records, the Cervix Cancer Information System (SISCOLO), and the Mortality Information System (SIM). The outcome was a histological diagnosis of cervical intraepithelial neoplasia grade 2 or more advanced lesions (CIN2+). We constructed progression curves of the baseline test results for the period, using the Kaplan-Meier method, and estimated sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratios for each test. Results A total of 1,440 women had at least one test during follow-up. Progression curves of the baseline test results indicated differences in capability to detect CIN2+ (p Pap smear (88.7% and 73.6%, respectively; p < 0.05) and had a better negative likelihood ratio (0.13 and 0.30, respectively). Specificity and positive likelihood ratio of the tests were similar. Conclusions These findings corroborate the importance of HPV test as a primary cervical cancer screening. PMID:27022786

  6. 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

  7. Assessment of effectiveness and cost-effectiveness of HPV testing in primary screening for cervical

    Directory of Open Access Journals (Sweden)

    Willich, Stefan N.

    2007-09-01

    Full Text Available Introduction: The introduction of a screening programme for cervical carcinoma in Germany has led to a significant reduction in incidence of the disease. To date, however, diagnosis in Germany has been based solely on cervical cytology, which has been criticised because of a low sensitivity and consequently high rate of false negative results. Because an infection with the human papillomavirus (HPV previously was found to be a necessary aetiological factor in the development of cervical cancer, there has been some discussion that HPV testing should be included in cervical cancer screening. Objectives: How do HPV tests compare to cytological tests in terms of sensitivity and specificity, and what are the effects of screening for cervical carcinoma in Germany? Is there health economic evidence that may foster an inclusion of HPV testing into national screening programms? Methods: A systematic literature review was performed, including studies that compared the HPV test to cervical cytology in terms of sensitivity and specificity in the diagnosis of CIN 2+ (CIN=Cervical Intraepithelial Neoplasia. In addition, a systematic review of the relevant health economic literature was performed to analyze cost-effectiveness in the German setting. Results: A total of 24 studies fulfilled the inclusion criteria. One study consisted of three substudies. Hence, results of 26 comparisons of HPV and cytology are reported. In 25 of these, the HPV test was more sensitive than cytology, whereas cytology had better specificity in 21 studies. The combination of HPV test and cytology increased sensitivity. Variability in results was considerably larger for cytology than for HPV testing. Results of the economic meta-analysis suggest that in health care settings with already established PAP screening programms, cost-effectiveness strongly depends on screening intervals. In analyses comparing HPV screening to conventional PAP screening with two-yearly intervals, only 25

  8. 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. PMID:19901435

  9. Knowledge, attitude, and practice of cervical cancer screening among Greek students: a short report.

    Science.gov (United States)

    Bakogianni, Giannoula D; Goutsou, Spiridoula C; Liti, Maria V; Rizopoulou, Sophia I; Nikolakopoulos, Konstantinos M; Nikolakopoulou, Nikoleta M

    2012-01-01

    Cervical cancer is a major cause of death in the developing world. The Papanicolaou (Pap) smear is a screening test that detects abnormal cells before they advance to cancer. The objective of this study was to assess the knowledge, attitude, and practice of cervical cancer screening among Greek students. A sample of 472 female students participated in the present study. Interviews were performed using a structured questionnaire. Of the participants, 94.07% were aware of the Pap test and 67.34% reported that the Pap test should be done yearly. The majority of them were informed about cervical cancer screening test by their parents. Of the participants, 44.82% had received Pap testing at least once in their life, whereas 36.2% had a Pap test yearly. The reported mean time of the respondents' first Pap test was 13.3±10.6 months after their first sexual intercourse. The reasons given by the participants for being noncompliant were lack of appreciation of the importance of the screening, embarrassment, fear, and high cost. Of the participants, 9.23% declared that those who had been administered the human papillomavirus vaccine do not need a Pap test. The results highlight the need for additional education and health promotion regarding cervical cancer screening. PMID:23183733

  10. Optoelectronic hit/miss transform for screening cervical smear slides

    Science.gov (United States)

    Narayanswamy, R.; Turner, R. M.; McKnight, D. J.; Johnson, K. M.; Sharpe, J. P.

    1995-06-01

    An optoelectronic morphological processor for detecting regions of interest (abnormal cells) on a cervical smear slide using the hit/miss transform is presented. Computer simulation of the algorithm tested on 184 Pap-smear images provided 95% detection and 5% false alarm. An optoelectronic implementation of the hit/miss transform is presented, along with preliminary experimental results.

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

    NARCIS (Netherlands)

    A.B Bos (A.)

    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

  12. Strategies for Increasing Cervical Cancer Screening Amongst First Nations Communities in Northwest Ontario, Canada.

    Science.gov (United States)

    Maar, Marion; Wakewich, Pamela; Wood, Brianne; Severini, Alberto; Little, Julian; Burchell, Ann N; Ogilvie, Gina; Zehbe, Ingeborg

    2016-04-01

    The high burden of cervical cancer in Indigenous populations worldwide is due to underscreening and inadequate follow-up. Using qualitative, participatory action research, we interviewed health care staff to identify ways to increase screening recruitment in First Nations communities in Northwest Ontario, Canada. Our findings suggest the value of a multilevel social-ecological model to promote behavioral changes at the community, health care service and stakeholder, and decision-maker level. Participants emphasized the central role of First Nations women as nurturers of life and for the well-being of their family members. They stressed the importance of building awareness and motivation for cervical cancer screening through various activities including continuous education, hosting screening events specifically for women, improving the attitude and service of health care providers, and promoting screening tools and policies that complement and are respectful of First Nations women. PMID:25375661

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

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Rebolj, Matejka

    2009-01-01

    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...... 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...... of a switch from primary screening with cytological testing to primary screening with HPV testing....

  14. 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.

  15. 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.

  16. Using lessons from breast, cervical, and colorectal cancer screening to inform the development of lung cancer screening programs.

    Science.gov (United States)

    Armstrong, Katrina; Kim, Jane J; Halm, Ethan A; Ballard, Rachel M; Schnall, Mitchell D

    2016-05-01

    Multiple advisory groups now recommend that high-risk smokers be screened for lung cancer by low-dose computed tomography. Given that the development of lung cancer screening programs will face many of the same issues that have challenged other cancer screening programs, the National Cancer Institute-funded Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium was used to identify lessons learned from the implementation of breast, cervical, and colorectal cancer screening that should inform the introduction of lung cancer screening. These lessons include the importance of developing systems for identifying and recruiting eligible individuals in primary care, ensuring that screening centers are qualified and performance is monitored, creating clear communication standards for reporting screening results to referring physicians and patients, ensuring follow-up is available for individuals with abnormal test results, avoiding overscreening, remembering primary prevention, and leveraging advances in cancer genetics and immunology. Overall, this experience emphasizes that effective cancer screening is a multistep activity that requires robust strategies to initiate, report, follow up, and track each step as well as a dynamic and ongoing oversight process to revise current screening practices as new evidence regarding screening is created, new screening technologies are developed, new biological markers are identified, and new approaches to health care delivery are disseminated. Cancer 2016;122:1338-1342. © 2016 American Cancer Society. PMID:26929386

  17. Breast and Cervical Cancer Screening: Impact of Health Insurance Status, Ethnicity, and Nativity of Latinas

    OpenAIRE

    Rodríguez, Michael A.; Ward, Lisa M.; Pérez-Stable, Eliseo J.

    2005-01-01

    PURPOSE Although rates of cancer screening for Latinas are lower than for non-Latina whites, little is known about how insurance status, ethnicity, and nativity interact to influence these disparities. Using a large statewide database, our study examined the relationship between breast and cervical cancer screening rates and socioeconomic and health insurance status among foreign-born Latinas, US-born Latinas, and non-Latina whites in California.

  18. Understanding the Disparities in Cervical Cancer Screening for Economically Disadvantaged Women

    OpenAIRE

    Gatchell, Melissa Sue

    2012-01-01

    Background: Cancer is the second leading cause of death in the United States, accounting for 22% of all deaths among women. Despite the importance of the Pap test in preventing and detecting cervical cancer, screening rates among poor women remain low. The pathways linking poverty with lower Pap test use remain unclear. The screening disparity for this low-cost test suggests that poor women may face other transaction costs, opportunity costs and barriers in accessing Pap tests that are no...

  19. Barriers and facilitators to cervical cancer screening in high incidence populations: A synthesis of qualitative evidence.

    Science.gov (United States)

    Driscoll, Susan D

    2016-01-01

    Despite the efficacy and availability of screening and treatment for cervical cancer, it remains the leading cause of death for women in many low resource countries. The inability or reluctance of women to use screening and treatment is the largest contributor to cervical cancer morbidity and mortality. The aim of the author in this article is to determine knowledge, attitudes, and beliefs that facilitate or hinder women's use of screening in high incidence countries through a synthesis of qualitative research. CINAHL, Medline, AnthroSource, Sociological Abstracts, Social Service Abstracts, GenderWatch, Ethnic News Watch, and ASSIA databases were queried for qualitative research published from 2008 to 2013. Ten studies meeting inclusion criteria were reviewed and analyzed using constant comparative analysis. Barriers to cervical cancer screening included fatalism, mistrust of non-traditional healthcare providers, masculine/feminine beliefs, limited knowledge, and misunderstandings of causes of cervical cancer. Facilitators included knowledge of sexual risk factors, recognition of signs and symptoms, and community/social support. Pragmatic solutions suggested by this synthesis, that may decrease barriers and enhance facilitators, involved cultural humility (a continual commitment to cultural competence), promotion of gender equality, collaboration among stakeholders, and the translation of evidence-based practices from low to high incidence populations. PMID:26496628

  20. Accuracy of Self-Reported Cervical and Breast Cancer Screening by Women with Intellectual Disability

    Science.gov (United States)

    Son, Esther; Parish, Susan L.; Swaine, Jamie G.; Luken, Karen

    2013-01-01

    This study examines the accuracy of self-report of cervical and breast cancer screening by women with intellectual disability ("n" ?=? 155). Data from face-to-face interviews and medical records were analyzed. Total agreement, sensitivity, specificity, positive predictive value and negative predictive value were calculated. Total…

  1. 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...

  2. Integration of human papillomavirus vaccination and cervical cancer screening in Latin America and the Caribbean.

    Science.gov (United States)

    Franco, Eduardo L; Tsu, Vivien; Herrero, Rolando; Lazcano-Ponce, Eduardo; Hildesheim, Allan; Muñoz, Nubia; Murillo, Raul; Sánchez, Gloria Ines; Andrus, Jon Kim

    2008-08-19

    Despite substantial efforts to control cervical cancer by screening, most Latin American and Caribbean countries continue to experience incidence rates of this disease that are much higher than those of other Western countries. The implementation of universal human papillomavirus (HPV) vaccination for young adolescent women is the best prospect for changing this situation. Even though there are financial challenges to overcome to implement such a policy, there is broad political support in the region for adopting universal HPV vaccination. The costs of implementing this policy could be largely alleviated by changing cervical cancer control practices that rely on inefficient use of resources presently allocated to cytology screening. In view of the strong evidence base concerning cervical cancer prevention technologies in the region and the expected impact of vaccination on the performance of cytology, we propose a reformulation of cervical cancer screening policies to be based on HPV testing using validated methods followed by cytologic triage. This approach would serve as the central component of a system that plays the dual role of providing screening and surveillance as integrated and complementary activities sharing centralized resources and coordination. PMID:18945406

  3. Cervical Cancer Histology, Staging and Survival before and after Implementation of Organised Cervical Screening Programme in Poland

    Science.gov (United States)

    Nowakowski, Andrzej; Cybulski, Marek; Buda, Irmina; Janosz, Iwona; Olszak-Wąsik, Katarzyna; Bodzek, Piotr; Śliwczyński, Andrzej; Teter, Zbigniew; Olejek, Anita; Baranowski, Włodzimierz

    2016-01-01

    A population-based organised cervical cancer screening programme (OCCSP) was introduced in Poland in 2006. In this study we have aimed to analyse whether selected parameters related to invasive cervical cancer (ICC) of patients diagnosed in two distant gynaecological oncology centres changed after the first screening round of the programme run between 2006–2008. We have run a retrospective cross-sectional analysis of 189 women diagnosed with ICC between 2002–2005 (directly before introduction of the programme) and 165 patients diagnosed between 2009–2012 (just after the first screening round of the programme) and compared their age at diagnosis, histology, stage of tumours and overall survival (OS). Mean age of patients diagnosed in years 2002–2005 and 2009–2012 was 52.1 and 52.6 years respectively. Squamous cell carcinomas constituted 90.5% and 86.1% of tumours diagnosed in years 2002–2005 and 2009–2012 respectively and the rest of tumours had glandular and other histologies. 74.5% and 61.0% of women diagnosed in years 2002–2005 and 2009–2012 respectively had early ICC (FIGO—International Federation of Gynaecology and Obstetrics stages I-IIA) and the rest had advanced disease (FIGO IIB-IV). We have noticed no significant differences in mean age of patients, histology of tumours and OS of patients with ICC diagnosed before and after the first screening round of OCSSP in Poland. Advanced stages of ICC were more commonly diagnosed after the introduction of OCSSP. Changes only in some clinical parameters of patients with ICC were noticed before and after the first screening round of OCSSP in Poland but OS of patients remained the same. PMID:27196050

  4. Individual, Provider, and System Risk Factors for Breast and Cervical Cancer Screening Among Underserved Black, Latina, and Arab Women

    OpenAIRE

    Roman, LeeAnne; Meghea, Cristian; Ford, Sabrina; Penner, Louis; Hamade, Hiam; Estes, Tamika; Williams, Karen Patricia

    2014-01-01

    Background: Socioeconomic and racial/ethnic disparities in breast and cervical cancer screening persist. An exploratory study was conducted to better understand co-occurring risk factors in underserved groups that could inform interventions to improve screening adherence. The objective of this study was to examine associations between breast and cervical cancer screening adherence and co-occurring risk factors in three racial/ethnic groups of underserved women.

  5. Cervical cancer screening in developing countries at a crossroad: Emerging technologies and policy choices.

    Science.gov (United States)

    Catarino, Rosa; Petignat, Patrick; Dongui, Gabriel; Vassilakos, Pierre

    2015-12-10

    Cervical cancer (CC) represents the fourth most common malignancy affecting women all over the world and is the second most common in developing areas. In these areas, the burden from disease remains important because of the difficulty in implementing cytology-based screening programmes. The main obstacles inherent to these countries are poverty and a lack of healthcare infrastructures and trained practitioners. With the availability of new technologies, researchers have attempted to find new strategies that are adapted to low- and middle-income countries (LMIC) to promote early diagnosis of cervical pathology. Current evidence suggests that human papillomavirus (HPV) testing is more effective than cytology for CC screening. Therefore, highly sensitive tests have now been developed for primary screening. Rapid molecular methods for detecting HPV DNA have only recently been commercially available. This constitutes a milestone in CC screening in low-resource settings because it may help overcome the great majority of obstacles inherent to previous screening programmes. Despite several advantages, HPV-based screening has a low positive predictive value for CC, so that HPV-positive women need to be triaged with further testing to determine optimal management. Visual inspection tests, cytology and novel biomarkers are some options. In this review, we provide an overview of current and emerging screening approaches for CC. In particular, we discuss the challenge of implementing an efficient cervical screening adapted to LMIC and the opportunity to introduce primary HPV-based screening with the availability of point-of-care (POC) HPV testing. The most adapted screening strategy to LMIC is still a work in progress, but we have reasons to believe that POC HPV testing makes part of the future strategies in association with a triage test that still needs to be defined. PMID:26677441

  6. Factors Associated with Uptake of Visual Inspection with Acetic Acid (VIA) for Cervical Cancer Screening in Western Kenya

    Science.gov (United States)

    Orang’o, Elkanah Omenge; Wachira, Juddy; Asirwa, Fredrick Chite; Busakhala, Naftali; Naanyu, Violet; Kisuya, Job; Otieno, Grieven; Keter, Alfred; Mwangi, Ann; Inui, Thomas

    2016-01-01

    Purpose Cervical cancer screening has been successful in reducing the rates of cervical cancer in developed countries, but this disease remains the leading cause of cancer deaths among women in sub-Saharan Africa. We sought to understand factors associated with limited uptake of screening services in our cervical cancer-screening program in Western Kenya. Participants and Methods Using items from a previously validated cancer awareness questionnaire repurposed for use in cervical cancer and culturally adapted for use in Kenya, we interviewed 2,505 women aged 18–55 years receiving care in gynecology clinics or seeking other services in 4 health facilities in Western Kenya between April 2014 and September 2014. We used logistic regression modeling to assess factors associated with uptake (or non-uptake), associated odds ratios (ORs) and the 95% confidence intervals (95% CI). Results Only two hundred and seventy-three women out of 2505 (11%) accepted VIA cervical cancer screening. Knowledge of just how women are screened for cervical cancer was significantly associated with reduced uptake of cervical cancer screening (OR: 0.53; CI 0.38–0.73) as was fear that screening would reveal a cancer (OR 0.70; CI 0.63–0.77), and reliance on prayer with the onset of illness (OR 0.43; CI 0.26–0.71). Participants who thought that one should get cervical cancer screening even if there were no symptoms were more than twice as likely to accept cervical cancer screening (OR 2.21; 95% CI 1.24–3.93). Older patients, patients living with HIV and women who do not know if bleeding immediately after sex might be a sign of cervical cancer were also more likely to accept screening (OR 1.03, CI 1.02–1.04; OR 1.78, CI 1.01–3.14; OR 2.39, CI 1.31–4.39, respectively). Conclusions In our population, a high percent of women knew that it is appropriate for all women to get cervical cancer screening, but only a small proportion of women actually got screening. There may be an

  7. 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.

  8. Cervical Cancer Screening Among Homeless Women of New York City Shelters.

    Science.gov (United States)

    Asgary, Ramin; Alcabes, Analena; Feldman, Rebecca; Garland, Victoria; Naderi, Ramesh; Ogedegbe, Gbenga; Sckell, Blanca

    2016-06-01

    Introduction Homeless persons have minimal opportunities to complete recommended cancer screening. The rates and predictors of cervical cancer screening are understudied among homeless women in the US. Methods We enrolled 297 homeless women 21-65 years old residing in 6 major New York City shelters from 2012 to 2014. We used a validated national survey to determine the proportion and predictors of cervical cancer screening using cytology (Pap test). Results Mean age was 44.72 (±11.96) years. Majority was Black, heterosexual, single, with high school or lower education; 50.9 % were smokers and 41.7 % were homeless more than a year. Despite a 76.5 % proportion of self-reported Pap test within the past 3 years, 65 % of women assumed their Pap test results were normal or did not get proper follow up after abnormal results. Forty-five-point-nine percent of women did not know about frequency of Pap test or causes of cervical cancer. Lower proportion of up-to-date Pap test was associated with lack of knowledge of recommended Pap test frequency (p homeless women was similar to a national sample. However, the majority of women surveyed were not aware of their results, received limited if any follow up and had significant education gaps about cervical cancer screening. We recommend improved counseling and patient education, patient navigators to close screening loops, and consideration of alternative test-and-treat modalities to improve effective screening. PMID:26649876

  9. Is cervical screening preventing adenocarcinoma and adenosquamous carcinoma of the cervix?

    Science.gov (United States)

    Castanon, Alejandra; Landy, Rebecca; Sasieni, Peter D

    2016-09-01

    While the incidence of squamous carcinoma of the cervix has declined in countries with organised screening, adenocarcinoma has become more common. Cervical screening by cytology often fails to prevent adenocarcinoma. Using prospectively recorded cervical screening data in England and Wales, we conducted a population-based case-control study to examine whether cervical screening leads to early diagnosis and down-staging of adenocarcinoma. Conditional logistic regression modelling was carried out to provide odds ratios (ORs) and 95% confidence intervals (CIs) on 12,418 women with cervical cancer diagnosed between ages 30 and 69 and 24,453 age-matched controls. Of women with adenocarcinoma of the cervix, 44.3% were up to date with screening and 14.6% were non-attenders. The overall OR comparing women up to date with screening with non-attenders was 0.46 (95% CI: 0.39-0.55) for adenocarcinoma. The odds were significantly decreased (OR: 0.22, 95% CI: 0.15-0.33) in up to date women with Stage 2 or worse adenocarcinoma, but not for women with Stage1A adenocarcinoma 0.71 (95% CI: 0.46-1.09). The odds of Stage 1A adenocarcinoma was double among lapsed attenders (OR: 2.35, 95% CI: 1.52-3.62) compared to non-attenders. Relative to women with no negative cytology within 7 years of diagnosis, women with Stage1A adenocarcinoma were very unlikely to be detected within 3 years of a negative cytology test (OR: 0.08, 95% CI: 0.05-0.13); however, the odds doubled 3-5 years after a negative test (OR: 2.30, 95% CI: 1.67-3.18). ORs associated with up to date screening were smaller for squamous and adenosquamous cervical carcinoma. Although cytology screening is inefficient at preventing adenocarcinomas, invasive adenocarcinomas are detected earlier than they would be in the absence of screening, substantially preventing Stage 2 and worse adenocarcinomas. PMID:27096255

  10. Automated cervical precancerous cells screening system based on Fourier transform infrared spectroscopy features

    Science.gov (United States)

    Jusman, Yessi; Mat Isa, Nor Ashidi; Ng, Siew-Cheok; Hasikin, Khairunnisa; Abu Osman, Noor Azuan

    2016-07-01

    Fourier transform infrared (FTIR) spectroscopy technique can detect the abnormality of a cervical cell that occurs before the morphological change could be observed under the light microscope as employed in conventional techniques. This paper presents developed features extraction for an automated screening system for cervical precancerous cell based on the FTIR spectroscopy as a second opinion to pathologists. The automated system generally consists of the developed features extraction and classification stages. Signal processing techniques are used in the features extraction stage. Then, discriminant analysis and principal component analysis are employed to select dominant features for the classification process. The datasets of the cervical precancerous cells obtained from the feature selection process are classified using a hybrid multilayered perceptron network. The proposed system achieved 92% accuracy.

  11. The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer: Results from the EPIC Cohort.

    Directory of Open Access Journals (Sweden)

    Esther Roura

    Full Text Available In addition to HPV, high parity and hormonal contraceptives have been associated with cervical cancer (CC. However, most of the evidence comes from retrospective case-control studies. The aim of this study is to prospectively evaluate associations between hormonal factors and risk of developing cervical intraepithelial neoplasia grade 3 (CIN3/carcinoma in situ (CIS and invasive cervical cancer (ICC.We followed a cohort of 308,036 women recruited in the European Prospective Investigation into Cancer and Nutrition (EPIC Study. At enrollment, participants completed a questionnaire and provided serum. After a 9-year median follow-up, 261 ICC and 804 CIN3/CIS cases were reported. In a nested case-control study, the sera from 609 cases and 1,218 matched controls were tested for L1 antibodies against HPV types 11,16,18,31,33,35,45,52,58, and antibodies against Chlamydia trachomatis and Human herpesvirus 2. Multivariate analyses were performed to estimate hazard ratios (HR, odds ratios (OR and corresponding 95% confidence intervals (CI. The cohort analysis showed that number of full-term pregnancies was positively associated with CIN3/CIS risk (p-trend = 0.03. Duration of oral contraceptives use was associated with a significantly increased risk of both CIN3/CIS and ICC (HR = 1.6 and HR = 1.8 respectively for ≥ 15 years versus never use. Ever use of menopausal hormone therapy was associated with a reduced risk of ICC (HR = 0.5, 95%CI: 0.4-0.8. A non-significant reduced risk of ICC with ever use of intrauterine devices (IUD was found in the nested case-control analysis (OR = 0.6. Analyses restricted to all cases and HPV seropositive controls yielded similar results, revealing a significant inverse association with IUD for combined CIN3/CIS and ICC (OR = 0.7.Even though HPV is the necessary cause of CC, our results suggest that several hormonal factors are risk factors for cervical carcinogenesis. Adherence to current cervical cancer screening

  12. The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer: Results from the EPIC Cohort

    Science.gov (United States)

    Roura, Esther; Travier, Noémie; Waterboer, Tim; de Sanjosé, Silvia; Bosch, F. Xavier; Pawlita, Michael; Pala, Valeria; Weiderpass, Elisabete; Margall, Núria; Dillner, Joakim; Gram, Inger T.; Tjønneland, Anne; Munk, Christian; Palli, Domenico; Khaw, Kay-Tee; Overvad, Kim; Clavel-Chapelon, Françoise; Mesrine, Sylvie; Fournier, Agnès; Fortner, Renée T.; Ose, Jennifer; Steffen, Annika; Trichopoulou, Antonia; Lagiou, Pagona; Orfanos, Philippos; Masala, Giovanna; Tumino, Rosario; Sacerdote, Carlotta; Polidoro, Silvia; Mattiello, Amalia; Lund, Eiliv; Peeters, Petra H.; Bueno-de-Mesquita, H. B(as).; Quirós, J. Ramón; Sánchez, María-José; Navarro, Carmen; Barricarte, Aurelio; Larrañaga, Nerea; Ekström, Johanna; Lindquist, David; Idahl, Annika; Travis, Ruth C.; Merritt, Melissa A.; Gunter, Marc J.; Rinaldi, Sabina; Tommasino, Massimo; Franceschi, Silvia; Riboli, Elio; Castellsagué, Xavier

    2016-01-01

    Background In addition to HPV, high parity and hormonal contraceptives have been associated with cervical cancer (CC). However, most of the evidence comes from retrospective case-control studies. The aim of this study is to prospectively evaluate associations between hormonal factors and risk of developing cervical intraepithelial neoplasia grade 3 (CIN3)/carcinoma in situ (CIS) and invasive cervical cancer (ICC). Methods and Findings We followed a cohort of 308,036 women recruited in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study. At enrollment, participants completed a questionnaire and provided serum. After a 9-year median follow-up, 261 ICC and 804 CIN3/CIS cases were reported. In a nested case-control study, the sera from 609 cases and 1,218 matched controls were tested for L1 antibodies against HPV types 11,16,18,31,33,35,45,52,58, and antibodies against Chlamydia trachomatis and Human herpesvirus 2. Multivariate analyses were performed to estimate hazard ratios (HR), odds ratios (OR) and corresponding 95% confidence intervals (CI). The cohort analysis showed that number of full-term pregnancies was positively associated with CIN3/CIS risk (p-trend = 0.03). Duration of oral contraceptives use was associated with a significantly increased risk of both CIN3/CIS and ICC (HR = 1.6 and HR = 1.8 respectively for ≥15 years versus never use). Ever use of menopausal hormone therapy was associated with a reduced risk of ICC (HR = 0.5, 95%CI: 0.4–0.8). A non-significant reduced risk of ICC with ever use of intrauterine devices (IUD) was found in the nested case-control analysis (OR = 0.6). Analyses restricted to all cases and HPV seropositive controls yielded similar results, revealing a significant inverse association with IUD for combined CIN3/CIS and ICC (OR = 0.7). Conclusions Even though HPV is the necessary cause of CC, our results suggest that several hormonal factors are risk factors for cervical carcinogenesis. Adherence to

  13. Effect of Fee on Cervical Cancer Screening Attendance—ScreenFee, a Swedish Population-Based Randomised Trial

    Science.gov (United States)

    Alfonzo, Emilia; Andersson Ellström, Agneta; Nemes, Szilard; Strander, Björn

    2016-01-01

    Background Attendance in the cervical cancer screening programme is one of the most important factors to lower the risk of contracting the disease. Attendance rates are often low in areas with low socioeconomic status. Charging a fee for screening might possibly decrease attendance in this population. Screening programme coverage is low in low socio-economic status areas in Gothenburg, Sweden, but has increased slightly after multiple interventions in recent years. For many years, women in the region have paid a fee for screening. We studied the effect of abolishing this fee in a trial emanating from the regular cervical cancer screening programme. Method Individually randomised controlled trial. All 3 124 women in three low-resource areas in Gothenburg, due for screening during the study period, were randomised to receive an offer of a free test or the standard invitation stating the regular fee of 100 SEK (≈11 €). The study was conducted during the first six months of 2013. Attendance was defined as a registered Pap smear within 90 days from the date the invitation was sent out. Results Attendance did not differ significantly between women who were charged and those offered free screening (RR 0.93; CI 0.85–1.02). No differences were found within the districts or as an effect of age, attendance after the most recent previous invitation or previous experience of smear taking. Conclusion Abolishment of a modest screening fee in socially disadvantaged urban districts with low coverage, after previous multiple systematic interventions, does not increase attendance in the short term. Other interventions might be more important for increasing attendance in low socio-economic status areas. Trial Registration ClinicalTrials.gov NCT02378324 PMID:26986848

  14. 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

  15. 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.

  16. Risk assessment to guide cervical screening strategies in a large Chinese population.

    Science.gov (United States)

    Zhao, Fang-Hui; Hu, Shang-Ying; Zhang, Qian; Zhang, Xun; Pan, Qin-Jing; Zhang, Wen-Hua; Gage, Julia C; Wentzensen, Nicolas; Castle, Philip E; Qiao, You-Lin; Katki, Hormuzd A; Schiffman, Mark

    2016-06-01

    Three different cervical screening methods [cytology, human papillomavirus(HPV) testing and visual inspection with acetic acid(VIA)] are being considered in China for the national cervical screening program. Comparing risks of CIN3 and cervical cancer (CIN3+) for different results can inform test choice and management guidelines. We evaluated the immediate risk of CIN3+ for different screening results generated from individual and combined tests. We compared tests using a novel statistic designed for this purpose called Mean Risk Stratification (MRS), in a pooled analysis of 17 cross sectional population-based studies of 30,371Chinese women screened with all 3 methods and diagnosed by colposcopically-directed biopsies. The 3 tests combined powerfully distinguished CIN3+ risk; triple-negative screening conferred a risk of 0.01%, while HPV-positive HSIL+ that was VIA-positive yielded a risk of 57.8%. Among the three screening tests, HPV status most strongly stratified CIN3+ risk. Among HPV-positive women, cytology was the more useful second test. In HPV-negative women, the immediate risks of CIN3+ ranged from 0.01% (negative cytology), 0.00% (ASC-US), 1.1% (LSIL), to 6.6 (HSIL+). In HPV-positive women, the CIN3+ risks were 0.9% (negative cytology), 3.6% (ASC-US), 6.3% (LSIL) and 38.5% (HSIL+). VIA results did not meaningful stratify CIN3+ risk among HPV-negative women with negative or ASC-US cytology; however, positive VIA substantially elevated CIN3+ risk for all other, more positive combinations of HPV and cytology compared with a negative VIA. Because all 3 screening tests had independent value in defining risk of CIN3+, different combinations can be optimized as pragmatic strategies in different resource settings. PMID:26800481

  17. Cost-Effectiveness of Different Cervical Screening Strategies in Islamic Republic of Iran: A Middle-Income Country with a Low Incidence Rate of Cervical Cancer

    Science.gov (United States)

    Nahvijou, Azin; Daroudi, Rajabali; Tahmasebi, Mamak; Amouzegar Hashemi, Farnaz; Rezaei Hemami, Mohsen; Akbari Sari, Ali; Barati Marenani, Ahmad; Zendehdel, Kazem

    2016-01-01

    Objective Invasive cervical cancer (ICC) is the fourth most common cancer among women worldwide. Cervical screening programs have reduced the incidence and mortality rates of ICC. We studied the cost-effectiveness of different cervical screening strategies in the Islamic Republic of Iran, a Muslim country with a low incidence rate of ICC. Methods We constructed an 11-state Markov model, in which the parameters included regression and progression probabilities, test characteristics, costs, and utilities; these were extracted from primary data and the literature. Our strategies included Pap smear screening and human papillomavirus (HPV) DNA testing plus Pap smear triaging with different starting ages and screening intervals. Model outcomes included lifetime costs, life years gained, quality-adjusted life years (QALY), and incremental cost-effectiveness ratios (ICERs). One-way sensitivity analysis was performed to examine the stability of the results. Results We found that the prevented mortalities for the 11 strategies compared with no screening varied from 26% to 64%. The most cost-effective strategy was HPV screening, starting at age 35 years and repeated every 10 years. The ICER of this strategy was $8,875 per QALY compared with no screening. We found that screening at 5-year intervals was also cost-effective based on GDP per capita in Iran. Conclusion We recommend organized cervical screening with HPV DNA testing for women in Iran, beginning at age 35 and repeated every 10 or 5 years. The results of this study could be generalized to other countries with low incidence rates of cervical cancer. PMID:27276093

  18. Process performance of cervical screening programmes in Europe

    DEFF Research Database (Denmark)

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

    2009-01-01

    proportion of abnormal tests (from 1.2% in Germany (Mecklenburg-Vorpommern) to 11.7% in Ireland-Midwest Region) and for their distribution by grade. Referral rates for repeat cytology (ranging from 2.9% of screened women in the Netherlands to 16.6% in Slovenia) or for colposcopy (ranging from 0.8% in Finland...... intraepithelial lesion (LSIL) cytology. However, cytology-specific PPV also showed remarkable variability. The detection rate of CIN2+ histology ranged from <0.1% of screened women in Poland to >1% in England and Denmark. Low attendance for colposcopy after referral was observed in some east-European countries...

  19. 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

  20. Dynamic Contrast-Enhanced MRI of Cervical Cancers: Temporal Percentile Screening of Contrast Enhancement Identifies Parameters for Prediction of Chemoradioresistance

    International Nuclear Information System (INIS)

    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.

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

    OpenAIRE

    Fauziah Abdullah; Michael O’Rorke; Liam Murray; Tin Tin Su

    2013-01-01

    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 school...

  2. Rural physicians' perspectives on cervical and breast cancer screening: a gender-based analysis.

    Science.gov (United States)

    Ahmad, F; Stewart, D E; Cameron, J I; Hyman, I

    2001-03-01

    Several studies highlight the role of physicians in determining cervical and breast cancer screening rates, and some urban studies report higher screening rates by female physicians. Rural women in North America remain underscreened for breast and cervical cancers. This survey was conducted to determine if there were significant gender differences in practices and perceptions of barriers to breast and cervical cancer screening among rural family physicians in Ontario, Canada. One hundred ninety-one family physicians (response rate 53.1%) who practiced in rural areas, small towns, or small cities completed a mail questionnaire. The physicians' mean age was 44.4 years (SD 9.9), and mean number of years in practice was 16.6 years (SD 10.3). Over 90% of physicians reported that they were very likely to conduct a Pap test and clinical breast examination (CBE) during a periodic health examination, and they had high levels of confidence and comfort in performing these procedures. Male (68%) and female (32%) physicians were similar in their likelihood to conduct screening, levels of confidence and comfort, and knowledge of breast and cervical cancer screening guidelines. However, the self-reported screening rates for Pap tests and CBE performed during last year were higher for female than male physicians (p < 0.01). Male physicians reported they were asked more frequently by patients for a referral to another physician to perform Pap tests and CBE (p < 0.001). Also, male physicians perceived patients' embarrassment as a stronger barrier to performing Pap tests (p < 0.05) and CBE (p < 0.01) than female physicians. No gender differences were observed in screening rates or related barriers to mammography referrals. These findings suggest that physicians' gender plays a role in sex-sensitive examination, such as Pap tests and CBE. There is a need to facilitate physician-patient interactions for sex-sensitive cancer screening examinations by health education initiatives

  3. Influence of Spirituality and Modesty on Acceptance of Self-Sampling for Cervical Cancer Screening.

    Directory of Open Access Journals (Sweden)

    Eileen O Dareng

    Full Text Available Whereas systematic screening programs have reduced the incidence of cervical cancer in developed countries, the incidence remains high in developing countries. Among several barriers to uptake of cervical cancer screening, the roles of religious and cultural factors such as modesty have been poorly studied. Knowledge about these factors is important because of the potential to overcome them using strategies such as self-collection of cervico-vaginal samples. In this study we evaluate the influence of spirituality and modesty on the acceptance of self-sampling for cervical cancer screening.We enrolled 600 participants in Nigeria between August and October 2014 and collected information on spirituality and modesty using two scales. We used principal component analysis to extract scores for spirituality and modesty and logistic regression models to evaluate the association between spirituality, modesty and preference for self-sampling. All analyses were performed using STATA 12 (Stata Corporation, College Station, Texas, USA.Some 581 (97% women had complete data for analysis. Most (69% were married, 50% were Christian and 44% were from the south western part of Nigeria. Overall, 19% (110/581 of the women preferred self-sampling to being sampled by a health care provider. Adjusting for age and socioeconomic status, spirituality, religious affiliation and geographic location were significantly associated with preference for self-sampling, while modesty was not significantly associated. The multivariable OR (95% CI, p-value for association with self-sampling were 0.88 (0.78-0.99, 0.03 for spirituality, 1.69 (1.09-2.64, 0.02 for religious affiliation and 0.96 (0.86-1.08, 0.51 for modesty.Our results show the importance of taking cultural and religious beliefs and practices into consideration in planning health interventions like cervical cancer screening. To succeed, public health interventions and the education to promote it must be related to the

  4. Review of recommendations on cervical cancer screening in the European Union.

    Science.gov (United States)

    Patnick, J

    2003-08-01

    In 2000 the European Commission Advisory Committee on Cancer Prevention published a position paper on cancer screening with recommendations. This followed working party deliberations in 1998 and conference discussion in 1999. Scientific advances, particularly in knowledge about the relationship of HPV and cervical cancer and political developments with the enlargement of the European Union, mean that the position paper and recommendations may shortly need revising in the light of changed circumstances. PMID:14581854

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

    OpenAIRE

    Jorge Salmerón-Castro; Eduardo César Lazcano Ponce; Ricardo Pérez Cuevas; Iliana del Río Gómez; Irene Torres Torija; Mauricio Hernández Avila

    1998-01-01

    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 CCS...

  6. 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...... treatment, anxiety flared up with recurrent check-ups. The bio-medical differentiation between pre-stage and actual cancer provided no comfort to the participants, who continued to see themselves as having early stage cancer....

  7. 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. PMID:23679334

  8. Rationale and design of a multicenter prospective cohort study for the eVALuation and monitoring of HPV infections and relATEd cervical diseases in high-risk women (VALHIDATE study

    Directory of Open Access Journals (Sweden)

    Orlando Giovanna

    2012-05-01

    Full Text Available Abstract Background Pap screening, an effective method for cervical cancer prevention, is now supported by molecular human papillomavirus (HPV testing. Recently commercialised preventive vaccines also provide new tools for the primary prevention of cervical cancer. To determine appropriate prevention strategies, the Health General Direction, Lombardy Region, funded a project that aims to characterize and monitor HPV infections and related cervical diseases in high-risk women. Methods/design VALHIDATE is a 5-year multicentre open prospective cohort study. It will recruit 7000 consenting women aged 13–65 years to provide information about the local biomolecular epidemiology of HPV infection and cervical diseases in high-risk women recruited from nine clinical centres and one faith-based organisation. The study will estimate the overall and type-specific prevalence of HPV infection and cervical abnormalities. It also aims to compare standard Pap screening with biomolecular screening, and to assist in the design of targeted regional prevention programs directed specifically at high-risk groups. Three groups of high-risk women: 1000 HIV-infected women (aged 26–65 years, 1000 recent migrant women (aged 26–65 years and 3000 young women (aged 13–26 years and 1 control group: 2000 women (aged 26–45 years attending a spontaneous screening program, will be recruited. Sample sizes will be revised after the first year. Adult participants will undergo conventional cervical cytology, HPV DNA screening and genotyping. Paediatric participants will undergo HPV DNA testing and genotyping of urine samples. HPV DNA, cytological abnormalities and HPV types will be analysed according to demographic, epidemiological, behavioural, and clinical data collected in an electronic case report form. Overall and stratified prevalences will be estimated to analyse the associations between HPV infection and selected characteristics. Logistic regression models

  9. Rationale and design of a multicenter prospective cohort study for the eVALuation and monitoring of HPV infections and relATEd cervical diseases in high-risk women (VALHIDATE study)

    International Nuclear Information System (INIS)

    Pap screening, an effective method for cervical cancer prevention, is now supported by molecular human papillomavirus (HPV) testing. Recently commercialised preventive vaccines also provide new tools for the primary prevention of cervical cancer. To determine appropriate prevention strategies, the Health General Direction, Lombardy Region, funded a project that aims to characterize and monitor HPV infections and related cervical diseases in high-risk women. VALHIDATE is a 5-year multicentre open prospective cohort study. It will recruit 7000 consenting women aged 13–65 years to provide information about the local biomolecular epidemiology of HPV infection and cervical diseases in high-risk women recruited from nine clinical centres and one faith-based organisation. The study will estimate the overall and type-specific prevalence of HPV infection and cervical abnormalities. It also aims to compare standard Pap screening with biomolecular screening, and to assist in the design of targeted regional prevention programs directed specifically at high-risk groups. Three groups of high-risk women: 1000 HIV-infected women (aged 26–65 years), 1000 recent migrant women (aged 26–65 years) and 3000 young women (aged 13–26 years) and 1 control group: 2000 women (aged 26–45 years) attending a spontaneous screening program, will be recruited. Sample sizes will be revised after the first year. Adult participants will undergo conventional cervical cytology, HPV DNA screening and genotyping. Paediatric participants will undergo HPV DNA testing and genotyping of urine samples. HPV DNA, cytological abnormalities and HPV types will be analysed according to demographic, epidemiological, behavioural, and clinical data collected in an electronic case report form. Overall and stratified prevalences will be estimated to analyse the associations between HPV infection and selected characteristics. Logistic regression models will be used to estimate crude and adjusted odds ratios. Cox

  10. Using online adverts to increase the uptake of cervical screening amongst “real Eastenders”: an opportunistic controlled trial

    OpenAIRE

    Jones, Ray B.; Soler-Lopez, Mar; Zahra, Daniel; Shankleman, Judith; Trenchard-Mabere, Esther

    2013-01-01

    Background Cervical screening uptake has increased as a result of occurrences of cervical cancer in TV ‘soap operas’ and in real life celebrities such as Jade Goody. Media analysis at the time of Jade Goody’s death suggested the NHS did not take sufficient advantage of this opportunity to improve cervical screening rates. Google AdWords has been used to recruit and raise awareness of health but we were not aware of its use to supplement media events. Methods This was an opportunistic service ...

  11. Knowledge, practice, and barriers toward cervical cancer screening in Elmina, Southern Ghana

    Directory of Open Access Journals (Sweden)

    Ebu NI

    2014-12-01

    Full Text Available Nancy Innocentia Ebu,1 Sylvia C Mupepi,2 Mate Peter Siakwa,1 Carolyn M Sampselle3 1University of Cape Coast, School of Nursing, Cape Coast, Ghana; 2Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, MI, USA; 3School of Nursing, University of Michigan, Ann Arbor, MI, USA Aims: The aims of this study were: 1 to assess the level of knowledge of women about Pap smear tests, 2 to determine the practices of women regarding Pap smear tests, and 3 to determine the barriers to Pap smear tests in Elmina, Ghana. Methods: A cross-sectional study was conducted with 392 randomly selected sexually active females aged 10–74 years using structured interview questions. The Institutional Review Board of the University of Cape Coast gave ethical approval for the study and informed consent was obtained from participants. Data were analyzed with SPSS software (v19.0 using frequencies, chi-square test, and exploratory factor analysis. Results: The results revealed that 68.4% had never heard about cervical cancer, 93.6% had no knowledge on the risk factors, nine (2.3% reported multiple sexual partners and being sexually active as risk factors, and 92% did not know about the prevention and treatment of cervical cancer. The majority (97.7% had never heard of the Pap smear test. Only three (0.8% women out of 392 had had a Pap smear test. Reasons for seeking a Pap smear test included referral, fear of cervical cancer, and radio campaigns. A significant association was found between institutional and personal barriers and having a Pap smear test. Conclusion: Comprehensive education on cervical cancer screening and removal of access barriers are critical in reducing risk associated with the disease and promoting women's health. Keywords: women, cervical screening, awareness, factors, community, developing countries

  12. 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

    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...... 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...... decisions. Objectives To determine women's preferences for the follow-up of low-grade cervical screening abnormalities. Search strategy Using Medical Subject Headings (MeSH) terms, PubMed was searched for articles published up to December 2010. The reference lists of the retrieved studies were consulted...

  13. Knowledge, attitudes and practice toward cervical cancer screening among Sikkimese nursing staff in India

    Directory of Open Access Journals (Sweden)

    Hafizur Rahman

    2015-01-01

    Full Text Available Objectives: To assess baseline knowledge of cancer cervix, screening and practice of Pap smear screening among Sikkimese staff nurses in India. Materials and Methods: Between April 2012 and February 2013, a predesigned, pretested, self -administered multiple responses questionnaire survey was conducted among staff nurses′ working in various hospitals of Sikkim. Questionnaire contained information about their demographics, knowledge of cervical cancer, its risk factors, screening methods, attitudes toward cervical cancer screening and practice of Pap smear amongst themselves. Results: Overall, 90.4% nurses responded that they were aware of cancer cervix. Three quarter of the staff nurses were not aware of commonest site being cancer cervix in women. Of the 320 participants, who had heard of cancer cervix, 253 (79.1% were aware of cancer cervix screening. Pap smear screening should start at 21 years or 3 years after sexual debut was known to only one-third of the nursing staff. Age was found to be a significant predictor of awareness of Pap smear screening among nursing staff. Awareness was significantly more prevalent among older staff (P < 0.007. Married nursing staffs were significantly more likely to be aware of screening methods, and nursing staff of Christian and Buddhist religion were 1.25 times and 2.03 times more likely to aware of screening methods than Hindu religion respectively. Only 16.6% nurses, who were aware of a Pap smear (11.9% of the total sample, had ever undergone a Pap smear test. Most common reason offered for not undergoing Pap smear test were, they felt they were not at risk (41%, uncomfortable pelvic examination (25% and fear of a bad result (16.6%. Conclusion: Knowledge of cancer cervix, screening and practice of Pap smear was low among Sikkimese nursing staff in India. There is an urgent need for re-orientation course for working nurses and integration of cervical cancer prevention issues in the nurses′ existing

  14. 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.

  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 among South Asian women in Canada: the role of education and acculturation.

    Science.gov (United States)

    Gupta, Abha; Kumar, Ashesh; Stewart, Donna E

    2002-02-01

    Cervical cancer screening by Papanicolaou (Pap) smear lowers the incidence and provides early detection of cervical cancer and is a preventative health care measure that should be available on a regular basis to all women at risk. As the population of ethnic women increases, it is important to assess whether these women are aware of and are utilizing this health service. A self-administered questionnaire was completed by 124 South Asian women, aged 18 to 60 years. Sixty-two South Asian students were selected from a university setting and 62 Tamil women were selected from a community center for South Asian women. This study examined the knowledge and use of Pap smears in South Asian women in Canada, and whether their level of acculturation or formal education influenced whether they know about and receive Pap smears. Low level of knowledge about the Pap test and a low prevalence of Pap testing behaviour was significantly correlated (p students were significantly more acculturated than Tamil women (p knowledge and prevalence of cervical cancer screening among South Asian women. This study highlights the need for educational interventions in Canada directed to ethnic women especially from South Asia. PMID:11868960

  17. A community-based cervical cancer screening program among women of Delhi using camp approach

    Directory of Open Access Journals (Sweden)

    Sharma Pragya

    2010-01-01

    Full Text Available Background: Cervical cancer is the commonest malignancy among women in developing countries. Cytological screening (Pap smear have been claimed to reduce incidence and mortality of carcinoma cervix significantly for which sensitization of women is required through community-based approach. Objectives: To find out number of cervical cancer cases among patients reporting to a general health care camp through screening program and study the prevalence of perceived morbidity and its confirmation. Settings: Cross-sectional study among women attending cancer awareness camps. Materials and Methods: A total of 435 women attending cancer awareness camps were screened for carcinoma cervix. The findings of history and clinical examination were recorded. Pap smears of all the symptomatic patients were collected and cytological diagnosis was confirmed by a pathologist. Results and Conclusions: The perceived gynecological morbidity was observed to be 59.8%. The smear of the women who were suspected of carcinoma on clinical examination was confirmed to be the cases of carcinoma-in-situ (7.8% and high-grade neoplasia (2.9% on laboratory investigations. The findings of the study highlight the utility and need of cancer cervix screening among the women at regular intervals through camp approach in the community.

  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. 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....... On the basis of the data from randomized controlled trials, we calculated the relative detection of CIN1 and CIN2, and the relative risks of false-positive tests (positive tests without subsequent =CIN3) per age group and trial for HPV testing versus cytology. For women aged at least 30 years in...... trials with a low cytology abnormality rate, detection of CIN1 increased significantly by 50-90% in the two trials with reported data; detection of CIN2 was doubled in three trials; the risks of false-positive HPV tests were also doubled. In trials with a high cytology abnormality rate, these risks were...

  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. Reasons for non-attendance to cervical screening and preferences for HPV self-sampling in Dutch women

    NARCIS (Netherlands)

    Bosgraaf, R.P.; Ketelaars, P.J.W.; Verhoef, V.M.; Massuger, L.F.A.G.; Meijer, C.J.W.; Melchers, W.J.G.; Bekkers, R.L.M.

    2014-01-01

    OBJECTIVES: High attendance rates in cervical screening are essential for effective cancer prevention. Offering HPV self-sampling to non-responders increases participation rates. The objectives of this study were to determine why non-responders do not attend regular screening, and why they do or do

  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. Family Caregivers' Perspectives on Barriers and Facilitators of Cervical and Breast Cancer Screening for Women with Intellectual Disability

    Science.gov (United States)

    Swaine, Jamie G.; Dababnah, Sarah; Parish, Susan L.; Luken, Karen

    2013-01-01

    Women with intellectual disability do not receive cervical and breast cancer screening at the same number as women without disabilities. Numerous barriers to receipt of screening have been reported by individuals with intellectual disability, paid caregivers, nurses, and other medical professionals. This study utilized semi-structured qualitative…

  5. Are Cervical and Breast Cancer Screening Programmes Equitable? The Case of Women with Intellectual and Developmental Disabilities

    Science.gov (United States)

    Cobigo, V.; Ouellette-Kuntz, H.; Balogh, R.; Leung, F.; Lin, E.; Lunsky, Y.

    2013-01-01

    Background: Effective cancer screening must be available for all eligible individuals without discrimination. Lower rates of cervical and breast cancer screening have been reported in certain groups compared with women from the general population, such as women with intellectual and developmental disabilities (IDD). Research on the factors…

  6. Teaching Tools to Engage Anishinaabek First Nations Women in Cervical Cancer Screening: Report of an Educational Workshop

    Science.gov (United States)

    Zehbe, Ingeborg; Wood, Brianne; Wakewich, Pamela; Maar, Marion; Escott, Nicholas; Jumah, Naana; Little, Julian

    2016-01-01

    Objective: To explore educational strategies for engaging First Nations women in Canada to attend cervical cancer screening. Design: Within a participatory action research framework, semi-structured interviews with health-care providers in First Nations communities revealed that education about the value of screening is perceived as being a key…

  7. Women's knowledge about cervical cancer, Pap smear and human papillomavirus and its relation to screening in Argentina.

    Science.gov (United States)

    Paolino, Melisa; Arrossi, Silvina

    2011-01-01

    The purpose of this study was to evaluate women's knowledge about cervical cancer, Pap smears, and human papilloma virus in relation to their cervical cancer screening behavior. This hospital-based study was conducted with a sample of 200 women: 100 women screened in the last three years and 100 non-screened women who attended a hospital located in the metropolitan area of Buenos Aires, between September 2008 and February 2009. Women at the hospital were surveyed using a structured questionnaire. Multiple logistic regression models were used to evaluate the relation of women's knowledge about Pap smears to screening behavior, controlling for socio-demographic characteristics. Of the women who had been screened, 49% compared to 73% of those not screened had inadequate knowledge about Pap smears (P = 0.001), and 47% of screened and 30% of non-screened women reported that they had ever heard about human papilloma virus (P = 0.013). In multivariate analysis, having adequate knowledge about Pap smears (odds ratio: 2.6 or 95%, confidence interval: 1.4-4.8) having health insurance (odds ratio: 2.6 or 95%, confidence interval: 1.1-6.4) and being married (odds ratio: 1.8 or 95%, confidence interval: 1.1-3.4) were the factors related to being screened in the previous three years. Knowledge was related to screening. Comprehensive educational approaches may enhance screening for cervical cancer prevention. PMID:21391162

  8. 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

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

    Directory of Open Access Journals (Sweden)

    Goldie Sue J

    2006-08-01

    Full Text Available Abstract Background Cost-effectiveness analyses (CEAs can provide useful information to policymakers concerned with the broad allocation of resources as well as to local decision makers choosing between different options for reducing the burden from a single disease. For the latter, it is important to use country-specific data when possible and to represent cost differences between countries that might make one strategy more or less attractive than another strategy locally. As part of a CEA of cervical cancer screening in five developing countries, we supplemented limited primary cost data by developing other estimation techniques for direct medical and non-medical costs associated with alternative screening approaches using one of three initial screening tests: simple visual screening, HPV DNA testing, and cervical cytology. Here, we report estimation methods and results for three cost areas in which data were lacking. Methods To supplement direct medical costs, including staff, supplies, and equipment depreciation using country-specific data, we used alternative techniques to quantify cervical cytology and HPV DNA laboratory sample processing costs. We used a detailed quantity and price approach whose face validity was compared to an adaptation of a US laboratory estimation methodology. This methodology was also used to project annual sample processing capacities for each laboratory type. The cost of sample transport from the clinic to the laboratory was estimated using spatial models. A plausible range of the cost of patient time spent seeking and receiving screening was estimated using only formal sector employment and wages as well as using both formal and informal sector participation and country-specific minimum wages. Data sources included primary data from country-specific studies, international databases, international prices, and expert opinion. Costs were standardized to year 2000 international dollars using inflation adjustment and

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

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    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

  11. 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

  12. Predictors of low cervical cancer screening among immigrant women in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Moineddin Rahim

    2011-05-01

    Full Text Available Abstract Background Disparities in cervical cancer screening are known to exist in Ontario, Canada for foreign-born women. The relative importance of various barriers to screening may vary across ethnic groups. This study aimed to determine how predictors of low cervical cancer screening, reflective of sociodemographics, the health care system, and migration, varied by region of origin for Ontario's immigrant women. Methods Using a validated billing code algorithm, we determined the proportion of women who were not screened during the three-year period of 2006-2008 among 455 864 identified immigrant women living in Ontario's urban centres. We created eight identical multivariate Poisson models, stratified by eight regions of origin for immigrant women. In these models, we adjusted for various sociodemographic, health care-related and migration-related variables. We then used the resulting adjusted relative risks to calculate population-attributable fractions for each variable by region of origin. Results Region of origin was not a significant source of effect modification for lack of recent cervical cancer screening. Certain variables were significantly associated with lack of screening across all or nearly all world regions. These consisted of not being in the 35-49 year age group, residence in the lowest-income neighbourhoods, not being in a primary care patient enrolment model, a provider from the same region, and not having a female provider. For all women, the highest population-attributable risk was seen for not having a female provider, with values ranging from 16.8% [95% CI 14.6-19.1%] among women from the Middle East and North Africa to 27.4% [95% CI 26.2-28.6%] for women from East Asia and the Pacific. Conclusions To increase screening rates across immigrant groups, efforts should be made to ensure that women have access to a regular source of primary care, and ideally access to a female health professional. Efforts should also be made

  13. Perception and utilization of cervical cancer screening services among female nurses in University College Hospital, Ibadan, Nigeria

    OpenAIRE

    Arulogun, Oyedunni Sola; Maxwell, Opemipo Olubunmi

    2012-01-01

    Background Cervical Cancer (CC) is the second most common cancer among women with early detection and prompt treatment as best management options. Female nurses have crucial roles to play in promoting the utilization of Cervical Cancer Screening Services (CCSS), yet little information exist regarding their perception and utilization of these services. The CCSS related knowledge, perception and utilization among female nurses at the University College Hospital, (UCH) Ibadan, Nigeria were there...

  14. Perception And Attitude About Breast And Cervical Cancer Screening Among Muslim Women In A Midwest University Campus

    OpenAIRE

    Yeasmeen, Tahira

    2013-01-01

    Early detection of breast and cervical cancer through mammograms and Pap smears can improve survival rates. Muslim women in the United States are faced with traditional beliefs and diverse socioeconomic and cultural backgrounds that may affect their knowledge and perceptions about these cancer screening practices. The objective of this study is to determine the overall health status and participation rates, knowledge, and perceptions about, and barriers to, breast and cervical cancer screenin...

  15. The impact of universal newborn hearing screening on longterm literacy outcomes: A prospective cohort study

    OpenAIRE

    Pimperton, H; Blythe, H.; Kreppner, J.; Mahon, H. M.; Stevenson, J.; Terletski, E.; Worsfold, S.; Yuen, H M; Kennedy, C

    2016-01-01

    Objective: To determine whether the benefits of universal newborn hearing screening (UNHS) seen at age 8 years persist through the second decade. Design: Prospective cohort study of a population sample of children with permanent childhood hearing impairment (PCHI) followed up for 17 years since birth in periods with (or without) UNHS. Setting: Birth cohort of 100 000 in southern England. Participants: 114 teenagers aged 13–19 years, 76 with PCHI and 38 with normal hearing. All had previously ...

  16. Sources of Information that Promote Breast and Cervical Cancer Knowledge and Screening Among Native Hawaiians in Southern California

    Science.gov (United States)

    Mouttapa, Michele; Ichinose, Travers Y.; Pang, Jane Ka'ala; Ueda, Dawn; Tanjasiri, Sora Park

    2013-01-01

    Breast and cervical cancers are the second and fourth leading causes of cancer death among Asian and Pacific Islander women. Despite screening exams that can detect these cancers early and increase survival, racial and ethnic populations continue to be disproportionately affected. This study examined the sources of information and their impacts on cancer screening compliance among native Hawaiians in Orange County, California. A community-based participatory research approach was used to conceive, design, implement, and analyze data. A relatively small proportion of the study's native Hawaiian women were compliant with recommended breast and cervical cancer screenings, and their screening rates were below the national Healthy People 2010 standards. Knowledge of screening procedures, seeking advice from a doctor, and obtaining information from internet medical sites were associated with higher rates of compliance with cancer-screening procedures. PMID:20237883

  17. Breast and Cervical Cancer Screening in Women Referred to Urban Healthcare Centers in Kerman, Iran, 2015.

    Science.gov (United States)

    Ahmadipour, Habibeh; Sheikhizade, Sahar

    2016-01-01

    Breast and cervical cancers are among leading causes of morbidity and mortality in women worldwide. Regular screening is very important for early detection of these cancers, but studies indicate low rates of screening participation. In this survey we studied the rate of screening participation among women 18-64 years old referred to urban health centers in Kerman, Iran in 2015. A cross-sectional study was carried out on 240 women who were selected using a multistage sampling method. Data collected using a questionnaire covered demographics and questions about common cancer screening status in women. Analysis was by SPSS 19. The mean age of participants was 31.7± 7. Most (97.1%) were married, housewives (83.3%), had high school diploma (43.8%) and a monthly income more than ten million Rls. The frequency of the Pap test performance was higher in women who were employed and with a university degree (pperformance in women over 40 years was also higher in women with university degree (p0.05). Our study found that the rate of screening participation among women is low. Investigation of the barriers, increasing the awareness of women about the importance and advantages of screening and also more incentives for health personnel especially family physicians to pay more attention to preventive programs could be effective. PMID:27165219

  18. 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

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

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    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.

  20. The Influence of Absolute and Comparative Risk Perceptions on Cervical Cancer Screening and the Mediating Role of Cancer Worry.

    Science.gov (United States)

    Zhao, Xinyan; Nan, Xiaoli

    2016-01-01

    This research investigates the interrelationships between cancer risk perceptions (absolute and comparative risk perceptions), cancer worry, and cervical cancer screening. Using a nationally representative survey data set (N = 2,304) from the 2012 Health Information National Trends Survey Circle 1, we found that although neither absolute risk perceptions nor comparative risk perceptions exerted a direct impact on women's compliance with the cervical cancer screening recommendation (i.e., that women ages 21 to 65 obtain Pap smear every 3 years; U.S. Preventive Services Task Force, 2012 ), both types of risk perceptions had an indirect effect on cervical cancer screening through the mediation of cancer worry. These results suggest a primal role of affect in health decision making. Implications of the findings for cancer risk communication are discussed. PMID:26312444

  1. Effectiveness of three interventions in improving adherence to cervical cancer screening.

    Science.gov (United States)

    López-Torres Hidalgo, Jesús; Sánchez Ortiz, María P; Rabanales Sotos, Joseba; Simarro Herráez, María J; López-Torres López, Jaime; Campos Rosa, Monchi

    2016-09-01

    In countries where cervical cancer screening programmes are conducted on an opportunistic basis, an active search for women at risk should be made to increase coverage. The objective of our study was to assess the effectiveness of three primary care interventions consisting of providing written, telephone and face-to-face information to increase screening participation among women over the age of 25 years. A randomized experimental study with only one post-test control group was conducted on women aged 25-70 years. A total of 1676 women were randomly distributed into four groups and the following interventions were implemented: written briefing; telephone briefing; an invitation to attend a group meeting and no briefing (control group). The women were evaluated 2 years after the intervention. The outcome variable was participation or nonparticipation in cervical cancer screening. It proved possible to interview a total of 1122 women. Among the groups, homogeneity was tested in terms of sociodemographic characteristics and health-related variables. Women who had undergone cytological testing in the 2 years preceding evaluation had a lower mean age (P<0.001) than women who had not done so (45.5±11.0 vs. 48.8±13.0 years). The proportion of women who had participated in screening was as follows: 35.3% in the written information group [95% confidence interval (CI) 29.8-40.9]; 38.4% in the telephone information group (95% CI 32.5-44.2); 29.3% in the face-to-face information group (95% CI 22.8-35.7) and 26.1% in the control group (95% CI 21.2-30.9), with this difference proving statistically significant (P=0.005). Logistic regression showed that only the interventions based on written or telephone briefing were effective vis-à-vis the control group. In conclusion, both written and telephone information can serve to improve women's participation in opportunistic cervical cancer screening. Current preventive strategies could be optimized by means of simple interventions

  2. 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.

  3. Stapled versus hand-sewn cervical esophagogastric anastomosis in patients undergoing esophagectomy: A Retrospective Cohort Study

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    Pramod Kumar Mishra

    2016-02-01

    Conclusion: Both hand sewn and stapled anastomotic techniques are equally effective way of performing a cervical esophagogastric anastomosis. However, patients having anastomotic leak develop anastomotic stricture more often in those having hand-sewn anastomosis compared to stapled anastomosis.

  4. Stapled versus hand-sewn cervical esophagogastric anastomosis in patients undergoing esophagectomy: A Retrospective Cohort Study

    OpenAIRE

    Pramod Kumar Mishra; Harsh Shah; Nikhil Gupta; Vaibhav Varshney; Nilesh Sadashiv Patil; Amit Jain; Sundeep Singh Saluja

    2016-01-01

    Introduction: Anastomotic leak is one of the main causes of morbidity following esophageal resection for carcinoma of the esophagus and gastroesophageal junction. We compared hand sewn and stapled cervical esophagogastric anastomotic techniques in terms of postoperative complications. Methods: All patients who underwent esophagectomy with cervical esophagogastric anastomosis at a single academic center from 2004 to 2014 were included in the study. Both early and late complications were ana...

  5. Prevent cervical cancer by screening with reliable human papillomavirus detection and genotyping

    International Nuclear Information System (INIS)

    The incidence of cervical cancer is expected to rise sharply in China. A reliable routine human papillomavirus (HPV) detection and genotyping test to be supplemented by the limited Papanicolaou cytology facilities is urgently needed to help identify the patients with cervical precancer for preventive interventions. To this end, we evaluated a nested polymerase chain reaction (PCR) protocol for detection of HPV L1 gene DNA in cervicovaginal cells. The PCR amplicons were genotyped by direct DNA sequencing. In parallel, split samples were subjected to a Digene HC2 HPV test which has been widely used for “cervical cancer risk” screen. Of the 1826 specimens, 1655 contained sufficient materials for analysis and 657 were truly negative. PCR/DNA sequencing showed 674 infected by a single high-risk HPV, 188 by a single low-risk HPV, and 136 by multiple HPV genotypes with up to five HPV genotypes in one specimen. In comparison, the HC2 test classified 713 specimens as infected by high-risk HPV, and 942 as negative for HPV infections. The high-risk HC2 test correctly detected 388 (57.6%) of the 674 high-risk HPV isolates in clinical specimens, mislabeled 88 (46.8%) of the 188 low-risk HPV isolates as high-risk genotypes, and classified 180 (27.4%) of the 657 “true-negative” samples as being infected by high-risk HPV. It was found to cross-react with 20 low-risk HPV genotypes. We conclude that nested PCR detection of HPV followed by short target DNA sequencing can be used for screening and genotyping to formulate a paradigm in clinical management of HPV-related disorders in a rapidly developing economy

  6. 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

    also reduced the burden of cervical cancer in some, but not all, of the other old member states (belonging to the European Union since 1995) but at a cost that is several times greater. Well organised screening programmes have the potential to achieve greater participation of the target population...... at regular intervals, equity of access and high quality. Despite the consistent evidence that organised screening is more efficient than non-organised screening, and in spite of the Cancer Screening Recommendations of the European Council, health authorities of eight old member states (Austria, Belgium......, France, Germany, Greece, Luxembourg, Portugal and Spain) have not yet started national organised implementation of screening for cervical cancer. A decision was made by the Irish government to extend their pilot programme nationally while new regional programmes commenced in Portugal and Spain...

  7. Evaluation of chemotherapy response with serum squamous cell carcinoma antigen level in cervical cancer patients: a prospective cohort study.

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    Mingzhu Yin

    Full Text Available MRI does not always reflect tumor response after chemotherapy. Therefore, it is necessary to explore additional parameters to more accurately evaluate tumor response for the subsequent clinical determination about radiotherapy or radical surgery. A training cohort and an external validation cohort were used to examine the predictive performance of SCC-ag to evaluate tumor response from teaching hospital of Harbin Medical University. The study included 397 women with SCC (age: 28-73 years. Patients consecutively enrolled between August 2008 and January 2010 (n = 205 were used as training cohort. Patients consecutively enrolled between February 2010 and May 2011 (n = 192 were used as validation cohort. A multivariate regression analysis of the data from the training cohort indicated that serum SCC-ag level is an independent factor for neo-adjuvant chemotherapy (NACT response. Analysis of the data from the validation cohort suggested that chemotherapy response could be more accurately predicted by SCC-ag than by magnetic resonance imaging (MRI (sensitivity (Se: 0.944 vs. 0.794; specificity (Sp: 0.727 vs. 0.636; positive predictive value (PPV: 0.869 vs. 0.806; negative predictive value (NPV: 0.873 vs. 0.618; the area under ROC curve (AUC: 0.898 vs. 0.734. Combining SCC-ag with MRI was more powerful than MRI alone (Se: 0.952 vs. 0.794; Sp: 0.833 vs. 0.636; PPV: 0.916 vs. 0.806; NPV: 0.902 vs. 0.618; AUC: 0.950 vs. 0.734. Our study indicates that serum SCC-ag level is a sensitive and reliable measure to evaluate cervical cancer response to chemotherapy. Using SCC-ag in combination with MRI findings further improves the predictive power.

  8. 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.

  9. Agreement Between Visual Inspection with Acetic Acid and Papanicolaous Smear as Screening Methods for Cervical Cancer

    International Nuclear Information System (INIS)

    Objective: To determine degree of agreement between visual inspection with acetic acid (VIA) and Papanicolaous (Pap) smear as screening methods for cervical cancer. Study Design: A cross-sectional study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Sir Ganga Ram Hospital, Lahore, from July to December 2012. Methodology: Two hundred and fifty women in reproductive age group presenting with various gynaecological complaints were included in the study. A Papanicolaous smear was taken and visual inspection with 5% acetic acid was done. VIA was reported as positive or negative according to acetowhite changes and cytology result was graded as CIN 1, 2, 3 and squamous carcinoma. Those women who showed positive result with either VIA or Pap smear or both were further subjected to colposcopic directed biopsy which was taken as gold standard. Results were computed using Statistical Package for Social Sciences (SPSS) version 16 and statistical test used was kappa. Results: Out of 250 women, VIA was positive in 55 (22%) patients and Pap smear was abnormal in 27 (10.8%). Histological diagnosis of CIN/cancer was made in 36 out of a total 62 patients who underwent biopsy. Conclusion: There was a fair agreement between VIA and Pap smear, with VIA detecting more abnormalities than cytology. In the absence of Pap smear availability, VIA may be a reasonable cervical cancer screening method, especially in low resource settings. (author)

  10. Clinical and radiographic results of cervical artificial disc arthroplasty: over three years follow-up cohort study

    Institute of Scientific and Technical Information of China (English)

    TIAN Wei; HAN Xiao; LIU Bo; LI Qin; HU Lin; LI Zhi-yu; YUAN Qiang; HE Da; XING Yong-gang

    2010-01-01

    Background Theoretic advantages of cervical disc arthroplasty include preservation of normal motion and biomechanics in the cervical spine, and reduction of adjacent-segment degeneration. The clinical and radiographic effects of cervical disc arthroplasty in short term have been ascertained. The aim of this study is to research the data of mid-term results.Methods In this prospective cohort study, 50 patients who underwent cervical disc arthroplasty from December 2003 to January 2006 were enrolled. There were 39 patients who received 1-level disc arthroplasty, and 11 patients received 2-level disc arthroplasty, with an average age of 50.9 years (range from 29 to 73). The median follow-up was 41.85months (range from 36.00-55.63 months). Patients were followed prospectively with respect to their symptoms,neurologic signs, and radiographic results.Results The median value of Japanese Orthopaedic Association (JOA) score was 14.0 before surgery, and 16.5 at the most recent follow-up (P <0.01). The median value of the recovery rate of the JOA score was 92.2%. The preoperative range of motion (ROM) at the indexed level was (10.40±4.97)°, which has significantly correlated with the most recent follow-up ROM which was (8.56±4.76)° (P <0.05, r=0.33). The ROM at the operative level at the most recent follow-upwas greater than the value at the 3-month follow-up of (7.52±3.37)° (P <0.05). The preoperative functional spinal unit (FSU) angulation was (-0.96±6.52)°, which was not significantly correlated with that of the most recent follow-up value of (-2.65±7.95)° (P <0.01, r=0.53). The preoperative endplate angulation was (2.61±4.85)°, which had no significant correlation with that of the most recent follow-up value of (0.71±6.41)° (p >0.05).Conclusions The clinical and radiographic results of cervical disc arthroplasty are good in mid-term follow-up. The normal range of motion of the operated level and the biomechanics in the cervical spine are well

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

    Directory of Open Access Journals (Sweden)

    von der Schulenburg, Johann-Matthias

    2007-08-01

    Full Text Available 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.

  12. 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

  13. Screening for cervical cancer: new alternatives and research Detección oportuna de cáncer cervical: nuevas alternativas y pautas de investigación

    OpenAIRE

    Lörincz, Attila T.

    2003-01-01

    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 stu...

  14. Effect of an antepartum Pap smear on the coverage of a cervical cancer screening programme: a population-based prospective study

    Directory of Open Access Journals (Sweden)

    Thoresen Steinar Ø

    2007-01-01

    Full Text Available Abstract Background Almost one-third of Norwegian women aged 25–69 years invited to have a Pap smear do not attend during the recommended period, and thus constitute a population with high-risk of cervical cancer (CC. Since the incidence of precancerous lesions of the cervix peak with occurrence of pregnancies within the same decade in women aged 25 to 35 years of age, antepartum care presents an opportunity to offer a Pap smear thereby increasing the coverage of the programme. The study objective was to describe the effect of the antepartum Pap smear on the coverage of a cytological CC screening programme. Methods Among 2 175 762 women resident in Norway in 31.12.1996, all women who gave birth in 1996–7 were identified from the Medical Birth Registry of Norway. Attendance to the cervical cancer screening was assessed by linkage to the Cytology Registry separately for the pregnant and non-pregnant women cohorts. The results were stratified by age, history of previous Pap smear and history of invitation to the CC screening programme. Logistic regression was used to estimate the relative probabilities of having a Pap smear adjusted for age, screening history, and time since invitation, for pregnant and non-pregnant women, respectively. Results 69% of the pregnant women had a Pap smear during one year of follow-up since beginning of the pregnancy with the majority taken during the antepartum period. Irrespectively of age or history of having a Pap smear, pregnant women were 4.3 times more likely to have a Pap smear during follow-up compared to non-pregnant women. 63.2% of the pregnant women had a smear as response to the invitation letter compared to 28.7% of the non-pregnant women, OR = 2.1 (95% CI 1.9 to 2.4. As an indication of "over-screening", 5397 pregnant women (57.8% with a smear shortly before the start of follow-up also had a new Papsmear, compared to 83 023 (32.3% in non-pregnant. Conclusion Pap smear screening during pregnancy

  15. Functional health literacy in Spanish-speaking Latinas seeking breast cancer screening through the National Breast and Cervical Cancer Screening Program

    OpenAIRE

    Samantha Garbers; Karen Schmitt; Anne Marie Rappa; Mary Ann Chiasson

    2010-01-01

    Samantha Garbers1, Karen Schmitt2, Anne Marie Rappa2, Mary Ann Chiasson11Public Health Solutions, New York, NY, USA; 2Columbia University Breast Cancer Screening Program, New York, NY, USABackground: This analysis examines the association between functional health literacy and follow-up after mammography among women receiving breast cancer screening at a National Breast and Cervical Cancer Early Detection Program site in New York City that provides universal bilingual case management.Methods:...

  16. Cervical screening: do gynecologists themselves practice what they preach? a study based in tertiary care hospitals of Lahore

    International Nuclear Information System (INIS)

    To determine the frequency of self-compliance to cervical screening guidance among the sexually active female gynecologists in tertiary care hospitals. To identify the possible barriers to effective screening in those who do not undergo cervical screening. Study Design: Cross sectional study. Place and Duration of Study: This study was conducted in the Obstetrics and Gynecology department of various tertiary care hospitals of Lahore from 1st Jun 2012 to 30th Nov 2012. Patients and Methods: Total 157 female gynecologists, serving in various positions in tertiary care hospitals of Lahore were interviewed by using a structured self reporting performa. The performa was designed to find out the number of gynecologists undergoing pap screening, and in those who fail to undergo screening the single most important barrier presumed to be preventing them from undergoing screening was also evaluated. Results: In this study, only 3.1% of the subject population was found to be undergoing pap-screening, which reflects the national level of screening in urban areas, in sharp contrast to the studies being conducted in developed countries, with screening coverage rates of more than 80%. Conclusion: The prevalence of pap screening in the subject population is disappointingly low and drastic steps are needed to bring about a change in attitude of the subject population which cannot be brought about without changing the current culture of self-negligence and least prioritization for self, in the feminine part of our society. (author)

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

    Science.gov (United States)

    Enerly, Espen; Bonde, Jesper; Schee, Kristina; Pedersen, Helle; Lönnberg, Stefan; Nygård, Mari

    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 to be part of the intervention group. Women in this group received one of two self-sampling devices, Evalyn Brush or Delphi Screener. To attend screening, women in the intervention group had the option of using the self-sampling device (self-sampling subgroup) or visiting their physician for a cervical smear. Self-sampled specimens were split and analyzed for the presence of high-risk (hr) HPV by the CLART® HPV2 test and the digene® Hybrid Capture (HC)2 test. The control group consisted of 2593 women who received a 2nd reminder letter according to the current guidelines of the NCCSP. The attendance rates were 33.4% in the intervention group and 23.2% in the control group, with similar attendance rates for both self-sampling devices. Women in the self-sampling subgroup responded favorably to both self-sampling devices and cited not remembering receiving a call for screening as the most dominant reason for previous non-attendance. Thirty-two of 34 (94.1%) hrHPV-positive women in the self-sampling subgroup attended follow-up. In conclusion, self-sampling increased attendance rates and was feasible and well received. This study lends further support to the proposal that self-sampling may be a valuable alternative for increasing cervical cancer screening coverage in Norway. PMID:27073929

  18. Adherence barriers and facilitators for cervical screening amongst currently disadvantaged women in the greater Cape Town region of South Africa

    Directory of Open Access Journals (Sweden)

    Chantelle De Abreu

    2013-01-01

    Full Text Available Background: In South Africa cervical cancer is the second most commonly occurring cancer amongst women, and black African women have the highest risk of developing this disease. Unfortunately, the majority of South African women do not adhere to recommended regular cervical screening.Objectives: The purpose of this research was to explore the perceptions, experiences and knowledge regarding cervical screening of disadvantaged women in two informal settlements in South African urban areas.Method: The Health Belief Model (HBM provided a theoretical framework for this study. Four focus groups (n = 21 were conducted, using questions derived from the HBM, and thematic analysis was used to analyse the data. The ages of the women who participated ranged from 21 to 53 years.Results: The analysis revealed lack of knowledge about screening as a key structural barrier to treatment. Other structural barriers were: time, age at which free screening is available, and health education. The psychosocial barriers that were identified included: fear of the screening procedure and of the stigmatisation in attending screening. The presence of physical symptoms, the perception that screening provides symptom relief, HIV status, and the desire to know one’s physical health status were identified as facilitators of cervical screening adherence.Conclusion: This knowledge has the potential to inform healthcare policy and services in South Africa. As globalisation persists and individuals continue to immigrate or seek refugee status in foreign countries, increased understanding and knowledge is required for successful acculturation and integration. Developed countries may therefore also benefit from research findings in developing countries.

  19. Intent to Participate in Future Cervical Cancer Screenings Is Lower when Satisfaction with the Decision to Be Vaccinated Is Neutral

    OpenAIRE

    Alexander, Natalie Marya; Harper, Diane Medved; Comes, Johanna Claire; Smith, Melissa Smith; Heutinck, Melinda Ann; Handley, Sandra Martin; Ahern, Debra Ann

    2014-01-01

    Background 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. Methods and Findings 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...

  20. 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…

  1. [Knowledge and attitudes of medical students at the end of their curriculum, towards breast and cervical cancer screening].

    Science.gov (United States)

    Hsairi, Mohamed; Gobrane, Heger Ben; Alaya, Nissaf Ben; Bellaaj, Ridha; Achour, Noureddine

    2007-01-01

    This study assesses knowledge and attitudes of medical students of the faculty of medicine of Tunis, at the end of their medical curriculum, towards breast and cervical cancer screening. Among the 644 medical students at the end of their curriculum, 592 answered to anonymous questionnaire (response rate = 92%). Results show that 34.1% have proposed systematic cervical cancer screening. This proportion was 61.0% for clinical breast cancer examination. The majority of students (70.2%) proposed to start this cervical screening since the first sexual activities. As for the periodicity of this screening, 44.2% are favourable for a yearly periodicity, 39.2% for every three years, 7.2% for every five years and 9.4% for a periodicity at least once in life. 94.1% of students declared to have learned clinical breast examination, contrarily to pap smear, for which this proportion was only 55.1%. Breast and cervical cancer control training, in the faculty of medicine of Tunis, is insufficient and should be improved and restructured. PMID:17561734

  2. 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…

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

    Science.gov (United States)

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

    2016-01-01

    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. PMID:26755465

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

    DEFF Research Database (Denmark)

    Møller, Johanne Cecilie Rask; Lynge, Elsebeth; Franzmann, Maria;

    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 ...... 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 in a...... 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...

  5. Barriers for Compliance to Breast, Colorectal, and Cervical Screening Cancer Tests among Hispanic Patients

    Science.gov (United States)

    Miranda-Diaz, Christine; Betancourt, Elba; Ruiz-Candelaria, Yelitza; Hunter-Mellado, Robert F.

    2015-01-01

    Hispanics are less likely to undergo screening tests for colorectal cancer and cervical cancer than non-Hispanic whites. Compliance with mammography, fecal occult blood testing (FOBT), colonoscopy, and cervical smears (PAP) and barriers for compliance were studied. A descriptive study was performed with 194 ambulatory patients while they attended routine medical visits. Women are more likely than men to undergo a colonoscopy. Conversely, FOBT was most likely reported by men. Reasons for compliance with FOBT differed by gender. Men were most likely to avoid FOBT due to lack of knowledge whereas women reported that physicians do not recommend the procedure. Both men and women reported that lack of physician’s recommendation was their primary reason for not undergoing a colonoscopy. Men tend to report lack of knowledge about colonoscopy procedure. A higher mammogram utilization rate was reported by women older than 40 years. PAP smears were reported by 74% of women older than 21 years. The major reasons for avoiding mammography and PAP tests were having a busy schedule, fear, and feeling uncomfortable during the procedure. In a multivariate regression analysis, occupational status was found to be a predictor for compliance with FOBT and colonoscopy. PMID:26703676

  6. Barriers for Compliance to Breast, Colorectal, and Cervical Screening Cancer Tests among Hispanic Patients

    Directory of Open Access Journals (Sweden)

    Christine Miranda-Diaz

    2015-12-01

    Full Text Available Hispanics are less likely to undergo screening tests for colorectal cancer and cervical cancer than non-Hispanic whites. Compliance with mammography, fecal occult blood testing (FOBT, colonoscopy, and cervical smears (PAP and barriers for compliance were studied. A descriptive study was performed with 194 ambulatory patients while they attended routine medical visits. Women are more likely than men to undergo a colonoscopy. Conversely, FOBT was most likely reported by men. Reasons for compliance with FOBT differed by gender. Men were most likely to avoid FOBT due to lack of knowledge whereas women reported that physicians do not recommend the procedure. Both men and women reported that lack of physician’s recommendation was their primary reason for not undergoing a colonoscopy. Men tend to report lack of knowledge about colonoscopy procedure. A higher mammogram utilization rate was reported by women older than 40 years. PAP smears were reported by 74% of women older than 21 years. The major reasons for avoiding mammography and PAP tests were having a busy schedule, fear, and feeling uncomfortable during the procedure. In a multivariate regression analysis, occupational status was found to be a predictor for compliance with FOBT and colonoscopy.

  7. Barriers for Compliance to Breast, Colorectal, and Cervical Screening Cancer Tests among Hispanic Patients.

    Science.gov (United States)

    Miranda-Diaz, Christine; Betancourt, Elba; Ruiz-Candelaria, Yelitza; Hunter-Mellado, Robert F

    2016-01-01

    Hispanics are less likely to undergo screening tests for colorectal cancer and cervical cancer than non-Hispanic whites. Compliance with mammography, fecal occult blood testing (FOBT), colonoscopy, and cervical smears (PAP) and barriers for compliance were studied. A descriptive study was performed with 194 ambulatory patients while they attended routine medical visits. Women are more likely than men to undergo a colonoscopy. Conversely, FOBT was most likely reported by men. Reasons for compliance with FOBT differed by gender. Men were most likely to avoid FOBT due to lack of knowledge whereas women reported that physicians do not recommend the procedure. Both men and women reported that lack of physician's recommendation was their primary reason for not undergoing a colonoscopy. Men tend to report lack of knowledge about colonoscopy procedure. A higher mammogram utilization rate was reported by women older than 40 years. PAP smears were reported by 74% of women older than 21 years. The major reasons for avoiding mammography and PAP tests were having a busy schedule, fear, and feeling uncomfortable during the procedure. In a multivariate regression analysis, occupational status was found to be a predictor for compliance with FOBT and colonoscopy. PMID:26703676

  8. 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.

  9. Comparison of visual inspection of cervix and pap smear for cervical cancer screening

    International Nuclear Information System (INIS)

    Objective: To evaluate the performance of visual inspection of cervix (VIA) after application of 3% acetic acid in cervical cancer screening in comparison with PAP smear. Results: Out of 540 subjects, 356 were negative with both screening techniques. One hundred and fifty-six subjects were positive with VIA (28.9%) while PAP smear was positive in seventy-eight subjects (14.4%). The sensitivity of VIA was 93.9% and of PAP smear was 46.9%. Corresponding specificities were 30.4% and 69.5%. There was no significant difference between the positive predictive value (PPV) of both test (p<0.05). The accuracy of VIA was 77.5% compared to 52.8% of PAP smear. The difference was highly significant (p < 0.01). Conclusion: These results indicate that VIA is more sensitive and has a higher accuracy as compared to PAP smear. It could, therefore, be valuable in detection of precancerous lesions of cervix. Low cost, easy applicability and immediate results make VIA a useful screening test in developing countries like Pakistan as compared to PAP smear. (author)

  10. Get Tested for Cervical Cancer

    Science.gov (United States)

    ... Cervical Cancer Print This Topic En español Get Tested for Cervical Cancer Browse Sections The Basics Overview ... be cured. How often should I get screened (tested)? How often you should get screened for cervical ...

  11. [Primary peripheral T-cell lymphoma of the vagina incidentally found at cervical cancer screening].

    Science.gov (United States)

    Isobe, Rei; Mituishi, Toshimi; Omote, Mayuko; Mori, Yuichi; Ida, Koichi; Oguchi, Osamu; Nakai, Ikuko; Oguchi, Masahiko

    2016-01-01

    A 50-year-old woman was referred to our hospital because a mass lesion had been palpable through the vaginal wall during a cervical cancer screening examination. A contrast-enhanced computed tomography (CT) scan and magnetic resonance imaging (MRI) revealed marked thickening of the vaginal wall, constituting a mass 96 mm in diameter. Abnormal FDG uptake was observed in the vaginal mass, but no other lesions were detected by positron emission tomography (PET/CT). A transvaginal biopsy from the tumor revealed peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS). Although endoscopic examinations revealed no signs of infiltration in either the bladder or the rectum, the MRI findings suggested invasion into the adjacent rectal wall. She achieved complete remission after six courses of biweekly THP-COP therapy, to which field radiation (39.6 Gy) was added. PTCL of the vagina is rare and this case therefore merits description in the literature. PMID:26861099

  12. Cellphone based mobile colposcope for the evaluation of women with abnormal cervical cancer screening

    Science.gov (United States)

    Kahn, Bruce S.; Kass, Alex J.; Waalen, Jill; Levitz, David

    2015-03-01

    Objective: Compare an inexpensive cell-phone based Mobile Colposcope, with a standard colposcope in the evaluation of women with abnormal Pap smear screening. Methodology: The study was a prospective, parallel noninferiority trial. Thirty women underwent colposcopy for the evaluation of an abnormal Pap smear. After application of acetic acid, images of the cervix were obtained with both a standard colposcope and the Mobile Colposcope. An additional set of images using both devices were obtained using the red-free (green filter) mode. Eight experienced gynecologists then evaluated 100 paired images (plain and green filter) from two different sites in random order using a web based assessment program. After reviewing each set of paired images, the expert would make an assessment of: 1) normal (no biopsy/ random biopsy), or 2) abnormal. For abnormal images, the expert then electronically marked the site(s) on the image where a biopsy was recommended. In image analysis, the cervical image was divided into 12 radial sectors and the marked sites for biopsy on the matched pairs were compared. Matched pairs that were considered normal, or those where biopsy site recommendations were within +/- 30° were considered equivalent; unmatched biopsy sites were considered non-equivalent. Results were compared using Wilcoxon Matched Pairs Signed Ranks Test. Expert assessment of Mobile Colposcope images compared with assessment by standard colposcope is currently onging. Conclusions: if the Mobile Colposcope demonstrates non-inferiority to imaging obtained with a standard colposcope and due to its low cost, it has the potential help improve cervical cancer screening in low resource settings.

  13. 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.

  14. 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

  15. 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

    2016-06-01

    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. PMID:26671002

  16. Evaluation of novel assays for the detection of human papilloma virus in self-collected samples for cervical cancer screening.

    Science.gov (United States)

    Chen, Q; Du, H; Zhang, R; Zhao, J H; Hu, Q C; Wang, C; Wang, G X; Tang, J L; Wu, R F

    2016-01-01

    The aim of this study was to evaluate the performance of three new high-risk human papillomavirus (HPV) assays for primary cervical cancer screening, by using self-collected samples, and to identify an HPV assay that could overcome the major obstacles faced during large-scale population-based screening. Two hundred and ten women showing abnormal cervical cytology (and referred for a colposcopy) were recruited in this study. Self-collected samples obtained from all women were tested with the Cobas, Seq, and BioPerfectus Multiplex Real Time HPV assays; simultaneously, clinician-collected samples (from the same women) were tested with the gold-standard Cobas HPV assay. The results of all the assays were consistent. The sensitivity, positive predictive value, and negative predictive value for cervical intraepithelial neoplasia 2+ (CIN2+) and CIN3+ were comparable between the self-collected samples tested with the three new assays and the clinician-collected samples tested with the Cobas HPV assay (P > 0.05). The single-genotype HPV load per sample did not differ significantly between the self- and clinician-collected samples (P = 0.195). In conclusion, the results of this study demonstrated the applicability of the three new HPV assays for primary cervical cancer screening based on self-collection. PMID:27420961

  17. Socioeconomic disparities in the uptake of breast and cervical cancer screening in Italy: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Damiani Gianfranco

    2012-02-01

    Full Text Available Abstract Background Breast and cervical cancer screening are widely recognized as effective preventive procedures in reducing cancer mortality. The aim of this study was to evaluate the impact of socioeconomic disparities in the uptake of female screening in Italy, with a specific focus on different types of screening programs. Methods A cross-sectional study was conducted using data from the 2004-2005 national health interview survey. A sample of 15, 486 women aged 50-69 years for mammography and one of 35, 349 women aged 25-64 years for Pap smear were analysed. Logistic regression models were used to estimate the association between socioeconomic factors and female screening utilization. Results Education and occupation were positively associated with attendance to both screening. Women with higher levels of education were more likely to have a mammogram than those with a lower level (OR = 1.28; 95% CI = 1.10-1.49. Women of intermediate and high occupational classes were more likely to use breast cancer screening (OR = 1.77; 95% CI = 1.55-2.03, OR = 1.63; 95% CI = 1.40-1.91 compared to unemployed women. Women in the highest occupational class had a higher likelihood of cervical cancer screening compared to those in the lowest class (OR = 1.81; 95% CI = 1.63-2.01. Among women who attended screening, those with lower levels of education and lower occupational classes were more likely than more advantaged women to attend organized screening programs rather than being screened on the basis of their own initiative. Conclusions Inequalities in the uptake of female screening widely exist in Italy. Organized screening programs may have an important role in increasing screening attendance and tackling inequalities.

  18. Stapled versus hand-sewn cervical esophagogastric anastomosis in patients undergoing esophagectomy: A Retrospective Cohort Study

    Science.gov (United States)

    Mishra, Pramod Kumar; Shah, Harsh; Gupta, Nikhil; Varshney, Vaibhav; Patil, Nilesh Sadashiv; Jain, Amit; Saluja, Sundeep Singh

    2016-01-01

    Introduction Anastomotic leak is one of the main causes of morbidity following esophageal resection for carcinoma of the esophagus and gastroesophageal junction. We compared hand sewn and stapled cervical esophagogastric anastomotic techniques in terms of postoperative complications. Methods All patients who underwent esophagectomy with cervical esophagogastric anastomosis at a single academic center from 2004 to 2014 were included in the study. Both early and late complications were analyzed. Results 153 patients underwent resection for carcinoma of the esophagus and gastroesophageal junction. Of these 140 patients had esophagectomy with cervical esophagogastric anastomosis. 66 patients underwent a hand sewn anastomosis and 74 patients had a side-to-side stapled anastomosis fashioned. Both groups were comparable with respect to preoperative characteristics. There was no difference in the operative blood loss and T and N stage of the disease. The overall morbidity and mortality was 32.8% and 6.4%, respectively. Overall leak rate was 17%. There was no difference in the leak rates among two groups (12 in the hand-sewn group & 12 in the Stapled stapled group; p = 0.82). The rate of anastomotic stricture was significantly higher for the hand sewn group (16.1% vs 4.3%; p = 0.03) at median follow up of 30 months. Conclusion Both hand sewn and stapled anastomotic techniques are equally effective way of performing a cervical esophagogastric anastomosis. However, patients having anastomotic leak develop anastomotic stricture more often in those having hand-sewn anastomosis compared to stapled anastomosis. PMID:27222711

  19. Limitations of widely used high-risk human papillomavirus laboratory-developed testing in cervical cancer screening

    Directory of Open Access Journals (Sweden)

    Naryshkin S

    2012-11-01

    Full Text Available Sonya Naryshkin,1 R Marshall Austin21Department of Pathology, Mercy Health System, Janesville, WI; 2Department of Pathology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USAObjective: To increase awareness of the limitations of high-risk human papillomavirus (hrHPV laboratory-developed testing (LDT widely used in US cervical cancer screening.Methods and results: A young woman in her 30s was diagnosed and treated for stage 1B1 cervical squamous cell carcinoma in which HPV 16 DNA was detected using polymerase chain reaction testing. Both 1 month before and 42 months before cervical cancer diagnosis, the patient had highly abnormal cytology findings; however, residual SurePath™ (Becton, Dickson and Company, Franklin Lakes, NJ vial fluid yielded negative Hybrid Capture 2 (HC2; Qiagen NV, Hilden, Germany hrHPV LDT results from each of the two specimens. This prompted questions to be asked concerning the performance characteristics of hrHPV LDT. A review of the available data indicates that (1 purification of DNA from SurePath specimens requires complex sample preparation due to formaldehyde crosslinking of proteins and nucleic acids, (2 HC2–SurePath hrHPV testing had not been Food and Drug Administration-approved after multiple premarket approval submissions, (3 detectible hrHPV DNA in the SurePath vial decreases over time, and (4 US laboratories performing HC2–SurePath hrHPV LDT testing are not using a standardized manufacturer-endorsed procedure.Conclusion: Recently updated cervical screening guidelines in the US recommend against the use of hrHPV LDT in cervical screening, including widely used HC2 testing from the SurePath vial. The manufacturer recently issued a technical bulletin specifically warning that use of SurePath samples with the HC2 hrHPV test may provide false negative results and potentially compromise patient safety. Co-collection using a Food and Drug Administration-approved hrHPV test

  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. 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.

  3. 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.

  4. To study the role of visual inspection of cervix with acetic acid (VIA in cervical cancer screening

    Directory of Open Access Journals (Sweden)

    Sunita Goyal

    2014-06-01

    Full Text Available Background: Objectives of current study were to evaluate visual inspection of cervix with acetic acid in picking up abnormal cervix and to correlate the findings of VIA with Pap smear, colposcopy and cervical biopsy. Methods: Study was conducted on 300 sexually active women attending the gynaecological OPD at Dayanand medical college and hospital, Ludhiana. All patients underwent VIA and Pap smear screening and if either of the two was abnormal, colposcopy was done and colposcopic guided cervical biopsy was taken if indicated. Total 105 colposcopies were done. Cervical biopsy was taken in 87 cases and the results were compared and statistically analysed. Results: The sensitivity of VIA was 86% and specificity 40.50%. No case was missed by VIA when cut off was taken as moderate dysplasia or higher lesions on biopsy. Conclusions: VIA is a sensitive, practical and a low cost affair in cervical cancer screening. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 684-687

  5. 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...

  6. Cervical screening and the aftermath of childhood sexual abuse: are clinical staff trained to recognise and manage the effect this has on their patients?

    OpenAIRE

    Walker, Judith; Allan, Helen T.

    2014-01-01

    Aims and objectives: To evaluate the training needs and awareness of childhood sexual abuse amongst clinical staff taking cervical screening samples in one inner city primary care trust. Background Studies exploring sexual abuse and nonparticipation in cervical screening have demonstrated that women can experience re-traumatisation if care during examinations is insensitive to their particular needs. Design: This was a mixed methods, service evaluation in three phases. Methods: A literature r...

  7. Utilization of cervical cancer screening services and its associated factors among primary school teachers in Ilala Municipality, Dar es Salaam, Tanzania

    OpenAIRE

    Kileo, Neema Minja; Michael, Denna; Neke, Nyasule Majura; Moshiro, Candida

    2015-01-01

    Background Worldwide cervical cancer is one of the more common forms of carcinoma among women, causing high morbidity and high mortality. Despite being a major health problem in Tanzania, screening services for cervical cancer are very limited, and uptake of those services is low. We therefore conducted a study to investigate utilization of cancer screening services, and its associated factors among female primary school teachers in Ilala Municipality, Dar es Salaam. Method We conducted a cro...

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

    Science.gov (United States)

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

    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, 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. PMID:23690785

  9. 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.

  10. 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. PMID:27510000

  11. Five year colorectal cancer outcomes in a large negative CT colonography screening cohort

    Energy Technology Data Exchange (ETDEWEB)

    Kim, David H.; Pooler, B.D.; Pickhardt, Perry J. [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States); Weiss, Jennifer M. [University of Wisconsin School of Medicine and Public Health, Section of Gastroenterology, Department of Internal Medicine, Madison, WI (United States)

    2012-07-15

    To assess the 5-year incidence of clinically presenting colorectal cancers following a negative CT colonography (CTC) screening examination, as few patient outcome data regarding a negative CTC screening result exist. Negative CTC screening patients (n = 1,050) in the University of Wisconsin Health system over a 14-month period were included. An electronic medical record (EMR) review was undertaken, encompassing provider, colonoscopy, imaging and histopathology reports. Incident colorectal cancers and other important GI tumours were recorded. Of the 1,050 cohort (mean [{+-}SD] age 56.9 {+-} 7.4 years), 39 (3.7%) patients were excluded owing to lack of follow-up within our system beyond the initial screening CTC. The remaining 1,011 patients were followed for an average of 4.73 {+-} 1.15 years. One incident colorectal adenocarcinoma represented a crude cancer incidence of 0.2 cancers per 1,000 patient years. EMR revealed 14 additional patients with clinically important GI tumours including: advanced adenomas (n = 11), appendiceal goblet cell carcinoid (n = 1), appendiceal mucinous adenoma (n = 1) and metastatic ileocolonic carcinoid (n = 1). All positive patients including the incident carcinoma are alive at the time of review. Clinically presenting colorectal adenocarcinoma is rare in the 5 years following negative screening CTC, suggesting that current strategies, including non-reporting of diminutive lesions, are appropriate. (orig.)

  12. Five year colorectal cancer outcomes in a large negative CT colonography screening cohort

    International Nuclear Information System (INIS)

    To assess the 5-year incidence of clinically presenting colorectal cancers following a negative CT colonography (CTC) screening examination, as few patient outcome data regarding a negative CTC screening result exist. Negative CTC screening patients (n = 1,050) in the University of Wisconsin Health system over a 14-month period were included. An electronic medical record (EMR) review was undertaken, encompassing provider, colonoscopy, imaging and histopathology reports. Incident colorectal cancers and other important GI tumours were recorded. Of the 1,050 cohort (mean [±SD] age 56.9 ± 7.4 years), 39 (3.7%) patients were excluded owing to lack of follow-up within our system beyond the initial screening CTC. The remaining 1,011 patients were followed for an average of 4.73 ± 1.15 years. One incident colorectal adenocarcinoma represented a crude cancer incidence of 0.2 cancers per 1,000 patient years. EMR revealed 14 additional patients with clinically important GI tumours including: advanced adenomas (n = 11), appendiceal goblet cell carcinoid (n = 1), appendiceal mucinous adenoma (n = 1) and metastatic ileocolonic carcinoid (n = 1). All positive patients including the incident carcinoma are alive at the time of review. Clinically presenting colorectal adenocarcinoma is rare in the 5 years following negative screening CTC, suggesting that current strategies, including non-reporting of diminutive lesions, are appropriate. (orig.)

  13. 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

  14. Health-related lifestyle factors and mammography screening attendance in a Swedish cohort study.

    Science.gov (United States)

    Lagerlund, Magdalena; Drake, Isabel; Wirfält, Elisabet; Sontrop, Jessica M; Zackrisson, Sophia

    2015-01-01

    To determine whether health-related lifestyle factors are associated with attendance at a population-based invitational mammography screening program in southern Sweden, data on health-related lifestyle factors (smoking, alcohol use, physical activity, BMI, diet, self-rated health, and stress) were obtained from the Malmö Diet and Cancer Study and linked to the Malmö mammography register (Sweden, 1992-2009). Women (n=11 409) who were free from breast cancer at study entry were included in the cohort, and mammography attendance was followed from cohort entry to 31 December 2009. Generalized estimating equations were used to account for repeated measures within patients. Adjusted odds ratios (OR) and 95% confidence intervals (CI) are reported. Nonattendance occurred in 8% of the 69 746 screening opportunities that were observed. Nonattendance was more common among women who were current or former smokers [OR=1.60 (1.45-1.76) and OR=1.15 (1.05-1.28)], had not used alcohol in the past year [OR=1.55 (1.32-1.83)], were less physically active outside of work [OR=1.10 (1.00-1.20)], had high physical activity at work (OR=1.13, 95% CI: 1.00-1.28), were vegetarians or vegans [OR=1.49 (1.11-1.99)], had not used dietary supplements [OR=1.11 (1.01-1.21)], had poor self-rated health [OR=1.24 (1.14-1.36)], and were experiencing greater stress [OR=1.25 (1.14-1.36)]. In this cohort, nonattendance was associated with smoking, alcohol abstinence, physical activity, poor self-rated health, stress, and following a vegetarian/vegan diet. These findings generally support the notion that women with less healthy lifestyles are less likely to engage in mammography screening. PMID:24787378

  15. Does cervical lordosis change after spinal manipulation for non-specific neck pain? A prospective cohort study

    OpenAIRE

    Shilton, Michael; Branney, Jonathan; de Vries, Bas Penning; Breen, Alan C

    2015-01-01

    Background The association between cervical lordosis (sagittal alignment) and neck pain is controversial. Further, it is unclear whether spinal manipulative therapy can change cervical lordosis. This study aimed to determine whether cervical lordosis changes after a course of spinal manipulation for non-specific neck pain. Methods Posterior tangents of C2 and C6 were drawn on the lateral cervical fluoroscopic images of 29 patients with subacute/chronic non-specific neck pain and 30 healthy vo...

  16. Prevalence of cervical neoplastic lesions and Human Papilloma Virus infection in Egypt: National Cervical Cancer Screening Project

    Directory of Open Access Journals (Sweden)

    Dandash Khadiga

    2007-07-01

    Full Text Available Abstract Background Data from Egyptian studies provide widely varying estimates on the prevalence of pre-malignant and malignant cervical abnormalities and human papilloma virus (HPVs infection. To define the prevalence and risk factors of pre-invasive and invasive cervical cancer (cacx, a community based full-scale cross sectional, household survey including 5453 women aged between 35 and 60 years was conducted. Methods The study period was between February 2000 and December 2002. Initially, conventional Papanicolaou (Pap smears were evaluated using the Bethesda system (TBS, followed by colposcopic guided biopsy (CGB for all epithelial abnormalities (EA. In a third step, HPV was tested on all EA by in-situ hybridization (ISH using first the broad spectrum HPV probe recognizing HPVs 6, 11, 16, 18, 30, 31, 35, 45, 51 and 52 followed by subtyping with probes 6/11, 16/18 and 31/33. Lastly, unequivocal cases were immunostained for herpes simplex type-2 (HSV-2, cytomegalovirus (CMV, and human immunodeficiency virus (HIV. Results EA representing 7.8% (424/5453, were categorized into atypical squamous cell of undetermined significance (ASCUS (34.4%, atypical glandular cell of undetermined significance (AGCUS (15.3%, combined ASCUS and AGCUS (3.1%, low grade squamous intraepithelial lesions (SIL (41.0%, high grade SIL (5.2% and invasive lesions (1%. CGB of EA (n = 281 showed non neoplastic lesions (12.8%, atypical squamous metaplasia (ASM (19.2%, cervical intraepithelial neoplasia I (CIN (44.4%, CIN II (4.4%, CINIII (2.8%, endocervical lesions (5.2%, combined squamous and endocervical lesions (10.0%, invasive squamous cell carcinoma (SCC (0.02% and extranodal marginal zone B cell lymphoma (MZBCL (0.02%. The overall predictive value of cytology was 87% while the predictive value for high grade lesions was 80%. On histological basis, HPVs were present in 94.3% of squamous lesions while it was difficult to be identified in endocervical ones. ISH revealed

  17. [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

  18. Modelling breast cancer in a TB fluoroscopy cohort: Implications for the Dutch mammography screening

    International Nuclear Information System (INIS)

    Breast cancer incidence in a tuberculosis fluoroscopy cohort has been modelled with a two-stage carcinogenesis model. The relatively simple model, in which hormonal influences only affect the number of sensitive target cells, fits the data very well. Under the assumption that individual hormonal differences average out, and with a relative biological effectiveness for mammographic X rays of 1, the model yields ∼10 fatal breast cancer cases induced by the entire Dutch screening programme over a period of 25 y. This is much lower than derived from standard ICRP risk estimates and should be compared with the number of lives saved, which is estimated at ∼350 y-1. As the extent of screening is currently being reconsidered in the Netherlands and elsewhere, this is an important result. (authors)

  19. 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…

  20. 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.

  1. 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 ...

  2. Tuberculosis screening and follow-up of asylum seekers in Norway: a cohort study

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    Garåsen Helge

    2009-05-01

    Full Text Available Abstract Background About 80% of new tuberculosis cases in Norway occur among immigrants from high incidence countries. On arrival to the country all asylum seekers are screened with Mantoux test and chest x-ray aimed to identify cases of active tuberculosis and, in the case of latent tuberculosis, to offer follow-up or prophylactic treatment. We assessed a national programme for screening, treatment and follow-up of tuberculosis infection and disease in a cohort of asylum seekers. Methods Asylum seekers ≥ 18 years who arrived at the National Reception Centre from January 2005 to June 2006, were included as the total cohort. Those with a Mantoux test ≥ 6 mm or positive x-ray findings were included in a study group for follow-up. Data were collected from public health authorities in the municipality to where the asylum seekers had moved, and from hospital based internists in case they had been referred to specialist care. Individual subjects included in the study group were matched with the Norwegian National Tuberculosis Register which receive reports of everybody diagnosed with active tuberculosis, or who had started treatment for latent tuberculosis. Results The total cohort included 4643 adult asylum seekers and 97.5% had a valid Mantoux test. At least one inclusion criterion was fulfilled by 2237 persons. By end 2007 municipal public health authorities had assessed 758 (34% of them. Altogether 328 persons had been seen by an internist. Of 314 individuals with positive x-rays, 194 (62% had seen an internist, while 86 of 568 with Mantoux ≥ 15, but negative x-rays (16% were also seen by an internist. By December 31st 2006, 23 patients were diagnosed with tuberculosis (prevalence 1028/100 000 and another 11 were treated for latent infection. Conclusion The coverage of screening was satisfactory, but fewer subjects than could have been expected from the national guidelines were followed up in the community and referred to an internist. To

  3. Mobile input device type, texting style and screen size influence upper extremity and trapezius muscle activity, and cervical posture while texting.

    Science.gov (United States)

    Kietrys, David M; Gerg, Michael J; Dropkin, Jonathan; Gold, Judith E

    2015-09-01

    This study aimed to determine the effects of input device type, texting style, and screen size on upper extremity and trapezius muscle activity and cervical posture during a short texting task in college students. Users of a physical keypad produced greater thumb, finger flexor, and wrist extensor muscle activity than when texting with a touch screen device of similar dimensions. Texting on either device produced greater wrist extensor muscle activity when texting with 1 hand/thumb compared with both hands/thumbs. As touch screen size increased, more participants held the device on their lap, and chose to use both thumbs less. There was also a trend for greater finger flexor, wrist extensor, and trapezius muscle activity as touch screen size increased, and for greater cervical flexion, although mean differences for cervical flexion were small. Future research can help inform whether the ergonomic stressors observed during texting are associated with musculoskeletal disorder risk. PMID:25959323

  4. 3D co-occurrence matrix based texture analysis applied to cervical cancer screening

    OpenAIRE

    Liang, Meng

    2012-01-01

    Cervical cancer is the second most common cancer in women worldwide, approximately 471,000 new cases are diagnosed each year. In 2005, there were about 500,000 cases of cervical cancer and 260,000 cases caused death in worldwide [1]. Cervical cancer starts as a precancerous condition, however the changes of precancerous are hardly detected  by the naked eyes, special test such as Papanicolaou test are used to spot the conditions. These are time consuming to inspect visually. In the last 50 ye...

  5. How do women who choose not to participate in population-based cervical cancer screening reason about their decision?

    Science.gov (United States)

    Blomberg, Karin; Ternestedt, Britt-Marie; Törnberg, Sven; Tishelman, Carol

    2008-06-01

    In Stockholm, Sweden, women are invited to a cost-free population-based cervical cancer screening programme (PCCSP) at regular intervals. Despite this, many women choose not to attend screening at all or to take opportunistic tests instead. This study explores how women who actively declined participation in the PCCSP reasoned about their choice. Qualitative telephone interviews and fax messages from women who actively declined participation in the PCCSP were analysed inductively. The manner in which women defined and conceptualized distinctions between, and the roles and responsibilities of, both private and public spheres were found to be central in explanations of decision making. Factors related to women's decisions not to participate in screening at all include a lack of confidence in the benefits of screening, previous negative health care and preventive experiences, a belief in one's own ability to discern health changes or a belief that one was not at risk for cervical cancer, as well as a number of unconventional standpoints on social and political issues. Women who chose not to participate in the organized PCCSP, but who did use private opportunistic screening, generally motivated this with direct or indirect criticism of the screening programme itself. Not only was the examination itself sensitive but also all facets of the PCCSP, from invitation letter on, were found to influence women's decisions. Using Jepson et al.'s ethical framework to peruse the evidence-base underlying women's 'informed decision-making' about CCS is suggested to be more constructive than discussing potential participants' knowledge versus lack of knowledge. PMID:17886262

  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. PMID:27006131

  7. 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.

  8. Parental concerns based general developmental screening tool and autism risk: the Taiwan National Birth cohort study.

    Science.gov (United States)

    Lung, For-Wey; Shu, Bih-Ching; Chiang, Tung-Liang; Lin, Shio-Jean

    2010-02-01

    Early detection of developmental delay and childhood disorders are important for early intervention. This study aimed to describe the distribution of responses in a large population-based survey, identify cutoff points for the parent concern checklist (PCC) suitable for the Chinese language and culture, and explore how many children were identified as having evidence of problems at age 18 mo different from those at age 6 mo. Using a national randomly selected sample, the overall development of 21,248 children was investigated using the Taiwan Birth Cohort study instrument, and the PCC, a problem-oriented screening instrument. The Newton-Raphson iteration showed that the PCC should be separated into three groups, those scoring 1-2 in the first group, 3- 6 in the second group, and 7- 8 in the third group.Structural equation models showed that 6-mo development was predictive of 18-mo development; additionally, 18-mo development and the PCC showed good concurrent validity. This study identified three groups with distinct developmental trajectories and two cutoff points of 2/3 and 6/7. Thus, the PCC can be used as a first-stage screening instrument in a two-stage window screening procedure. Further studies are needed to investigate the factors, which contribute to the differences among these groups;follow-up on the typical and atypical development of these children is necessary. PMID:20091940

  9. 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.

  10. Prevalence and cumulative incidence of abnormal cervical cytology among HIV-infected Thai women: a 5.5-year retrospective cohort study

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    Thamkhantho Manopchai

    2011-01-01

    Full Text Available Abstract Background Cervical cancer is one of the most common AIDS-related malignancies in Thailand. To prevent cervical cancer, The US Public Health Service and The Infectious Disease Society of America have recommended that all HIV-infected women should obtain 2 Pap smears 6 months apart after the initial HIV diagnosis and, if results of both are normal, should undergo annual cytological screening. However, there has been no evidence in supporting whether this guideline is appropriate in all settings - especially in areas where HIV-infected women are living in resource-constrained condition. Methods To determine the appropriate interval of Pap smear screenings for HIV-infected Thai women and risk factors for subsequent abnormal cervical cytology, we assessed the prevalence, cumulative incidence and associated factors of cervical cell abnormalities (atypical squamous cell of undetermined significance or higher grades, ASCUS+ among this group of patients. Results The prevalence of ASCUS+ was 15.4% at the first visit, and the cumulative incidence of ASCUS+ gradually increased to 37% in the first 3.5 years of follow-up appointments (first 7 times, and tended to plateau in the last 2 years. For multivariate correlation analysis, women with a CD4 count P = 0.043. There were no associations of subsequent ASCUS+ with age, pregnancy, contraceptive method, highly active anti-retroviral treatment, assumed duration of infection, or the CD4 count nadir level. Conclusion There are high prevalence and cumulative incidence of ASCUS+ in HIV-infected Thai women. With a high lost-to-follow-up rate, an appropriate interval of Pap smear screening cannot be concluded from the present study. Nevertheless, the HIV-infected Thai women may require more than two normal semi-annual Pap smears before shifting to routinely annual cytologic screening.

  11. Comparison of breast and bowel cancer screening uptake patterns in a common cohort of South Asian women in England

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    Gumber Anil K

    2010-04-01

    Full Text Available Abstract Background Inequalities in uptake of cancer screening by ethnic minority populations are well documented in a number of international studies. However, most studies to date have explored screening uptake for a single cancer only. This paper compares breast and bowel cancer screening uptake for a cohort of South Asian women invited to undertake both, and similarly investigates these women's breast cancer screening behaviour over a period of fifteen years. Methods Screening data for rounds 1, 2 and 5 (1989-2004 of the NHS breast cancer screening programme and for round 1 of the NHS bowel screening pilot (2000-2002 were obtained for women aged 50-69 resident in the English bowel screening pilot site, Coventry and Warwickshire, who had been invited to undertake breast and bowel cancer screening in the period 2000-2002. Breast and bowel cancer screening uptake levels were calculated and compared using the chi-squared test. Results 72,566 women were invited to breast and bowel cancer screening after exclusions. Of these, 3,539 were South Asian and 69,027 non-Asian; 18,730 had been invited to mammography over the previous fifteen years (rounds 1 to 5. South Asian women were significantly less likely to undertake both breast and bowel cancer screening; 29.9% (n = 1,057 compared to 59.4% (n = 40,969 for non-Asians (p Conclusions Culturally appropriate targeted interventions are required to reduce observed disparities in cancer screening uptakes.

  12. RESEARCH PROGRESS OF SCREENING METHOD OF CERVICAL INTRAEPITHELIAL NEOPLASIA%宫颈上皮内瘤变筛查方法的研究进展

    Institute of Scientific and Technical Information of China (English)

    张俊绘; 宋静慧

    2011-01-01

    宫颈癌是女性最常见的恶性肿瘤之一,从癌前病变发展到癌大约需要10a时间,及早发现癌前病变对宫颈癌的防治具有重要意义.目前筛查宫颈癌前病变的方法有液基细胞学检测、HPV-DNA检测、阴道镜检查、组织病理学检查等.综述宫颈癌前病变的筛查方法,探讨最为高效合理的宫颈癌的筛查方法,提高诊断的准确率,从而降低宫颈癌的发病率和死亡率.%Cervical cancer is one of the most common cancers of women, it will take about 10 years from precancerous lesion to cancer, early detection of precancerous lesion is significant for prevention and cure of cervical cancer. At present, the methods of screening precancerous lesions of cervical cancer mainly include thin prep liquid based cytology test, HPV - DNA test, colposcopy examination , histopathology examination, etc. This article summarized the screening methods of precancerous lesions of cervical cancer, seek the most effective and rational screening methods of cervical cancer , improve the accuracy of diagnosis, so as to decrease the incidence and mortality of cervical cancer.

  13. 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

  14. Predictors and Health Consequences of Screen-Time Change During Adolescence—1993 Pelotas (Brazil) Birth Cohort Study

    OpenAIRE

    Dumith, Samuel Carvalho; Leandro Martin Totaro GARCIA; da Silva, Kelly Samara; Menezes, Ana Maria Baptista; Hallal, Pedro Curi

    2012-01-01

    Purpose To investigate screen-time change from early to mid adolescence, its predictors, and its influence on body fat, blood pressure, and leisure-time physical activity. Methods We used data from a longitudinal prospective study, conducted among participants of the 1993 Pelotas (Brazil) Birth Cohort Study. At baseline, adolescents were, on average, 11 years old. They were later visited at age 15 years. Screen time was self-reported, accounting for the time spent watching television, playing...

  15. Pooled analysis of the accuracy of five cervical cancer screening tests assessed in eleven studies in Africa and India.

    Science.gov (United States)

    Arbyn, Marc; Sankaranarayanan, Rengaswamy; Muwonge, Richard; Keita, Namory; Dolo, Amadou; Mbalawa, Charles Gombe; Nouhou, Hassan; Sakande, Boblewende; Wesley, Ramani; Somanathan, Thara; Sharma, Anjali; Shastri, Surendra; Basu, Parthasarathy

    2008-07-01

    Cervical cancer is the main cancer among women in sub-Saharan Africa, India and other parts of the developing world. Evaluation of screening performance of effective, feasible and affordable early detection and management methods is a public health priority. Five screening methods, naked eye visual inspection of the cervix uteri after application of diluted acetic acid (VIA), or Lugol's iodine (VILI) or with a magnifying device (VIAM), the Pap smear and human papillomavirus testing with the high-risk probe of the Hybrid Capture-2 assay (HC2), were evaluated in 11 studies in India and Africa. More than 58,000 women, aged 25-64 years, were tested with 2-5 screening tests and outcome verification was done on all women independent of the screen test results. The outcome was presence or absence of cervical intraepithelial neoplasia (CIN) of different degrees or invasive cervical cancer. Verification was based on colposcopy and histological interpretation of colposcopy-directed biopsies. Negative colposcopy was accepted as a truly negative outcome. VIA showed a sensitivity of 79% (95% CI 73-85%) and 83% (95% CI 77-89%), and a specificity of 85% (95% CI 81-89%) and 84% (95% CI 80-88%) for the outcomes CIN2+ or CIN3+, respectively. VILI was on average 10% more sensitive and equally specific. VIAM showed similar results as VIA. The Pap smear showed lowest sensitivity, even at the lowest cutoff of atypical squamous cells of undetermined significance (57%; 95% CI 38-76%) for CIN2+ but the specificity was rather high (93%; 95% CI 89-97%). The HC2-assay showed a sensitivity for CIN2+ of 62% (95% CI 56-68%) and a specificity of 94% (95% CI 92-95%). Substantial interstudy variation was observed in the accuracy of the visual screening methods. Accuracy of visual methods and cytology increased over time, whereas performance of HC2 was constant. Results of visual tests and colposcopy were highly correlated. This study was the largest ever done that evaluates the cross

  16. Comparison of Visual Inspection with acetic acid and Pap smear in cervical cancer screening at a tertiary care hospital

    International Nuclear Information System (INIS)

    Objective: To determine the accuracy of visual inspection with acetic acid in comparison with Pap smear against colposcopic directed biopsy, for detection of pre-cancerous lesion. Methods: The comparative cross-sectional study was conducted at the Maternal and Child Health Centre (MCHC), Pakistan Institute of Medical Sciences (PIMS), Islamabad, from January to December 2010. Every married women with age range 19 to 51 years underwent conventional cytology and visual inspection with 5% acetic acid. Distinct acetowhite areas were taken as positive, while cervical intra-epithelial neoplasia on cytology was labelled as Pap smear positive. Colposcopic directed biopsy was taken as the gold standard. SPSS 13 was used for statistical analysis. Results: Of 519 subjects, 70(13.4%) were screened positive and 29(5.6%) were biopsy positive for cervical intra-epithelial neoplasia. Of these, 26(37.1 %) were positive on visual inspection; 14 (20 %) on cytology; and 30 (42.8%) on combined test. The sensitivity of visual inspection was 78.5% vs 61.1% for Pap smear (p<0.001). The specificity of visual inspection was 99.3% vs 99.4% for cytology (p<0.1). Significantly higher sensitivity and specificity was found for the combined test than either of the two alone; 93.1% and 99.1% respectively (p<0.001). The positive predictive value of visual inspection vs pap was 84.6% vs 78.5% (p<0.001) and negative predictive value was 98.6% vs 96.5% (p<0.1). Both values of combined test were significantly higher than either of the two tests alone (p<0.01). Conclusion: Visual inspection with acetic acid has significantly higher sensitivity than Pap smear and may replace pap smear as a primary screening tool for universal screening. Combined test with higher predictive accuracy may be used for opportunistic screening. (author)

  17. Exploring the Cervical Cancer Screening Experiences of Black Lesbian, Bisexual, and Queer Women: The Role of Patient-Provider Communication.

    Science.gov (United States)

    Agénor, Madina; Bailey, Zinzi; Krieger, Nancy; Austin, S Bryn; Gottlieb, Barbara R

    2015-01-01

    Few studies have focused on the health and health care of U.S. black lesbian, bisexual, and queer (LBQ) women. To understand the facilitators of and barriers to cervical cancer screening in this population, focus group discussions were conducted in Boston and Cambridge, Massachusetts between November and December 2012. Using purposive sampling methods, the authors enrolled 18 black LBQ women who participated in one of four focus groups. Using thematic analysis, patient-provider communication was identified, which consisted of four sub-themes--health care provider communication style and demeanor; heteronormative provider assumptions; heterosexism, racism, and classism; and provider professional and sociodemographic background--as the most salient theme. Participants reported fears and experiences of multiple forms of discrimination and preferred receiving care from providers who were knowledgeable about same-sex sexual health and shared their life experiences at the intersection of gender, race/ethnicity, and sexual orientation. The cervical cancer screening experiences of black LBQ women would be improved by training all health care providers in same-sex sexual health, offering opportunities for clinicians to learn about the effects of various forms of discrimination on women's health care, and increasing the presence of LBQ women of color in health care settings. PMID:25909663

  18. 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.

  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

    enrollment activities of the Morelos HPV study are the basis for a prevalent case-control study and a prospective cohort study that will investigate the natural history of HPV infections and determine if an HPV-based screening strategy is a safe and cost-effective alternative to Pap screening.Objetivo. Describir los métodos y el diseño del Estudio de VPH en Morelos. El objetivo principal de este estudio es examinar el uso de dos diferentes técnicas para obtener muestras de ADN de VPH, autotoma vaginal y toma clínica cervical, para detectar lesiones cervicales preinvasoras y cáncer. Material y métodos. Este estudio se realizó en el marco del Programa de Detección Oportuna de Cáncer Cervical (DOC del Instituto Mexicano del Seguro Social (IMSS en Morelos. Un total de 7 868 mujeres aceptaron participar en el estudio durante los meses de mayo a octubre de 1999. Esta muestra es representativa de la población de mujeres que acudieron a los programas de DOC en las 23 clínicas del IMSS en Morelos durante ese año. Se les proporcionó una explicación detallada del estudio a las participantes antes de que firmaran una carta de consentimiento informado. Se obtuvo información básica de todas las participantes y se usó el formato oficial de registro de datos del programa institucional de DOC del IMSS. Además se seleccionó una submuestra aleatoria de 1 069 participantes que fueron entrevistadas durante su visita inicial para obtener información adicional sobre los factores de riesgo de cáncer cervical, aceptabilidad de las pruebas de Papanicolaou (Pap y VPH-autotoma, y los costos de las pacientes. Todas las participantes se tomaron una muestra de exudado vaginal para la prueba de VPH-autotoma. Posteriormente, se les realizó una exploración pélvica para obtener muestras cervicales para las pruebas de VPH-clínica y Pap. Se evaluó la información de 7 732 mujeres con resultados completos de las tres pruebas. A las 1 147 mujeres que recibieron un diagnóstico positivo

  20. Cervical Cancer Screening between 35–40 Aged Women at Kisecik Region of Hatay Provinence

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    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

  1. Screening Methods for Cervical Lesion and its New Development%宫颈病变筛查方法及其新进展综述

    Institute of Scientific and Technical Information of China (English)

    邓晓红

    2016-01-01

    综述宫颈病变的筛查技术及新进展,早期发现宫颈癌和提高治愈率。宫颈癌是最常见的妇科恶性肿瘤之一,严重威胁着妇女的健康,且近几年趋向年轻化。人乳头瘤病毒(HPV DNA)感染是引起宫颈病变尤其是宫颈癌的主要原因,TCT是宫颈细胞学筛查的一种新的全自动细胞学检测技术,阴道镜是宫颈早期浸润癌筛查的重要应用。三者联合筛查宫颈病变,早期发现、早期诊断和早期干预宫颈的癌前病变,能够有效预防宫颈癌发生,降低宫颈癌的发病率和死亡率。%This paper reviews screening technologies and new developments for cervical lesions, early detection of cervical cancer, so as to improve in cure rate. Cervical cancer is one of the most common gynecologic malignant tumor, it is a serious threat to women's health, and in recent years it trends to target the younger ages. Human papilloma virus (HPV DNA) infection is the primary cause of cervical lesions, especially for cervical cancer. TCT is a new automatic cytology detection technology for cervical cytology screening. Colposcopy is an important application in early invasive cervical cancer screening. Combining the above mentioned three screening technologies could achieve the purposes of early detection, early diagnosis and early intervention of cervical precancerous lesions, so as to effectively prevent the occurrence of cervical cancer, reduce the morbidity and mortality of cervical cancer.

  2. 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...

  3. 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...

  4. Functional health literacy in Spanish-speaking Latinas seeking breast cancer screening through the National Breast and Cervical Cancer Screening Program

    Directory of Open Access Journals (Sweden)

    Samantha Garbers

    2009-03-01

    Full Text Available Samantha Garbers1, Karen Schmitt2, Anne Marie Rappa2, Mary Ann Chiasson11Public Health Solutions, New York, NY, USA; 2Columbia University Breast Cancer Screening Program, New York, NY, USABackground: This analysis examines the association between functional health literacy and follow-up after mammography among women receiving breast cancer screening at a National Breast and Cervical Cancer Early Detection Program site in New York City that provides universal bilingual case management.Methods: A total of 707 Latinas who spoke Spanish as their primary language completed a survey of health and demographic characteristics and the Test of Functional Health Literacy in Spanish (TOFHLA-S. Survey results were matched with clinical outcome data.Results: Among the survey participants, 98% were foreign-born and 99% had no health insurance. While the study found significant differences in access to health information and past screening behavior, women without adequate health literacy in Spanish were no less likely to receive clinical resolution of abnormal mammograms within 60 days (81.8% overall; n = 110 or to return for a repeat mammogram within 18 months (57.2% overall; n = 697. In fact, among those referred for a Pap test (n = 310, women without adequate health literacy were more likely to receive a Pap test within 60 days of their mammogram than those with adequate health literacy (82% compared to 71%, OR: 1.83, 95% CI: 1.04–3.22.Discussion: The lack of significantly lower follow-up outcomes among women with inadequate and marginal functional health literacy in this population of primary Spanish-speaking Latinas suggests that, once women have accessed screening services, programmatic approaches may exist to mitigate barriers to follow-up and to ensure optimal cancer screening outcomes for women of all literacy levels.Keywords: health literacy, mammography, Latinas, case management, cancer screening

  5. 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 cervical samples lacking......-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...

  6. The impact of universal newborn hearing screening on long-term literacy outcomes: a prospective cohort study

    OpenAIRE

    Kennedy, Colin R.; Pimperton, Hannah; Blythe, Hazel I.; Kreppner, Jana; Mahon, Merle; Peacock, Janet L; Stevenson, Jim; Terlektsi, Emmanouela; Worsfold, Sarah; Yuen, Ho Ming

    2016-01-01

    Objective To determine whether the benefits of universal newborn hearing screening (UNHS) seen at age 8 years persist through the second decade. Design Prospective cohort study of a population sample of children with permanent childhood hearing impairment (PCHI) followed up for 17 years since birth in periods with (or without) UNHS. Setting Birth cohort of 100 000 in southern England. Participants 114 teenagers aged 13–19 years, 76 with PCHI and 38 with normal hearing. All had previously thei...

  7. Self-perceived risk and barriers to cervical cancer screening among patients seeking care at a tertiary care teaching hospital in Tamil Nadu

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    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

  8. Breast cancer correlates in a cohort of breast screening program participants in Riyadh, KSA

    International Nuclear Information System (INIS)

    Background: Breast cancer is the first cancer among females in the Kingdom of Saudi Arabia, accounting for 27.4% of all newly diagnosed female cancers in 2010. There are several risk factors affecting the incidence of breast cancer where some factors influence the risk more than the others. Aim: We aimed to identify the different risk factors related to breast cancer among females participating in the breast-screening program in Riyadh, KSA. Methods: Based on data from phase-I of the breast-screening program, a case-control study was conducted on women living in Riyadh, KSA. A sample of 349 women (58 cases and 290 controls) was recruited to examine the different breast cancer correlates. Multivariate regression model was built to investigate the most important risk factors. Results: The mean age of cases was 48.5 ± 7.1 years. Age at marriage, number of pregnancy, age at menopause, oral contraceptive pills, breast feeding and family history of breast cancer in first-degree relative were identified as the most important correlates among the studied cohort. Conclusions: The findings of the current work suggested that age at marriage, age at menopause ≥50 years, and 1st degree family history of breast cancer were risk factors for breast cancer, while, age at menopause<50 years, number of pregnancies and practicing breast feeding were protective factors against breast cancer. There was no effect of body mass index or physical inactivity. Further studies are needed to explore the hereditary, familial and genetic background risk factors in Saudi population.

  9. HPV Infection and Cervical Screening in Socially Isolated Indigenous Women Inhabitants of the Amazonian Rainforest.

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    Allex Jardim Fonseca

    Full Text Available Indigenous women from the Amazon regions have some of the highest rates of cervical cancer in the world. This study evaluated cervical cytology and human papillomavirus (HPV in native women that differ by lifestyle and interaction with western society. Yanomami women are isolated deep in the Amazon with a hunter/gatherer lifestyle. Macuxi and Wapishana women live in proximity to western society.To select a representative group of women from each district, random cluster sampling was used, considering each registered village as a cluster. Cervical samples were collected for cytology and HPV detection and typing by PCR amplification and next generation sequencing. The study was approved by the National IRB and by tribal leaders.664 native women were enrolled from 13 indigenous villages (76% participation rate. Yanomami women had higher rates of abnormal cytology (5.1% vs. 1.8%, p = 0.04 and prevalent HR-HPV (34.1% vs. 19.2%, p35 y of age were significantly more likely to have HR-HPV, whereas women ≤ 35 y did not significantly differ between groups. Prevalence of HPV was significantly different amongst geographically clustered Yanomami women (p<0.004. The most prevalent HPV types in the entire group were HPV31 (8.7%, HPV16 (5.9% and HPV18 (4.4%.Isolated endogenous Yanomami women were more likely to be HPV+ and rates increased with age. Study of HPV in isolated hunter-gather peoples suggests that long-term persistence is a characteristic of prehistoric humans and patterns reflecting decreased prevalence with age in western society represents recent change. These studies have implications for cervical cancer prevention and viral-host relationships.

  10. 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.

  11. 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.

  12. Primary Screening for Cervical Cancer Based on High-Risk Human Papillomavirus (HPV) Detection and HPV 16 and HPV 18 Genotyping, in Comparison to Cytology

    Science.gov (United States)

    Constantinidis, Theocharis; Constantinidis, Theodoros C.

    2015-01-01

    Objectives The objective of the present study is to assess the performance of a high-risk human papillomavirus (HR-HPV) DNA test with individual HPV-16/HPV-18 genotyping as a method for primary cervical cancer screening compared with liquid-based cytology (LBC) in a population of Greek women taking part in routine cervical cancer screening. Methods The study, conducted by the “HEllenic Real life Multicentric cErvical Screening” (HERMES) study group, involved the recruitment of 4,009 women, aged 25–55, who took part in routine cervical screening at nine Gynecology Departments in Greece. At first visit cervical specimens were collected for LBC and HPV testing using the Roche Cobas 4800 system. Women found positive for either cytology or HPV were referred for colposcopy, whereas women negative for both tests will be retested after three years. The study is ongoing and the results of the first screening round are reported herein. Results Valid results for cytology and HPV testing were obtained for 3,993 women. The overall prevalence of HR-HPV was 12.7%, of HPV-16 2.7% and of HPV-18 1.4%. Of those referred for colposcopy, cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was detected in 41 women (1.07%). At the threshold of CIN2+, cytology [atypical squamous cells of undetermined significance (ASC-US) or worse] and HPV testing showed a sensitivity of 53.7% and 100% respectively, without change between age groups. Cytology and HPV testing showed specificity of 96.8% and 90.3% respectively, which was increased in older women (≥30) in comparison to younger ones (25–29). Genotyping for HPV16/18 had similar accuracy to cytology for the detection of CIN2+ (sensitivity: 58.5%; specificity 97.5%) as well as for triage to colposcopy (sensitivity: 58.5% vs 53.7% for cytology). Conclusion HPV testing has much better sensitivity than cytology to identify high-grade cervical lesions with slightly lower specificity. HPV testing with individual HPV-16/HPV-18

  13. 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. PMID:22118240

  14. Factors associated with cervical cancer screening in women from middle and low socioeconomic status in Bogotá, Colombia

    Directory of Open Access Journals (Sweden)

    Isabel C. Scarinci

    2012-03-01

    Full Text Available Objective: in Colombia, cervical cancer (cc is the secondmost common type of cancer among women. It has an agestandardizedincidence of 21.5/100,000. The purpose of thisstudy was to examine the knowledge and perceived factorsassociated with CC screening among women from low mediumincome status in Bogotá, Colombia. Methodology: the studywas conducted with 10 focus groups segmented by age groups(18-33, 34-49, and 50-66. Two researchers conducted contentanalysis and identified the emerging categories. Results: thesample consisted of 81 women whose ages ranged from 18to 66. Early onset of sexual activity, promiscuity, vaginalinfections, hpv, genetics, abortions, and lack of hygienewere identified as the most important risk factors for cc.Participants recognized that this disease does not alwayshave symptoms, and that pap smears detect it early. However,they mentioned fear of undergoing a pap test, discomfort orpain, embarrassment, poor services, procrastination, and fearof a cancer diagnosis as the main barriers preventing regularscreening. Women recommended educational campaignsand improved customer service as strategies to motivatethem. Conclusion: participants reported basic knowledgeabout CC and screening. Actions to facilitate screening mustbe multifaceted and based on the barriers and facilitatorsmentioned by each age group.

  15. Comparing two theories of health behavior: a prospective study of noncompletion of treatment following cervical cancer screening.

    Science.gov (United States)

    Orbell, Sheina; Hagger, Martin; Brown, Val; Tidy, John

    2006-09-01

    Some women receiving abnormal cervical screening tests do not complete recommended treatment. A prospective study (N = 660) investigated the value of conceptualizing attendance at colposcopy for treatment as either (a) an active problem-solving response to a health threat, motivated by attitudes toward an abnormal result, as implied by self-regulation theory (H. Leventhal, D. Meyer, & D. Nerenz, 1980); or (b) as a behavior motivated by attitudes toward clinic attendance, as implied by the theory of planned behavior (TPB; I. Ajzen, 1985). Responses to questionnaires containing variables specified by these models were used to predict women's subsequent attendance or nonattendance for treatment over the following 15 months. Although the TPB offered superior prediction of intentions and completion of treatment, discriminant function analyses showed that consideration of both models was important in distinguishing between those who attended all their appointments as scheduled, attended after being prompted, or ceased attending. Implications for measurement and theory in health protection are discussed. PMID:17014278

  16. 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

  17. A population-based cohort study of chest x-ray screening in smokers: lung cancer detection findings and follow-up

    International Nuclear Information System (INIS)

    Case-control studies of mass screening for lung cancer (LC) by chest x-rays (CXR) performed in the 1990s in scarcely defined Japanese target populations indicated significant mortality reductions, but these results are yet to be confirmed in western countries. To ascertain whether CXR screening decreases LC mortality at community level, we studied a clearly defined population-based cohort of smokers invited to screening. We present here the LC detection results and the 10-year survival rates. The cohort of all smokers of > 10 pack-years resident in 50 communities of Varese, screening-eligible (n = 5,815), in July 1997 was invited to nonrandomized CXR screening. Self-selected participants (21% of cohort) underwent screening in addition to usual care; nonparticipants received usual care. The cohort was followed-up until December 2010. Kaplan-Meier LC-specific survival was estimated in participants, in nonparticipants, in the whole cohort, and in an uninvited, unscreened population (control group). Over the initial 9.5 years of study, 67 LCs were diagnosed in screening participants (51% were screen-detected) and 178 in nonparticipants. The rates of stage I LC, resectability and 5-year survival were nearly twice as high in participants (32% stage I; 48% resected; 30.5% 5-year survival) as in nonparticipants (17% stage I; 27% resected; 13.5% 5-year survival). There were no bronchioloalveolar carcinomas among screen-detected cancers, and median volume doubling time of incidence screen-detected LCs was 80 days (range, 44-318), suggesting that screening overdiagnosis was minimal. The 10-year LC-specific survival was greater in screening participants than in nonparticipants (log-rank, p = 0.005), and greater in the whole cohort invited to screening than in the control group (log-rank, p = 0.001). This favourable long-term effect was independently related to CXR screening exposure. In the setting of CXR screening offered to a population-based cohort of smokers, screening

  18. Non-participation in breast cancer screening for persons with chronic diseases and multimorbidity: a population-based cohort study

    DEFF Research Database (Denmark)

    Andersen, Berit

    2015-01-01

    Background Chronic diseases and multimorbidity are common in western countries and associated with increased breast cancer mortality. This study aims to investigate non-participation in breast cancer screening among women with chronic diseases and multimorbidity and the role of time in this...... association. Method This population-based cohort study used regional and national registries. Women who were invited to the first breast cancer screening round in the Central Denmark Region in 2008–09 were included (n = 149,234). Selected chronic diseases and multimorbidity were assessed up to 10 years before...... the screening date. Prevalence ratios (PR) were used as an association measure. Results The results indicated that women with at least one chronic condition were significantly more likely not to participate in breast cancer screening. In adjusted analysis, a significantly higher likelihood of non...

  19. Cost-effectiveness analysis of risk-factor guided and birth-cohort screening for chronic hepatitis C infection in the United States.

    Directory of Open Access Journals (Sweden)

    Shan Liu

    Full Text Available BACKGROUND: No consensus exists on screening to detect the estimated 2 million Americans unaware of their chronic hepatitis C infections. Advisory groups differ, recommending birth-cohort screening for baby boomers, screening only high-risk individuals, or no screening. We assessed one-time risk assessment and screening to identify previously undiagnosed 40-74 year-olds given newly available hepatitis C treatments. METHODS AND FINDINGS: A Markov model evaluated alternative risk-factor guided and birth-cohort screening and treatment strategies. Risk factors included drug use history, blood transfusion before 1992, and multiple sexual partners. Analyses of the National Health and Nutrition Examination Survey provided sex-, race-, age-, and risk-factor-specific hepatitis C prevalence and mortality rates. Nine strategies combined screening (no screening, risk-factor guided screening, or birth-cohort screening and treatment (standard therapy-peginterferon alfa and ribavirin, Interleukin-28B-guided (IL28B triple-therapy-standard therapy plus a protease inhibitor, or universal triple therapy. Response-guided treatment depended on HCV genotype. Outcomes include discounted lifetime costs (2010 dollars and quality adjusted life-years (QALYs. Compared to no screening, risk-factor guided and birth-cohort screening for 50 year-olds gained 0.7 to 3.5 quality adjusted life-days and cost $168 to $568 per person. Birth-cohort screening provided more benefit per dollar than risk-factor guided screening and cost $65,749 per QALY if followed by universal triple therapy compared to screening followed by IL28B-guided triple therapy. If only 10% of screen-detected, eligible patients initiate treatment at each opportunity, birth-cohort screening with universal triple therapy costs $241,100 per QALY. Assuming treatment with triple therapy, screening all individuals aged 40-64 years costs less than $100,000 per QALY. CONCLUSIONS: The cost-effectiveness of one-time birth-cohort

  20. Treatment Options by Stage (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 ...

  1. 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.

  2. Australian nurses in general practice, enabling the provision of cervical screening and well women’s health care services: a qualitative study

    Directory of Open Access Journals (Sweden)

    Mills Jane

    2012-11-01

    Full Text Available Abstract Background The role of Australian general practice nurses (PNs has developed exponentially since the introduction of service based funding in 2005. In particular, their role has expanded to include cervical screening and well women’s health care services provided under the supervision of a general practitioner (GP. While previous research identifies barriers to the provision of these services, this study sought to investigate enablers for nurse led care in this area. Methods A number of grounded theory methods including constantly comparing data, concurrent data collection and analysis and theoretical sampling are utilised in this qualitative, exploratory study. A purposive sample of PNs who completed the required program of education in order to provide cervical screening and well women’s health care services was recruited to the study. Data is presented in categories, however a limitation of the study is that a fully integrated grounded theory was unable to be produced due to sampling constraints. Results Four enablers for the implementation of a change in the PN role to include cervical screening and well women’s health checks are identified in this study. These enablers are: GPs being willing to relinquish the role of cervical screener and well women’s health service provider; PNs being willing to expand their role to include cervical screening and well women’s health services; clients preferring a female practice nurse to meet their cervical screening and well women’s health needs; and the presence of a culture that fosters interprofessional teamwork. Seven strategies for successfully implementing change from the perspective of PNs are also constructed from the data. This study additionally highlights the lack of feedback on smear quality provided to PNs cervical screeners and well women’s health service providers. Conclusions The influence of consumers on the landscape of primary care service delivery in Australia is

  3. Screening for vulnerability in older cancer patients: the ONCODAGE Prospective Multicenter Cohort Study.

    Directory of Open Access Journals (Sweden)

    Pierre Soubeyran

    Full Text Available Geriatric Assessment is an appropriate method for identifying older cancer patients at risk of life-threatening events during therapy. Yet, it is underused in practice, mainly because it is time- and resource-consuming. This study aims to identify the best screening tool to identify older cancer patients requiring geriatric assessment by comparing the performance of two short assessment tools the G8 and the Vulnerable Elders Survey (VES-13.The diagnostic accuracy of the G8 and the (VES-13 were evaluated in a prospective cohort study of 1674 cancer patients accrued before treatment in 23 health care facilities. 1435 were eligible and evaluable. Outcome measures were multidimensional geriatric assessment (MGA, sensitivity (primary, specificity, negative and positive predictive values and likelihood ratios of the G8 and VES-13, and predictive factors of 1-year survival rate.Patient median age was 78.2 years (70-98 with a majority of females (69.8%, various types of cancer including 53.9% breast, and 75.8% Performance Status 0-1. Impaired MGA, G8, and VES-13 were 80.2%, 68.4%, and 60.2%, respectively. Mean time to complete G8 or VES-13 was about five minutes. Reproducibility of the two questionnaires was good. G8 appeared more sensitive (76.5% versus 68.7%, P =  0.0046 whereas VES-13 was more specific (74.3% versus 64.4%, P<0.0001. Abnormal G8 score (HR = 2.72, advanced stage (HR = 3.30, male sex (HR = 2.69 and poor Performance Status (HR = 3.28 were independent prognostic factors of 1-year survival.With good sensitivity and independent prognostic value on 1-year survival, the G8 questionnaire is currently one of the best screening tools available to identify older cancer patients requiring geriatric assessment, and we believe it should be implemented broadly in daily practice. Continuous research efforts should be pursued to refine the selection process of older cancer patients before potentially life-threatening therapy.

  4. 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

    OpenAIRE

    Yvonne Flores; David Bishai; Eduardo Lazcano; Keerti Shah; Attila Lörincz; Mauricio Hernández; Jorge Salmerón; Daron Ferris; Pilar Hernández; Sherman, Mark E.; Brigitte M Ronnett; Enrique Carmona; Alfredo Antúnez; Horacio Manzanares; Mario Uribe

    2003-01-01

    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-col...

  5. Regret on choice of colorectal cancer screening modality was associated with poorer screening compliance: a 4-year prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Martin C S Wong

    Full Text Available Very few studies examined the issue of regret on choosing colorectal cancer (CRC screening tests. We evaluated the determinants of regret and tested the hypothesis that regret over screening choices was associated with poorer screening compliance.A bowel cancer screening centre invited all Hong Kong citizens aged 50-70 years who were asymptomatic of CRC to participate in free-of-charge screening programmes. Upon attendance they attended health seminars on CRC and its screening, and were offered an option to choose yearly faecal immunochemical test (FIT for up to four years vs. one direct colonoscopy. They were not allowed to switch the screening option after decision. A self-administered, four-item validated survey was used to assess whether they regretted over their choice (> 2 = regretful from a scale of 0 [no regret]-5 [extreme regret]. A binary logistic regression model evaluated if initial regret over their choice was associated with poorer programme compliance.From 4,341 screening participants who have chosen FIT or colonoscopy, 120 (2.8% regretted over their decision and 1,029 (23.7% were non-compliant with the screening programme. Younger subjects and people who felt pressure when making their decision were associated with regret. People who regretted their decision were 2.189 (95% C.I. 1.361-3.521, p = 0.001 times more likely to be non-compliant with the programme.This study is the first to show that regret over the initial CRC screening choice was associated with later non-compliance. Screening participants who expressed regret over their choice should receive additional reminders to improve their programmatic compliance.

  6. Real-Time Monitoring and Evaluation of a Visual-Based Cervical Cancer Screening Program Using a Decision Support Job Aid.

    Science.gov (United States)

    Peterson, Curtis W; Rose, Donny; Mink, Jonah; Levitz, David

    2016-01-01

    In many developing nations, cervical cancer screening is done by visual inspection with acetic acid (VIA). Monitoring and evaluation (M&E) of such screening programs is challenging. An enhanced visual assessment (EVA) system was developed to augment VIA procedures in low-resource settings. The EVA System consists of a mobile colposcope built around a smartphone, and an online image portal for storing and annotating images. A smartphone app is used to control the mobile colposcope, and upload pictures to the image portal. In this paper, a new app feature that documents clinical decisions using an integrated job aid was deployed in a cervical cancer screening camp in Kenya. Six organizations conducting VIA used the EVA System to screen 824 patients over the course of a week, and providers recorded their diagnoses and treatments in the application. Real-time aggregated statistics were broadcast on a public website. Screening organizations were able to assess the number of patients screened, alongside treatment rates, and the patients who tested positive and required treatment in real time, which allowed them to make adjustments as needed. The real-time M&E enabled by "smart" diagnostic medical devices holds promise for broader use in screening programs in low-resource settings. PMID:27196932

  7. 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

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    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

  8. Rationale and design of the iPap trial: a randomized controlled trial of home-based HPV self-sampling for improving participation in cervical screening by never- and under-screened women in Australia

    International Nuclear Information System (INIS)

    Organized screening based on Pap tests has substantially reduced deaths from cervical cancer in many countries, including Australia. However, the impact of the program depends upon the degree to which women participate. A new method of screening, testing for human papillomavirus (HPV) DNA to detect the virus that causes cervical cancer, has recently become available. Because women can collect their own samples for this test at home, it has the potential to overcome some of the barriers to Pap tests. The iPap trial will evaluate whether mailing an HPV self-sampling kit increases participation by never- and under-screened women within a cervical screening program. The iPap trial is a parallel randomized controlled, open label, trial. Participants will be Victorian women age 30–69 years, for whom there is either no record on the Victorian Cervical Cytology Registry (VCCR) of a Pap test (never-screened) or the last recorded Pap test was between five to fifteen years ago (under-screened). Enrolment information from the Victorian Electoral Commission will be linked to the VCCR to determine the never-screened women. Variables that will be used for record linkage include full name, address and date of birth. Never- and under-screened women will be randomly allocated to either receive an invitation letter with an HPV self-sampling kit or a reminder letter to attend for a Pap test, which is standard practice for women overdue for a test in Victoria. All resources have been focus group tested. The primary outcome will be the proportion of women who participate, by returning an HPV self-sampling kit for women in the self-sampling arm, and notification of a Pap test result to the Registry for women in the Pap test arm at 3 and 6 months after mailout. The most important secondary outcome is the proportion of test-positive women who undergo further investigations at 6 and 12 months after mailout of results. The iPap trial will provide strong evidence about whether HPV self

  9. Tele-cytology: An innovative approach for cervical cancer screening in resource-poor settings.

    Science.gov (United States)

    Singh, Sandeep; Badaya, Sorabh

    2016-01-01

    Carcinoma cervix remains a leading cause of cancer mortality among women in countries lacking any screening program. The existing screening policy and approach via conventional cytology centered mainly in Tertiary Care Center, is totally unaffordable to Indian women, especially in the remote areas. This suggests the need of depolarizing the resources via generating the near real time modalities which could be used at the door step of the needy ones. For any screening modality to be effective it should be adequately sensitive, specific, reproducible, cheap, simple, affordable, and the most important is should be real time to ensure wide coverage and curtail loss to follow-up. Incorporating telecytology as a screening tool could make the dream come true. Telecytology is the interpretation of cytology material at a distance using digital images. Use of mobile telecytology unit housed in a van carrying satellite equipment and the automated image capturing systems is the central theme behind this idea. The imaging equipment would be carrying out the imaging of Papanicolaou smears prepared at the screening site and sending the images to the central laboratories situated at some tertiary care level. This concept could overcome the hindrance of trained cytology infrastructure in the resource poor settings and could provide an efficient and economical way of screening patients. There is possibility that the designed approach may not detect the entire women positive for the disease but if the desired objective was to diagnose as many cases as possible in resource poor setting, then this process offers an advantage over no screening at all. PMID:27461597

  10. Tele-cytology: An innovative approach for cervical cancer screening in resource-poor settings

    Directory of Open Access Journals (Sweden)

    Sandeep Singh

    2016-01-01

    Full Text Available Carcinoma cervix remains a leading cause of cancer mortality among women in countries lacking any screening program. The existing screening policy and approach via conventional cytology centered mainly in Tertiary Care Center, is totally unaffordable to Indian women, especially in the remote areas. This suggests the need of depolarizing the resources via generating the near real time modalities which could be used at the door step of the needy ones. For any screening modality to be effective it should be adequately sensitive, specific, reproducible, cheap, simple, affordable, and the most important is should be real time to ensure wide coverage and curtail loss to follow-up. Incorporating telecytology as a screening tool could make the dream come true. Telecytology is the interpretation of cytology material at a distance using digital images. Use of mobile telecytology unit housed in a van carrying satellite equipment and the automated image capturing systems is the central theme behind this idea. The imaging equipment would be carrying out the imaging of Papanicolaou smears prepared at the screening site and sending the images to the central laboratories situated at some tertiary care level. This concept could overcome the hindrance of trained cytology infrastructure in the resource poor settings and could provide an efficient and economical way of screening patients. There is possibility that the designed approach may not detect the entire women positive for the disease but if the desired objective was to diagnose as many cases as possible in resource poor setting, then this process offers an advantage over no screening at all.

  11. Oral HPV prevalence in women positive for cervical HPV infection and their sexual partners: a German screening study.

    Science.gov (United States)

    Uken, Ralf B; Brummer, Oliver; von Schubert-Bayer, Carolin; Brodegger, Thomas; Teudt, Ingo U

    2016-07-01

    The incidence of human papillomavirus (HPV) associated oropharyngeal squamous cell cancer (OSCC) is on the rise. With the HPV-positive uterine cervix as a reservoir, HPV-positive OSCC is discussed as a sexually transmitted disease. Mechanisms of HPV transmission to the oral cavity are poorly understood. To gain more insight into HPV-transmission routes, cervically HPV-positive women and their sexual partners are screened for oral HPV infection. Women with cervical dysplasia underwent HPV testing of the uterine cervix and tonsillar region via brush test. In addition, sexual partners received oral HPV testing. Tonsillar brush tests of patients admitted for routine surgery served as the control group. The HPV-PCR (Roche Linear Array Kit) was used to differentiate 37 HPV types. All participants completed a risk-factor questionnaire focusing on sexual habits. 101 women were tested HPV-positive at the cervix. Only 3/101 (3 %) were tested HPV-positive in the oropharynx. In 60/101 (60 %) women the sexual partner could be tested for oral HPV infection: testing was positive in 3/60 (5 %). No oral HPV was detected in the control group. The risk-factor questionnaire revealed significant differences between the female study- and control group in terms of age at first sexual intercourse and smoking habits. The limited data suggest that among sexual partners in Germany, HPV transmission to the oropharynx by oral-genital sex or by autoinoculation is a rare and unlikely event with low HPV concordance. Another explanation for the low oral prevalence could be an independent clearance of HPV from the oropharyngeal site compared to cervix uteri or at different time intervals. PMID:26961518

  12. Symptomatic reactions, clinical outcomes and patient satisfaction associated with upper cervical chiropractic care: A prospective, multicenter, cohort study

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    Hurwitz Eric L

    2011-10-01

    Full Text Available Abstract Background Observational studies have previously shown that adverse events following manipulation to the neck and/or back are relatively common, although these reactions tend to be mild in intensity and self-limiting. However, no prospective study has examined the incidence of adverse reactions following spinal adjustments using upper cervical techniques, and the impact of this care on clinical outcomes. Methods Consecutive new patients from the offices of 83 chiropractors were recruited for this practice-based study. Clinical outcome measures included 1 Neck pain disability index (100-point scale, 2 Oswestry back pain index (100-point scale, 3 11-point numerical rating scale (NRS for neck, headache, midback, and low back pain, 4 treatment satisfaction, and 5 Symptomatic Reactions (SR. Data were collected at baseline, and after approximately 2 weeks of care. A patient reaching sub-clinical status for pain and disability was defined as a follow-up score 30% based on an 11-point numeric rating scale occurring Results A total of 1,090 patients completed the study having 4,920 (4.5 per patient office visits requiring 2,653 (2.4 per patient upper cervical adjustments over 17 days. Three hundred thirty- eight (31.0% patients had SRs meeting the accepted definition. Intense SR (NRS ≥8 occurred in 56 patients (5.1%. Outcome assessments were significantly improved for neck pain and disability, headache, mid-back pain, as well as lower back pain and disability (p 5 million career upper cervical adjustments without a reported incidence of serious adverse event. Conclusions Upper cervical chiropractic care may have a fairly common occurrence of mild intensity SRs short in duration (

  13. Economic evaluation of three populational screening strategies for cervical cancer in the county of Valles Occidental: CRICERVA clinical trial

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    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

  14. Natural history of breast cancers detected in the Swedish mammography screening programme: a cohort study

    DEFF Research Database (Denmark)

    Zahl, Per-Henrik; Gøtzsche, Peter C; Mæhlen, Jan

    2011-01-01

    The natural history of screen-detected breast cancers is not well understood. A previous analysis of the incidence change during the introduction of the Norwegian screening programme in the late 1990s suggested that the natural history of many screen-detected invasive breast cancers is to regress...

  15. ROLE OF COLPOSCOPY USING MODIFIED REID’S INDEX IN SCREENING OF CERVICAL CANCER IN WOMEN WITH ABNORMAL CERVIX ON NAKED EYE EXAMINATION

    OpenAIRE

    Deshpande; Yelikar; Andurkar; Dahitankar

    2014-01-01

    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 biops...

  16. Evaluation of a pilot study for breast and cervical cancer screening with Bradford's minority ethnic women; a community development approach, 1991-93.

    OpenAIRE

    Kernohan, E E

    1996-01-01

    The objectives were: to provide information about breast and cervical cancer and related screening services to minority ethnic women, to enable them to make well informed decisions and choices; to adopt a health education strategy based on a community development approach, augmented by a local publicity campaign; and to evaluate both the direct and indirect effects of this project. To this end a community development intervention study was made over 18 months from October 1991 to March 1993 i...

  17. Community-based participatory research increases cervical cancer screening among Vietnamese-Americans.

    Science.gov (United States)

    Nguyen, Tung T; McPhee, Stephen J; Bui-Tong, Ngoc; Luong, Thien-Nhien; Ha-Iaconis, Tuyet; Nguyen, Thoa; Wong, Ching; Lai, Ky Q; Lam, Hy

    2006-05-01

    Using community-based participatory research methods, a community-research coalition in Santa Clara County, California (SCC) conducted a quasi-experimental, controlled trial to increase Pap test receipt and to build community capacity among Vietnamese-American women. From 1999 to 2004, the Coalition planned and implemented an Action Plan with six components: multimedia campaign, lay health worker outreach, Vietnamese Pap clinic with patient navigation, registry and reminder system, continuing medical education for Vietnamese physicians, and restoring a Breast and Cervical Cancer Control Program site. Components were evaluated individually. Community-wide, cross-sectional telephone surveys of Vietnamese women in SCC (intervention community) and Harris County, Texas (comparison community) measured overall project impact. Receipt and currency of Pap tests increased significantly in the intervention compared with the comparison community. Community involvement, system changes, community and research capacity building, dissemination of results, and program sustainability were also demonstrated. Community-based participatory research is feasible and effective in Vietnamese-American communities. PMID:16809874

  18. Screening of biomarkers in cervical squamous cell carcinomas via gene expression profiling.

    Science.gov (United States)

    Chen, Bing; Li, Chundong; Zhang, Lei; Lv, Jiahui; Tong, Ying

    2015-11-01

    In the present study, gene expression profiles of high-grade squamous intraepithelial lesions (HSIL) and invasive cervical squamous cell carcinomas (CSCC) were analyzed using bioinformatic tools to identify key genes and potential biomarkers. Analyses of differentially expressed genes (DEGs) were performed for HSIL vs. normal control and invasive CSCC vs. normal control tissues using the Limma package in R. Pathway enrichment analysis was performed using KOBAS. A protein‑protein interaction (PPI) network for the DEGs in invasive CSCC was constructed using String. Functional enrichment analysis was performed for the DEGs in the PPI network using DAVID. Relevant small molecules were predicted using Cmap. A total of 633 and 881 DEGs were identified in HSIL and invasive CSCC, respectively, and the two groups had 305 DEGs in common. Genes associated with the mitogen-activated protein kinase signaling pathway were enriched in the HSIL, while cell cycle-associated genes were over‑represented in invasive CSCC. The PPI network, containing 72 upregulated genes and 434 edges, was illustrated. Functional enrichment analysis showed that the cell cycle was the most significant gene ontology term. A total of six small molecules associated with the pathology of CSCC were identified, including the anti-cancer drug piperlongumine, which showed a negative correlation. The findings of the present study not only enhanced the current understanding of the pathogenesis of CSCC, but may also be a basis for the development of novel therapies. PMID:26398134

  19. 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

  20. Abnormal cervical smears in the unchanged uterine cervix: difficulties in the screening, diagnosis, and treatment of cervical intraepithelial neoplasias and microinvasive cancer

    Directory of Open Access Journals (Sweden)

    L. I. Korolenkova

    2011-01-01

    Full Text Available The author analyzes an algorithm for identifying and treating w omen with cervical intraepithelial neoplasias (CIN and microinv asive cancer of the cervix uteri in cases of the hidden area of transformation and in the absence of visible cervical changes. There are excep- tional difficulties of making the diagnosis of epithelial damages due to the incomplete reproducibility of cytological abnormal ities and the low informative value of a histological study of scrapes from the cervical canal. To avoid hypodiagnosis, it is justifiable to prefer human papillomavirus testing (Hybrid Capture 2 (HC2 to repeat smears for the choice of a management tactic. Conization is recommend ed as a diagnostic and/or therapeutic procedure when the viral load is high in over 35-year-old patients with abnormal smears anda hidden transformation area.

  1. 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

  2. The role of medical interpretation on breast and cervical cancer screening among Asian American and Pacific Islander women.

    Science.gov (United States)

    Dang, Jeff; Lee, Jessica; Tran, Jacqueline H; Kagawa-Singer, Marjorie; Foo, Mary Anne; Nguyen, Tu-Uyen N; Valdez-Dadia, Annalyn; Thomson, Jasmin; Tanjasiri, Sora Park

    2010-06-01

    We examined whether the impact of medical interpretation services was associated with the receipt of a mammogram, clinical breast exam, and Pap smear. We conducted a large cross-sectional study involving four Asian American and Pacific Islander (AAPI) communities with high proportions of individuals with limited English proficiency (LEP). Participants were recruited from community clinics, churches and temples, supermarkets, and other community gathering sites in Northern and Southern California. Among those that responded, 98% completed the survey rendering a total of 1,708 AAPI women. In a series of multivariate logistic regression models, it was found that women who typically used a medical interpreter had a greater odds of having received a mammogram (odds ratio [OR] = 1.85; 95% confidence interval [CI] = 1.21, 2.83), clinical breast exam (OR = 3.03; 95% CI = 1.82, 5.03), and a Pap smear (OR = 2.34; 95% CI = 1.38, 3.97) than those who did not usually use an interpreter. The study provides support for increasing language access in healthcare settings. In particular, medical interpreters may help increase the utilization of breast and cervical cancer screening among LEP AAPI women. PMID:20352398

  3. Access to Cancer Screening in People with Learning Disabilities in the UK: Cohort Study in the Health Improvement Network, a Primary Care Research Database

    OpenAIRE

    Osborn, D. P.; Horsfall, L.; Hassiotis, A.; Petersen, I.; Walters, K; Nazareth, I

    2012-01-01

    Objectives To assess whether people with learning disability in the UK have poorer access to cancer screening. Design Four cohort studies comparing people with and without learning disability, within the recommended age ranges for cancer screening in the UK. We used Poisson regression to determine relative incidence rates of cancer screening. Setting The Health Improvement Network, a UK primary care database with over 450 General practices. Participants Individuals with a...

  4. Psychopathology predicts the outcome of medial branch blocks with corticosteroid for chronic axial low back or cervical pain: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Tipirneni Naveen

    2009-02-01

    Full Text Available Abstract Background Comorbid psychopathology is an important predictor of poor outcome for many types of treatments for back or neck pain. But it is unknown if this applies to the results of medial branch blocks (MBBs for chronic low back or neck pain, which involves injecting the medial branch of the dorsal ramus nerves that innervate the facet joints. The objective of this study was to determine whether high levels of psychopathology are predictive of pain relief after MBB injections in the lumbar or cervical spine. Methods This was a prospective cohort study. Consecutive patients in a pain medicine practice undergoing MBBs of the lumbar or cervical facets with corticosteroids were recruited to participate. Subjects were selected for a MBB based on operationalized selection criteria and the procedure was performed in a standardized manner. Subjects completed the Brief Pain Inventory (BPI and the Hospital Anxiety and Depression Scale (HADS just prior to the procedure and at one-month follow up. Scores on the HADS classified the subjects into three groups based on psychiatric symptoms, which formed the primary predictor variable: Low, Moderate, or High levels of psychopathology. The primary outcome measure was the percent improvement in average daily pain rating one-month following an injection. Analysis of variance and chi-square were used to analyze the analgesia and functional rating differences between groups, and to perform a responder analysis. Results Eighty six (86 subjects completed the study. The Low psychopathology group (n = 37 reported a mean of 23% improvement in pain at one-month while the High psychopathology group (n = 29 reported a mean worsening of -5.8% in pain (p Low group had at least 30% improvement in pain versus 10% in the High group (p Conclusion Psychiatric comorbidity is associated with diminished pain relief after a MBB injection performed with steroid at one-month follow-up. These findings illustrate the importance

  5. Factors influencing the decline in lung density in a Danish lung cancer screening cohort

    DEFF Research Database (Denmark)

    Shaker, Saher B.; Dirksen, Asger; Lo, Pechin; Skovgaard, L.T.; de Bruijne, Marleen; Pedersen, Jesper H.

    2012-01-01

    Lung cancer screening trials provide an opportunity to study the natural history of emphysema by using CT lung density as a surrogate parameter.In the Danish Lung Cancer Screening Trial, 2,052 participants were included. At screening rounds, smoking habits were recorded and spirometry was performed....... CT lung density was measured as the volume-adjusted 15th percentile density (PD15). A mixed effects model was used with former smoking males with...

  6. Preventing preterm birth with progesterone: costs and effects of screening low risk women with a singleton pregnancy for short cervical length, the Triple P study

    Directory of Open Access Journals (Sweden)

    Duvekot Johannes J

    2011-10-01

    Full Text Available Abstract Background Women with a short cervical length in mid-trimester pregnancy have a higher risk of preterm birth and therefore a higher rate of neonatal mortality and morbidity. Progesterone can potentially decrease the number of preterm births and lower neonatal mortality and morbidity. Previous studies showed good results of progesterone in women with either a history of preterm birth or a short cervix. However, it is unknown whether screening for a short cervix and subsequent treatment in mid trimester pregnancy is effective in low risk women. Methods/Design We plan a combined screen and treat study among women with a singleton pregnancy without a previous preterm birth. In these women, we will measure cervical length at the standard anomaly scan performed between 18 and 22 weeks. Women with cervical length ≤ 30 mm at two independent measurements will be randomly allocated to receive either vaginal progesterone tablets or placebo between 22 and 34 weeks. The primary outcome of this trial is adverse neonatal condition, defined as a composite outcome of neonatal mortality and severe morbidity. Secondary outcomes are time to delivery, preterm birth rate before 32, 34 and 37 weeks, days of admission in neonatal intensive care unit, maternal morbidity, maternal admission days for preterm labour and costs. We will assess growth, physical condition and neurodevelopmental outcome of the children at two years of age. Discussion This study will provide evidence for the usefulness and cost-effectiveness of screening for short cervical length at the 18-22 weeks and subsequent progesterone treatment among low risk women. Trial registration Netherlands Trial Register (NTR: NTR207

  7. The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer

    DEFF Research Database (Denmark)

    Roura, Esther; Travier, Noémie; Waterboer, Tim; de Sanjosé, Silvia; Bosch, F Xavier; Pawlita, Michael; Pala, Valeria; Weiderpass, Elisabete; Margall, Núria; Dillner, Joakim; Gram, Inger T; Tjønneland, Anne; Munk, Christian; Palli, Domenico; Khaw, Kay-Tee; Overvad, Kim; Clavel-Chapelon, Françoise; Mesrine, Sylvie; Fournier, Agnès; Fortner, Renée T; Ose, Jennifer; Steffen, Annika; Trichopoulou, Antonia; Lagiou, Pagona; Orfanos, Philippos; Masala, Giovanna; Tumino, Rosario; Sacerdote, Carlotta; Polidoro, Silvia; Mattiello, Amalia; Lund, Eiliv; Peeters, Petra H; Bueno-de-Mesquita, H B As; Quirós, J Ramón; Sánchez, María-José; Navarro, Carmen; Barricarte, Aurelio; Larrañaga, Nerea; Ekström, Johanna; Lindquist, David; Idahl, Annika; Travis, Ruth C; Merritt, Melissa A; Gunter, Marc J; Rinaldi, Sabina; Tommasino, Massimo; Franceschi, Silvia; Riboli, Elio; Castellsagué, Xavier

    2016-01-01

    BACKGROUND: In addition to HPV, high parity and hormonal contraceptives have been associated with cervical cancer (CC). However, most of the evidence comes from retrospective case-control studies. The aim of this study is to prospectively evaluate associations between hormonal factors and risk of...... developing cervical intraepithelial neoplasia grade 3 (CIN3)/carcinoma in situ (CIS) and invasive cervical cancer (ICC). METHODS AND FINDINGS: We followed a cohort of 308,036 women recruited in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study. At enrollment, participants.......7). CONCLUSIONS: Even though HPV is the necessary cause of CC, our results suggest that several hormonal factors are risk factors for cervical carcinogenesis. Adherence to current cervical cancer screening guidelines should minimize the increased risk of CC associated with these hormonal risk factors....

  8. Assessment of health-related quality of life using the SF-36 in Chinese cervical spondylotic myelopathy patients after surgery and its consistency with neurological function assessment: a cohort study

    OpenAIRE

    Zhang, Yilong; Zhou, Feifei; SUN, Yu

    2015-01-01

    Background We aimed to calculate the responsiveness and statistically prove the reliability of the Medical Outcomes Study Short Form Health Survey (SF-36) in a prospective cohort study. We investigated the profile of mid-term health-related quality of life (QOL) outcome assessments after surgery for cervical spondylotic myelopathy (CSM) and determined the consistency of the SF-36 assessments of neurological function. Methods A total of 142 consecutive patients with CSM who underwent surgery w...

  9. [Physical activity, screen time, and use of medicines among adolescents: the 1993 Pelotas (Brazil) birth cohort study].

    Science.gov (United States)

    Bergmann, Gabriel Gustavo; Bertoldi, Andréa Dâmaso; Mielke, Grégore Iven; Camargo, Aline Lins; Matijasevich, Alicia; Hallal, Pedro Curi

    2016-01-01

    This study aimed to evaluate cross-sectional and longitudinal associations between physical activity, screen time, and use of medicines among adolescents from the 1993 Pelotas (Brazil) birth cohort study, followed at 11 (N = 4,452), 15 (N = 4,325), and 18 years of age (N = 4,106). The study recorded the use of medicines in the previous 15 days, continuous use of some medication, level of physical activity (by questionnaire and accelerometry), and screen time (TV, computer, and videogame). One-third of adolescents had used at least one medicine in the previous 15 days and approximately 10% were on some continuous medication. In the adjusted analysis, the results showed that higher levels of physical activity at 18 years and less screen time at 15 years in boys were associated with lower overall use of medicines (p < 0.05). For boys, physical activity at 11 and 18 years were inversely related to continuous medication (p < 0.05). More physically active boys and those with less screen time in adolescence showed lower use of medicines at 18 years of age. PMID:27167041

  10. New paradigms in cervical cancer prevention: opportunities and risks

    Directory of Open Access Journals (Sweden)

    Giorgi Rossi Paolo

    2008-12-01

    Full Text Available Testing for the DNA of high-risk types of papilloma virus (HPV is more sensitive than cytology in detecting pre-cancerous lesions. One of the main advantages will be the possibility of applying prolonged screening intervals. However adequate screening protocols (age of start and stop, screening intervals, management of HPV positive women need to be applied in order to avoid over-referral to colposcopy and over-treatment and to maintain sustainable costs. Further follow-up of running trials and research on molecular markers will better define these parameters. The new situation will require organised screening programmes with rigorous protocols and monitoring. This will be even more needed when women vaccinated for HPV 16 and 18 will be screened. Research on how to best screen vaccinated women is a priority. This paper proposes an overview of the plausible impact of new technologies in cervical cancer screening in the near future and in the vaccinated cohorts.

  11. Impact of a new national screening policy for Down's syndrome in Denmark: population based cohort study

    DEFF Research Database (Denmark)

    Ekelund, Charlotte K; Jørgensen, Finn Stener; Petersen, Olav Bjørn; Sundberg, Karin; Tabor, Ann; NN, NN

    2008-01-01

    OBJECTIVES: To evaluate the impact of a screening strategy in the first trimester, introduced in Denmark during 2004-6, on the number of infants born with Down's syndrome and the number of chorionic villus samplings and amniocenteses, and to determine detection and false positive rates in the...... newborn infants with Down's syndrome diagnosed prenatally and postnatally and number of chorionic villus samplings and amniocenteses carried out. Secondary outcomes measured were number of women screened in 2005 and 2006, screen positive rate, and information on screening in 2005 and 2006 for infants with...... detection rate in the screened population in 2005 was 86% (95% confidence interval 79% to 92%) and in 2006 was 93% (87% to 97%). The corresponding false positive rates were 3.9% (3.7% to 4.1%) and 3.3% (3.1% to 3.4%). CONCLUSION: The introduction of a combined risk assessment during the first trimester at a...

  12. 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.…

  13. Changes in depression in a cohort of Danish HIV-positive individuals: time for routine screening

    DEFF Research Database (Denmark)

    Rodkjaer, Lotte; Laursen, Tinne; Christensen, Nils B;

    2011-01-01

    Background: The aim of this study was to follow a cohort of HIV-positive individuals for 3 years in order to assess changes in depression, adherence, unsafe sex and emotional strains from living with HIV. Methods: Participants were assessed for depression, adherence, emotional strain and unsafe s...

  14. 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 HR-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 performance, consequently, longitudinal studies linking HPV status to disease outcomes in vaccinated women are warranted. PMID:26845632

  15. Risk factors and distribution of oncogenic strains of human papilloma virus in women presenting for cervical cancer screening in Port Harcourt, Nigeria

    Science.gov (United States)

    Kennedy, Nyengidiki Tamunomie; Ikechukwu, Durugbo; Goddy, Bassey

    2016-01-01

    Introduction Human papilloma virus(HPV) accounts for most cases of cervical cancer with high risk HPV(hrHPV) genotypes largely responsible. The objective is to ascertain the distribution of oncogenic strains of human papilloma virus genotypes and predisposing risk factors in women presenting for cervical cancer screening in Nigeria. Methods A cross-sectional study of 80 women who presented for cervical cancer screening. The biodata of the participants, the presence of risk factors to HPV were recorded and hrHPV were identified using PCR technique. The information obtained was processed using the SPSS version 20 software. Results were presented in tables, test of significance and association done using student's t-test and Odds ratio, with P value < 0.05 as significant. Results The age range of patients was 19-62 years with prevalence of hrHPV of 10%. HrHPV are more in patients with more than one life time sexual partner (OR 1.26,95%CI 0.13-29.99), multiple sexual partners (OR 1.55, 95% CI 0.28-8.70), early coitarche (OR 1.57, 95% CI 0.14-15.00) and previous STI (OR 150, 95%CI 9.53-1979. 62). Four hrHPV genotypes: 16, 18, 31 and 35 were detected. Conclusion HPV genotype 18 was predominant in Port Harcourt, Nigeria. High risk sexual behaviours are associated with acquisition of hrHPV.

  16. APPLICATION OF VIA IN SCREENING OF CERVICAL DISEASES AMONG WOMEN WORKERS%VIA在女职工体检中的应用

    Institute of Scientific and Technical Information of China (English)

    高琨; 李力; 梁欢欢; 黄玲莎

    2011-01-01

    [目的]评价在女职工体检中采用醋酸肉眼观察法(VIA)的筛查宫颈病变的效果.[方法]对737位女职工进行妇科检查,同时采用VIA及巴氏涂片法进行宫颈病变的筛查,评价两种方法的宫颈病变检出率.[结果]参检率为75.20%(737/980),参检妇女关于癌症的知晓率为62.5%;宫颈癌的筛查方法的知晓率为42.5%,其中宫颈细胞学检查知晓率为36.5%;人乳头瘤病毒知晓率为19%;CIN Ⅱ级以上病变的检出率VIA法为0.54%(4/737);巴氏涂片法为0,两种检查方法比较差异有统计学意义(P<0.05).[结论]大多数妇女对宫颈癌症的防治知识了解甚少,需加强知识的普及:应用VIA联合巴氏涂片法进行宫颈癌的初筛可进一步提高癌前病变的检出率.%[ Objective] To explore feasibilities of visual inspection with acetic acid ( VIA) in screening of cervical diseases among women workers. [Methods] 737 female workers were screened by using VIA and Pap smear screening for cervical lesions. The detection rates of cervical lesions were evaluated. [ Results] Participation rate was 75.20% (737/980). The rate of awareness about cancer in the women worker was 62.5%, and the rate of awareness about screening methods for cervical cancer was 36.5%, in which the rate of awareness of cervical cy(t)ology was 42.5%, and 19% knew human papillomavirus. CIN Ⅱ lesion detection rate was 0.54% by using VIA method, but we did not find cases by the Pap smear screening. Comparing two methods,there was a significant difference (P< 0.05). [Conclusion] Most of the women poorly understand ahout the prevention and treatment of cervical cancer, so we should strengthen the popularization of health knowledge. Application of VIA method combined Pap smear screening for cervical cancer may further improve the detection rate of precancerous lesions.

  17. The Study of the Prevention of Anal Cancer (SPANC): design and methods of a three-year prospective cohort study

    OpenAIRE

    Machalek, Dorothy A; Grulich, Andrew E; Hillman, Richard J; Jin, Fengyi; Templeton, David J; Tabrizi, Sepehr N.; Garland, Suzanne M; Prestage, Garrett; McCaffery, Kirsten; Howard, Kirsten; Tong, Winnie; Fairley, Christopher K.; Roberts, Jennifer; Farnsworth, Annabelle; Poynten, I Mary

    2013-01-01

    Background The incidence of human papillomavirus (HPV)-associated anal cancer is increasing in men who have sex with men (MSM). Screening for the presumed cancer precursor, high-grade anal squamous intraepithelial lesions (HSIL) in a manner analogous to cervical cancer screening has been proposed. Uncertainty remains regarding anal HPV natural history and the role of anal cytology and high-resolution anoscopy (HRA) as screening tests. Well-designed cohort studies are required to address these...

  18. Value of Cervical Smear Cytology for Cervical Cancer Screening%宫颈刮片脱落细胞学检查对宫颈癌筛选的价值

    Institute of Scientific and Technical Information of China (English)

    黄瑞虹

    2013-01-01

    Objective:To explore the clinical value of cervical smear cytology for cervical cancer screening.Methods:5963 cases of gynecological examination of women underwent the cervical scraping levy cytology and TCT detection,the positive rate was compared.The TCT test result showed positive or suspected positive underwent colposcopy sampling biopsy,and was compared with the results of TCT test.Results:The positive rate of TCT detection of cervical lesions was significantly higher than that in the control group(P<0.01).There were a total of 538 cases of positive or suspected positive subjects by TCT detected, 449 cases of cervical precancerous lesions detected by biopsy,the detection rate was 83.46%.Conclusion:TCT detection of cervical precancerous lesions can help to improve clinical detection rate,the more significant of TCT diagnosis of abnormalities,the detection rate of biopsy is higher.%  目的:探讨宫颈刮片脱落细胞学检查对宫颈癌筛查的临床价值。方法:5963例妇科体检妇女均行宫颈刮片脱落细胞学检查及TCT检测,比较阳性率;TCT检测结果为阳性或疑似阳性受检者行阴道镜取样病理活检,并与TCT检测结果比较。结果:TCT检测宫颈病变的阳性率明显高于对照组(P<0.01);TCT检测共发现阳性或疑似阳性受检者538例,病理活检共检出宫颈癌前病变449例,检出率83.46%。结论:TCT检测有利于提高宫颈癌前病变的临床检出率,TCT诊断的异常性越显著,病理活检的检出率越高。

  19. A randomized controlled trial of Human Papillomavirus (HPV) testing for cervical cancer screening: trial design and preliminary results (HPV FOCAL Trial)

    International Nuclear Information System (INIS)

    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. 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 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. International Standard Randomised Controlled Trial Number Register, ISRCTN79347302

  20. Impact of a new national screening policy for Down's syndrome in Denmark: population based cohort study

    DEFF Research Database (Denmark)

    Ekelund, Charlotte Kvist; Petersen, O.B.; Sundberg, K.;

    2008-01-01

    OBJECTIVES: To evaluate the impact of a screening strategy in the first trimester, introduced in Denmark during 2004-6, on the number of infants born with Down's syndrome and the number of chorionic villus samplings and amniocenteses, and to determine detection and false positive rates in the...... newborn infants with Down's syndrome diagnosed prenatally and postnatally and number of chorionic villus samplings and amniocenteses carried out. Secondary outcomes measured were number of women screened in 2005 and 2006, screen positive rate, and information on screening in 2005 and 2006 for infants with...... a postnatal diagnosis of Down's syndrome. RESULTS: The number of infants born with Down's syndrome decreased from 55-65 per year during 2000-4 to 31 in 2005 and 32 in 2006. The total number of chorionic villus samplings and amniocenteses carried out decreased from 7524 in 2000 to 3510 in 2006. The...

  1. 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....

  2. 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\\').

  3. Screening for depression and anxiety: correlates of non-response and cohort attrition in the Netherlands study of depression and anxiety (NESDA).

    Science.gov (United States)

    Van Der Veen, Willem Jan; Van Der Meer, Klaas; Penninx, Brenda W

    2009-12-01

    A major problem in the analysis of attrition of cohorts in studies on mental health problems is that data on those who do not participate at the outset of a study are largely unavailable. It is not known how underlying psychopathology affects the first stages of screening where non-response and selectivity are usually highest. This article presents results of one of the centres of the Netherlands Study of Depression and Anxiety (NESDA), a longitudinal study aimed at describing the long-term course and consequences of depression and anxiety disorders. The aim is to describe the different ways of attrition during the first NESDA-wave in a cohort of patients aged 18-65 years of the Registration Network Groningen and to analyse whether attrition is related to gender, age and psychopathology as recorded in general practice. The attrition of the study cohort (n = 8475) was highest during the first stages, eventually leading to a population of 169 patients only who participated in the full NESDA-programme. Probabilities of transition from one stage of the screening process to the next were regressed on selected background variables using binary logistic regression. Correlates of participation were being female and being older (>40). Psychopathology was an important variable in the formation of the initial sample cohort, but only had a weak influence on patient response to the screening questionnaire. Study design factors had a stronger impact on the changing composition of the cohort at each screening stage compared to patient factors. PMID:20027601

  4. 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

  5. Association of cervical biopsy with HIV type 1 genital shedding among women on highly active antiretroviral therapy.

    Science.gov (United States)

    Woo, Victoria G; Liegler, Teri; Cohen, Craig R; Sawaya, George F; Smith-McCune, Karen; Bukusi, Elizabeth A; Huchko, Megan J

    2013-07-01

    HIV-1 genital shedding is associated with increased HIV-1 transmission risk. Inflammation and ulceration are associated with increased shedding, while highly active antiretroviral therapy (HAART) has been shown to have a protective effect. We sought to examine the impact of cervical biopsies, a routine component of cervical cancer screening, on HIV-1 genital RNA levels in HIV-infected women on HAART. We enrolled HIV-1-infected women undergoing cervical biopsy for diagnosis of cervical intraepithelial neoplasia (CIN) 2/3 in this prospective cohort study. All were stable on HAART for at least 3 months. Clinical and demographic information as well as plasma HIV-1 viral load were collected at the baseline visit. Specimens for cervical HIV-1 RNA were collected immediately prior to biopsy, and 2 and 7 days afterward. Quantitative PCR determined HIV-1 concentration in cervical specimens at each time point to a lower limit of detection of 40 copies/specimen. Among the 30 participants, five (16.6%) women had detectable cervical HIV-1 RNA at baseline, of whom four (80%) had detectable HIV-1 RNA after cervical biopsy, with no significant increase in viral load in the follow-up specimens. Only one woman (3.3%) with undetectable baseline cervical HIV-1 RNA had detection postbiopsy. Detectable plasma HIV-1 RNA was the only factor associated with baseline cervical HIV-1 RNA. In women on HAART, an increase in cervical HIV-1 RNA detection or concentration was not associated with cervical biopsy. These findings help provide safety data regarding cervical cancer screening and diagnosis in HIV-infected women and inform postprocedure counseling. PMID:23594240

  6. Reflections on the ACS-ASCCP-ASCP Cervical Cancer Screening Guidelines 2012%美国最新子宫颈癌筛查指南学习与思考

    Institute of Scientific and Technical Information of China (English)

    孙丽芳

    2015-01-01

    Cervical cancer screening has become a widely accepted practice to reduce the incidence of cervical cancer. Standardized protocols of screening would help prevent the failure of diagnosis and therapy. ACS-ASCCP-ASCP Cervical Cancer Screening Guidelines 2012 recommends standardized screening methods for females of different ages with different types of abnormal cervical cytology. Specifically, it states that the joint screening on cervical cytology and HPV (co-test) is the most effective practice for females of 30 years old and older.%虽然子宫颈癌筛查已较为普及,但规范诊治仍有待进一步加强。美国2012子宫颈癌筛查指南细化了不同年龄各种宫颈细胞学异常的处理原则,特别强化了宫颈细胞学+人乳头状瘤病毒(HPV)联合检测是30岁以上女性最好的筛查方法。

  7. Important Variables When Screening for Students at Suicidal Risk: Findings from the French Cohort of the SEYLE Study.

    Science.gov (United States)

    Kahn, Jean-Pierre; Tubiana, Alexandra; Cohen, Renaud F; Carli, Vladimir; Wasserman, Camilla; Hoven, Christina; Sarchiapone, Marco; Wasserman, Danuta

    2015-10-01

    Due to early detection of mental ill-health being an important suicide preventive strategy, the multi-centre EU funded "Saving and Empowering Young Lives in Europe" (SEYLE) study compared three school-based mental health promotion programs to a control group. In France, 1007 students with a mean age of 15.2 years were recruited from 20 randomly assigned schools. This paper explores the French results of the SEYLE's two-stage screening program (ProfScreen) and of the cross-program suicidal emergency procedure. Two-hundred-thirty-five ProfScreen students were screened using 13 psychopathological and risk behaviour scales. Students considered at risk because of a positive finding on one or more scales were offered a clinical interview and, if necessary, referred for treatment. A procedure for suicidal students (emergency cases) was set up to detect emergencies in the whole cohort (n = 1007). Emergency cases were offered the same clinical interview as the ProfScreen students. The interviewers documented their reasons for referrals in a short report. 16,2% of the ProfScreen students (38/235) were referred to treatment and 2,7% of the emergency cases (27/1007) were also referred to treatment due to high suicidal risk. Frequent symptoms in those students referred for evaluation were depression, alcohol misuse, non-suicidal self-injuries (NSSI), and suicidal behaviours. According to the multivariate regression analysis of ProfScreen, the results show that the best predictors for treatment referral were NSSI (OR 2.85), alcohol misuse (OR 2.80), and depressive symptoms (OR 1.13). Analysis of the proportion for each scale of students referred to treatment showed that poor social relationships (60%), anxiety (50%), and suicidal behaviours (50%) generated the highest rate of referrals. Qualitative analysis of clinician's motivations to refer a student to mental health services revealed that depressive symptoms (51%), anxiety (38%), suicidal behaviours (40%), and negative life

  8. Important Variables When Screening for Students at Suicidal Risk: Findings from the French Cohort of the SEYLE Study

    Directory of Open Access Journals (Sweden)

    Jean-Pierre Kahn

    2015-09-01

    Full Text Available Due to early detection of mental ill-health being an important suicide preventive strategy, the multi-centre EU funded “Saving and Empowering Young Lives in Europe” (SEYLE study compared three school-based mental health promotion programs to a control group. In France, 1007 students with a mean age of 15.2 years were recruited from 20 randomly assigned schools. This paper explores the French results of the SEYLE’s two-stage screening program (ProfScreen and of the cross-program suicidal emergency procedure. Two-hundred-thirty-five ProfScreen students were screened using 13 psychopathological and risk behaviour scales. Students considered at risk because of a positive finding on one or more scales were offered a clinical interview and, if necessary, referred for treatment. A procedure for suicidal students (emergency cases was set up to detect emergencies in the whole cohort (n = 1007. Emergency cases were offered the same clinical interview as the ProfScreen students. The interviewers documented their reasons for referrals in a short report. 16,2% of the ProfScreen students (38/235 were referred to treatment and 2,7% of the emergency cases (27/1007 were also referred to treatment due to high suicidal risk. Frequent symptoms in those students referred for evaluation were depression, alcohol misuse, non-suicidal self-injuries (NSSI, and suicidal behaviours. According to the multivariate regression analysis of ProfScreen, the results show that the best predictors for treatment referral were NSSI (OR 2.85, alcohol misuse (OR 2.80, and depressive symptoms (OR 1.13. Analysis of the proportion for each scale of students referred to treatment showed that poor social relationships (60%, anxiety (50%, and suicidal behaviours (50% generated the highest rate of referrals. Qualitative analysis of clinician’s motivations to refer a student to mental health services revealed that depressive symptoms (51%, anxiety (38%, suicidal behaviours (40%, and

  9. 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; Lynge, Elsebeth

    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).......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)....

  10. Three-cohort targeted gene screening reveals a non-synonymous TRKA polymorphism associated with schizophrenia

    DEFF Research Database (Denmark)

    van Schijndel, Jessica E; van Loo, Karen M J; van Zweeden, Martine;

    2009-01-01

    selected non-synonymous single-nucleotide polymorphisms (SNPs) in three independent Caucasian schizophrenia case-control cohorts (USA, Denmark and Norway). A meta-analysis revealed ten non-synonymous SNPs that were nominally associated with schizophrenia, nine of which have not been previously linked to...... most attractive candidate for further study concerns SNP rs6336 (q=0.12) that causes the substitution of an evolutionarily highly conserved amino acid residue in the kinase domain of the neurodevelopmentally important receptor TRKA. Thus, TRKA signaling may represent a novel susceptibility pathway for...

  11. 宫颈癌机会性筛查的临床价值%Clinical Value of Cervical Cancer Opportunistic Screening

    Institute of Scientific and Technical Information of China (English)

    吴新容

    2012-01-01

    目的 分析研究宫颈癌机会性筛查的意义及临床价值.方法 以我院2007年11月至2010年11月在妇科门诊对前来就诊的患者进行宫颈癌机会性筛查研究.接受筛查对象均进行液基细胞学检查,细胞学异常行HPV结合阴道镜检查.并以患者进行活检组织病理学诊断作为宫颈癌的定性诊断.结果 2402例患者愿意接受筛查,顺应性为98.84%;液基细胞学阳性检出率为11.65%;阴道镜检查感染率为33.21%;病理活检阳性率为21.23%.将此次研究与2003 ~2005年的研究进行比较,存在明显差异(P<0.05).结论 通过对患者宫颈癌的机会性筛查,有效地提高了防治效果及群众对宫颈癌的认知度,对宫颈癌的早期诊治具有十分重要的意义,值得临床推广.%Objective To analyze the significance and clinical value of opportunistic screening in cervical cancer. Methods Patients in gynecologic clinic from Nov. 2007 to Nov. 2010 were given opportunistic screening of cervical cancer. All of them were performed liquid-based cytology examination. Those with abnormal cytology were given HPV combined with colposcopy examination. Pathological diagnosis of biopsy tissues were regarded as qualitative diagnosis of cervical cancer. Results 2402 patients were willing to take screening, the compliance was 98.84% ; liquid-based cytology detection rate was 11.65% ; colposcopy examination infection rate was 33.21%; pathologic biopsy positive rate was 21.23 %. Compared with the results of 2003 -2005,the difference was statistically significant,? <0. 05. Conclusion Opportunistic screening can effectively improve cognition degree of cervical cancer. It has very important significance to the early diagnosis and treatment of the disease,which is worth of spreading in clinic.

  12. Impact of 2-, 4- and 9-valent HPV vaccines on morbidity and mortality from cervical cancer.

    Science.gov (United States)

    Luckett, Rebecca; Feldman, Sarah

    2016-06-01

    Cervical cancer causes significant morbidity and mortality worldwide. Most cervical cancers are associated with oncogenic human papillomavirus (HPV), and vaccination with any of 3 available HPV vaccines is anticipated to greatly reduce the burden of cervical cancer. This review provides an overview of the burden of HPV, the efficacy and clinical effectiveness of the bivalent (HPV 16, 18), quadrivalent (HPV 6, 11, 16, 18) and 9vHPV (HPV 6, 11, 16, 1831, 33, 45, 52, 58) vaccines in order to assess the anticipated impact on cervical cancer. All three vaccines show high efficacy in prevention of vaccine-specific HPV-type infection and associated high-grade cervical dysplasia in HPV-naïve women. Early clinical effectiveness data for the bivalent and quadrivalent vaccine demonstrate reduced rates of HPV 16 and 18 prevalence in vaccinated cohorts; data evaluating cervical dysplasia and cervical procedures as outcomes will shed further light on the clinical effectiveness of both vaccines. The bivalent vaccine has demonstrated cross-protection to non-vaccine HPV types, including the types in the 9vHPV vaccine. No clinical effectiveness data is yet available for the 9vHPV vaccine.  While HPV vaccination has great promise to reduce cervical cancer morbidity and mortality, estimated benefits are largely theoretical at present. Large population-based clinical effectiveness studies will provide long-term immunogenicity and effectiveness, as well as assessment of cervical cancer as an endpoint, particularly as young vaccinated women enter the appropriate age range to initiate screening for cervical cancer. Strengthening screening and treatment programs will likely have the greatest impact in the short-term on cervical cancer morbidity and mortality. PMID:26588179

  13. Role of visual inspection of cervix with acetic acid and high risk human papilloma virus DNA testing in screening for cervical cancer

    Directory of Open Access Journals (Sweden)

    Neha Gami

    2013-04-01

    Full Text Available Background: To evaluate the role of VIA alone and in combination with high risk Human Papilloma virus DNA testing as a screening test for cervical dysplasia and cancer. Methods: 400 symptomatic patients from the gynecology outpatient department were screened using Pap smear and VIA. HPV DNA testing was done for 62 VIA positive and 100 VIA negative women. Colposcopy was done for all women. Those found positive on any or all of the screening tests were subjected to cervical biopsy. The results were analysed for PAP, VIA, HPV and a combined test using VIA and HPV both. Results: VIA had the highest sensitivity (91% to detect any grade of dysplasia. The sensitivity of the combination test (VIA + HPV was 80.6% which was lower than that of VIA (91% and also lower than that of HR HPV DNA detection (86%. The specificity of the combination test (VIA + HPV was 68.3 % which was significantly higher than that of VIA alone (39% (p = 0.000 and also higher than that for HPV DNA detection when used alone (56%. Pap smear had the highest specificity (95.12 % but sensitivity was much lower at 52.7 %. Conclusions: VIA is a highly sensitive screening test. The main disadvantage is its low specificity. However the combination test of VIA + HR HPV testing overcomes this and at the same time maintains a high sensitivity. Thus a test which combines VIA plus HR HPV testing is better screening method than either of the three tests (VIA, HPV, PAP done alone. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 152-156

  14. Cervical dysplasia

    Science.gov (United States)

    ... by your provider. Make sure to get the HPV vaccine when it is offered to you. This vaccine prevents many cervical cancers. ... Early diagnosis and prompt treatment cures most cases of cervical ... severe cervical dysplasia may change into cervical cancer.

  15. Fertility drug use and mammographic breast density in a mammography screening cohort of premenopausal women

    OpenAIRE

    Sprague, Brian L.; Trentham-Dietz, Amy; Terry, Mary Beth; Nichols, Hazel B.; Bersch, Andy J.; Buist, Diana S. M.

    2008-01-01

    The widespread use of ovulation-inducing drugs to enhance fertility has raised concerns regarding potential effects on breast cancer risk, as ovarian stimulation is associated with increases in estrogen and progesterone levels. We investigated the short-term relation between fertility drug use and mammographic breast density, a strong marker of breast cancer risk, among participants in the Group Health Breast Cancer Screening Program. Data linkage with Group Health’s automated pharmacy record...

  16. The usefulness of the Retinomax autorefractor for childhood screening validated against a Danish preterm cohort examined at the age of 4 years

    DEFF Research Database (Denmark)

    Fledelius, H C; Bangsgaard, R; Slidsborg, C; Dornonville de la Cour, Morten

    2015-01-01

    BACKGROUND AND PURPOSE: Refractometers have gained a foothold in childhood screening for ophthalmic disorders. Given the results of an ophthalmic follow-up of an extremely preterm Danish cohort, the results of the Retinomax autorefractor were further evaluated. MATERIALS AND METHODS: A nationwide...

  17. Evaluating the Impact of PSA as a Selection Criteria for Nerve Sparing Radical Prostatectomy in a Screened Cohort

    Directory of Open Access Journals (Sweden)

    Shyam K. Tanguturi

    2014-01-01

    Full Text Available Purpose. We investigated whether NS-RP increased risk of PSA failure and whether PSA should be included as a selection criterion for NS. Methods. We evaluated 357 consecutive men with screen-detected PC who underwent open RP without adjuvant radiotherapy between 9/11/2001 and 12/30/2008. Criteria for NS included Gleason score ≤3 + 4, percentage of positive biopsies (PPB ≤50%, percentage of core involvement ≤50%, nonapical location, no perineural invasion, and no palpable disease on pre- or intraoperative exam but did not include a PSA threshold. Cox multivariable regression assessed whether increasing PSA or unilateral- or bilateral-NS versus non-NS-RP was associated with PSA failure adjusting for prognostic factors. Results. After a median follow-up of 3.96 years, 34 men sustained PSA failure (9.5%. Increasing PSA was significantly associated with increased risk of PSA failure in the interaction model (adjusted hazard ratio (AHR: 1.09 [95% CI: 1.03–1.16]; P=0.005, whereas unilateral (AHR: 1.24 [95% CI: 0.36–4.34]; P=0.73 or bilateral NS (AHR: 0.41 [95% CI: 0.06–2.59]; P=0.34 versus non-NS RP was not. Conclusion. NS-RP in a screened cohort did not increase risk of PSA failure using NS criteria not including PSA.

  18. Cost-effectiveness of conventional cytology and HPV DNA testing for cervical cancer screening in Colombia Costo-efectividad de la citología y la tamización con pruebas de ADN-VPH para cáncer de cuello uterino en Colombia

    OpenAIRE

    Oscar Andrés-Gamboa; Liliana Chicaíza; Mario García-Molina; Jorge Díaz; Mauricio González; Raúl Murillo; Mónica Ballesteros; Ricardo Sánchez

    2008-01-01

    OBJECTIVE: To assess cost-effectiveness of conventional cytology and HPV DNA testing for cervical-cancer screening in Colombia. MATERIAL AND METHODS: The National Cancer Institute of Colombia (NCIC) in 2007 developed a Markov model on the natural history of cervical cancer; no screening, conventional cytology, and HPV DNA testing were compared. Only direct costs were used. Outcomes comprise cervical cancer mortality, years of life saved, and lifetime costs. Discounted incremental cost-effecti...

  19. The Vicious Cycle of Inadequate Early Detection: A Complementary Study on Barriers to Cervical Cancer Screening Among Middle-Aged and Older Women

    Directory of Open Access Journals (Sweden)

    Corinne R. Leach, MS

    2007-10-01

    Full Text Available IntroductionAlthough rates of invasive cervical cancer have declined precipitously over the past 50 years, nearly 10,000 new cases and 3700 deaths result from this cancer annually. Given the efficacy of early detection, invasive cervical cancer should no longer constitute a health threat; however, national studies reveal that many women, especially older women, do not receive Papanicolaou (Pap tests.MethodsIn this complementary study, we examined data from the National Health Interview Survey focusing on the correlates of screening for women aged 55 years or older, an age group in which invasive cervical cancer rates escalate and rates of obtaining Pap tests decline. To more richly understand grounded perspectives, we queried 25 women who were rarely or never screened about factors and circumstances underlying their decision not to obtain a Pap test.ResultsQuantitative data indicate an association between Pap test use and demographic factors (being married, being younger, and having suburban or urban residence and access to preventive care (obtaining mammograms, having a regular source of health care, and having contact with an obstetrician/gynecologist. Participants who provided qualitative data echoed this theme of inadequate use of preventive services, particularly among women with weak social ties, who were older, and who lived in rural areas. Shortages of health care professionals and a lack of continuity of care and privacy contribute to suboptimal prevention.ConclusionA vicious cycle emerges: many women decline to pursue preventive care because of competing health and financial demands and insufficient resources to seek care. When such women do go to the doctor’s office, they feel chastised by providers, which alienates them and thwarts future preventive care.

  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. Breast cancer correlates in a cohort of breast screening program participants in Riyadh, KSA

    OpenAIRE

    Fahad A. Al-Amri; Mohammed Y. Saeedi; Fatina M. Al-Tahan; Ali, Arwa M.; Shaker A. Alomary; Mostafa Arafa; Ibrahim, Ahmed K.; Kassim A. Kassim

    2015-01-01

    Background: Breast cancer is the first cancer among females in the Kingdom of Saudi Arabia, accounting for 27.4% of all newly diagnosed female cancers in 2010. There are several risk factors affecting the incidence of breast cancer where some factors influence the risk more than the others. Aim: We aimed to identify the different risk factors related to breast cancer among females participating in the breast-screening program in Riyadh, KSA. Methods: Based on data from phase-I of the br...

  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. 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…

  4. What Should I Know about Screening?

    Science.gov (United States)

    ... Informed Cancer Home What Should I Know About Screening? Language: English Español (Spanish) Recommend on Facebook Tweet ... any treatment that may be needed. Cervical Cancer Screening Guidelines The Cervical Cancer Screening Guidelines chart [PDF- ...

  5. 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.

  6. The BD Onclarity HPV Assay on Samples Collected in SurePath Medium Meets the International Guidelines for Human Papillomavirus Test Requirements for Cervical Screening

    Science.gov (United States)

    Bottari, Fabio; Pedersen, Helle; Sandri, Maria Teresa; Bonde, Jesper

    2016-01-01

    This study describes a validation of the BD Onclarity HPV (Onclarity) assay using the international guidelines for HPV test requirements for cervical cancer screening of women 30 years old and older using Danish SurePath screening samples. The clinical specificity (0.90, 95% confidence interval [CI] = 0.88 to 0.91) and sensitivity (0.97, 95% CI = 0.87 to 1.0) of the Onclarity assay were shown to be not inferior to the reference assay (specificity, 0.90 [95% CI = 0.88 to 0.92]; sensitivity, 0.98 [95% CI = 0.91 to 1.0]). The intralaboratory reproducibility of Onclarity was 97%, with a lower confidence bound of 96% (kappa value, 0.93). The interlaboratory agreement was 97%, with a lower confidence bound of 95% (kappa value, 0.92). The BD Onclarity HPV assay fulfills all the international guidelines for a new HPV test to be used in primarily screening. This is the first clinical validation of a new HPV assay using SurePath screening samples, and thus the Onclarity HPV assay is the first HPV assay to hold an international validation for both SurePath and ThinPrep. PMID:27307461

  7. 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.

  8. 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

  9. Effectiveness analysis of new methods of cervical & breast cancer screen-ing for Changshu rural women%常熟市农村妇女“两癌”筛查新方法效果分析

    Institute of Scientific and Technical Information of China (English)

    薛峰; 罗英; 陈波

    2015-01-01

    目的:探讨将宫颈薄层液基细胞学检查(TCT)技术和乳腺超声用于妇女“两癌”(宫颈癌和乳腺癌)筛查的效果。方法2013~2014年为常熟市35~64岁妇女开展“两癌”筛查,宫颈癌初筛应用TCT,乳腺癌初筛应用临床查体和彩超检查,对初筛阳性者进行进一步检查,以宫颈癌检出率、宫颈癌及癌前病变检出率、乳腺癌检出率作为评估指标,并与2010~2011年采用巴氏涂片筛查宫颈癌、乳腺临床查体筛查乳腺癌的结果进行比较。结果“两癌”检查新方法实施2年,共完成宫颈癌筛查100075人,宫颈癌检出率为29.98/10万,宫颈癌及癌前病变检出率为296.78/10万;乳腺癌筛查76014人,乳腺癌检出率为90.77/10万;“两癌”检出率明显高于2010~2011年的老方法。结论将TCT技术用于宫颈癌筛查、乳腺超声用于乳腺癌筛查可以有效提高农村妇女“两癌”的早期预防、早期诊断和早期治疗,应建立一套合理有效的管理机制,从而降低妇女“两癌”发病率和死亡率。%Objective To discuss the efficacy of thinprep cytologic test (TCT) and breast ultrasound for screening cervi-cal cancer and breast cancer (“Two Cancers”) in the rural area of Changshu City. Methods The screening of "Two Cancers"was carried out for rural women aged 35-64 in Changshu City during 2013 to 2014. TCT was applied for pre-liminary screening of cervical cancer. Meanwhile, the physical examination and Color Doppler Ultrasound were used to screen the preliminary breast cancer. For those women whose preliminary screening results were positive, further exam-inations were needed. The accuracy of the positive findings was evaluated by the detection rates of cervical cancer, pre-cancerous lesion, and breast cancer. Then the rates were compared with those by the Pap test and the physical exami-nations during 2010 to 2011. Results The new screening methods of "Two Cancers" had

  10. Risk of spinal cord injury in patients with cervical spondylotic myelopathy and ossification of posterior longitudinal ligament: a national cohort study.

    Science.gov (United States)

    Chen, Li-Fu; Tu, Tsung-Hsi; Chen, Yu-Chun; Wu, Jau-Ching; Chang, Peng-Yuan; Liu, Laura; Huang, Wen-Cheng; Lo, Su-Shun; Cheng, Henrich

    2016-06-01

    OBJECTIVE This study aimed to estimate the risk of spinal cord injury (SCI) in patients with cervical spondylotic myelopathy (CSM) with and without ossification of posterior longitudinal ligament (OPLL). Also, the study compared the incidence rates of SCI in patients who were managed surgically and conservatively. METHODS This retrospective cohort study covering 15 years analyzed the incidence of SCI in patients with CSM. All patients, identified from the National Health Insurance Research Database, were hospitalized with the diagnosis of CSM and followed up during the study period. These patients with CSM were categorized into 4 groups according to whether they had OPLL or not and whether they received surgery or not: 1) surgically managed CSM without OPLL; 2) conservatively managed CSM without OPLL; 3) surgically managed CSM with OPLL; and 4) conservatively managed CSM with OPLL. The incidence rates of subsequent SCI in each group during follow-up were then compared. Kaplan-Meier and Cox regression analyses were performed to compare the risk of SCI between the groups. RESULTS Between January 1, 1999, and December 31, 2013, there were 17,258 patients with CSM who were followed up for 89,003.78 person-years. The overall incidence of SCI in these patients with CSM was 2.022 per 1000 person-years. Patients who had CSM with OPLL and were conservatively managed had the highest incidence of SCI, at 4.11 per 1000 person-years. Patients who had CSM with OPLL and were surgically managed had a lower incidence of SCI, at 3.69 per 1000 person-years. Patients who had CSM without OPLL and were conservatively managed had an even lower incidence of SCI, at 2.41 per 1000 person-years. Patients who had CSM without OPLL and were surgically managed had the lowest incidence of SCI, at 1.31 per 1000 person-years. The Cox regression model demonstrated that SCIs are significantly more likely to happen in male patients and in those with OPLL (HR 2.00 and 2.24, p risk for approximately 50

  11. Correlates of prevalent sexually transmitted infections among participants screened for an HIV incidence cohort study in Kisumu, Kenya.

    Science.gov (United States)

    Otieno, Fredrick Odhiambo; Ndivo, Richard; Oswago, Simon; Pals, Sherri; Chen, Robert; Thomas, Timothy; Kunneke, Ernesta; Mills, Lisa A; McLellan-Lemal, Eleanor

    2015-03-01

    We determined the prevalence of four sexually transmitted infections and the demographic and behavioural correlates associated with having one or more sexually transmitted infections among participants in an HIV incidence cohort study in Kisumu, western Kenya. Participants were enrolled from a convenience sample and underwent aetiologic sexually transmitted infection investigation. Demographic and behavioural information were collected and basic clinical evaluation performed. Multiple regression analysis was done to determine variables associated with having one or more sexually transmitted infections. We screened 846, 18- to 34-year-olds. One-third had at least one sexually transmitted infection with specific prevalence being: syphilis, 1.6%; gonorrhoea, 2.4%; herpes simplex virus type-2, 29.1%; chlamydia, 2.8%; and HIV, 14.8%. Odds of having any sexually transmitted infection were higher among participants who were women, were aged 20-24 or 30-34 years compared to 18-19 years, had secondary or lower education compared to tertiary education, were divorced, widowed or separated compared to singles, reported having unprotected sex compared to those who did not, reported previous sexually transmitted infection treatment, and tested HIV-positive. Multiple strategies are needed to address the overall high prevalence of sexually transmitted infections as well as the gender disparity found in this Kenyan population. Structural interventions may be beneficial in addressing educational and socio-economic barriers, and increasing the uptake of health-promoting practices. PMID:24810218

  12. Implementation of cervical cancer screening using visual inspection with acetic acid in rural Mozambique: successes and challenges using HIV care and treatment programme investments in Zambézia Province

    OpenAIRE

    Baptista, Alberto J; Mohsin Sidat; Troy D Moon; Sten H Vermund; Aventina Cordoso; Carla Silva-Matos

    2012-01-01

    Background: In order to maximize the benefits of HIV care and treatment investments in sub-Saharan Africa, programs can broaden to target other diseases amenable to screening and efficient management. We nested cervical cancer screening into family planning clinics at select sites also receiving PEPFAR support for antiretroviral therapy (ART) rollout. This was done using visual inspection with acetic acid (VIA) by maternal child health nurses. We report on achievements and obstacles in the fi...

  13. Clinical utility of Liqui-PREP™ cytology system for primary cervical cancer screening in a large urban hospital setting in China

    Directory of Open Access Journals (Sweden)

    Deshou Hao

    2009-01-01

    Full Text Available Background: Liquid based cytology (LBC has been reported to increase the sensitivity of cervical cytology, in comparison with conventional cytology Pap smear (CPS. Most LBC systems though require expensive automated devices. Aims: To evaluate the efficiency of a new and inexpensive LBC system - LPT cytology system. Materials and Methods: Cervical screening was performed on 31500 patients utilizing the LPT cytology system test from January 2006 to May 2007. A similar number (n = 31500 of CPS were performed from January 2004 to July 2006. All cytology positive patients underwent colposcopy and cervical biopsy with histopathology examination. Fifty cases positive both on cytology and biopsy were submitted to the high-risk human papillomavirus (HPV L1 protein (HR-HPV L1 tests. Results: The LPT cytology system adequately preserved cellular structure for morphologic evaluation. There was a significant difference of the histology/cytology diagnosis concordant rate between that of the CPS and LPT systems [93.6 vs. 78.4%, p=0.001]. The significant higher concordant rate was also seen in the low grade intraepithelial lesion (LSIL (95.4 vs. 78.9%, p=0.001 and in high grade intraepithelial lesion (HSIL (90.2 vs. 76.1%, p=0.001 cytology diagnosis. There was no statistical difference in rate in atypical glandular cells (AGC (61.5 vs. 60% and glandular cell carcinoma (GCC (83.3 vs. 80%. LPT resulted in a marked increased global detection over the CPS. Nuclear expression of HPV L1 was seen in 34% (17/50 of cases. Conclusions: LPT showed an increase in detection rate compared to CPS (P = 0.001 and a significantly higher histological versus cytological concordant referral rate.

  14. Reduced risk of malaria parasitemia following household screening and treatment: a cross-sectional and longitudinal cohort study.

    Directory of Open Access Journals (Sweden)

    Catherine G Sutcliffe

    Full Text Available BACKGROUND: In regions of declining malaria transmission, new strategies for control are needed to reduce transmission and achieve elimination. Artemisinin-combination therapy (ACT is active against immature gametocytes and can reduce the risk of transmission. We sought to determine whether household screening and treatment of infected individuals provides protection against infection for household members. METHODOLOGY/PRINCIPAL FINDINGS: The study was conducted in two areas in Southern Province, Zambia in 2007 and 2008/2009. To determine the impact of proactive case detection, households were randomly selected either to join a longitudinal cohort, in which participants were repeatedly screened throughout the year and those infected treated with artemether-lumefantrine, or a cross-sectional survey, in which participants were visited only once. Cross-sectional surveys were conducted throughout the year. The prevalence of RDT positivity was compared between the longitudinal and cross-sectional households at baseline and during follow-up using multilevel logistic regression. In the 2007 study area, 174 and 156 participants enrolled in the cross-sectional and longitudinal groups, respectively. In the 2008/2009 study area, 917 and 234 participants enrolled in the cross-sectional and longitudinal groups, respectively. In both study areas, participants and households in the longitudinal and cross-sectional groups were similar on demographic characteristics and prevalence of RDT positivity at baseline (2007: OR = 0.97; 95% CI:0.46, 2.03 | 2008/2009: OR = 1.28; 95% CI:0.44, 3.79. After baseline, the prevalence of RDT positivity was significantly lower in longitudinal compared to cross-sectional households in both study areas (2007: OR = 0.44; 95% CI:0.20, 0.96 | 2008/2009: OR = 0.16; 95% CI:0.05, 0.55. CONCLUSIONS/SIGNIFICANCE: Proactive case detection, consisting of screening household members with an RDT and treating those positive with

  15. Mutation screening of the TPO gene in a cohort of 192 Chinese patients with congenital hypothyroidism

    Science.gov (United States)

    Fu, Chunyun; Xie, Bobo; Zhang, Shujie; Wang, Jin; Luo, Shiyu; Zheng, Haiyang; Su, Jiasun; Hu, Xuyun; Chen, Rongyu; Fan, Xin; Luo, Jingsi; Gu, Xuefan; Chen, Shaoke

    2016-01-01

    Objectives Defects in the human thyroid peroxidase (TPO) gene are reported to be one of the causes of congenital hypothyroidism (CH) due to dyshormonogenesis. The aim of this study was to examine the TPO mutation spectrum and prevalence among patients with CH in the Guangxi Zhuang Autonomous Region of China and to define the relationships between TPO genotypes and clinical phenotypes. Methods Blood samples were collected from 192 patients with CH in the Guangxi Zhuang Autonomous Region, China and genomic DNA was extracted from peripheral blood leucocytes. All exons of the 10 common CH-associated genes including TPO together with their exon-intron boundaries were screened by next-generation sequencing (NGS). The effect of the novel TPO mutation was investigated by ‘in silico’ studies. Results NGS analysis of TPO in 192 patients with CH revealed 3 different variations in 2 individuals (2/192, 1%). Sequencing other CH candidate genes in the patients with TPO variants revealed that patient 1 was homozygous for c.2422delT TPO mutation combined with double heterozygous DUOX2 pathogenic variants (p.R683L/p.L1343F) and patient 2 was triallelic for TPO pathogenic variants (p.R648Q/p.T561M/p.T561M). The present study identified a novel TPO variation c.1682C>T/p.T561M; and four known mutations: c.2422delT/p.C808Afs×24 and c.1943C>T/p.R648Q in TPO, c.2048G>T/p.R683L and c.4027C>T/p.L1343F in DUOX2. Conclusions Our study indicated that the prevalence of TPO mutations was 1% among studied Chinese patients with CH. More than two variations in one or more CH-associated genes can be found in a single patient, and may, in combination, affect the phenotype of the individual. A novel TPO variation c.1682C>T/p.T561M was found, thereby expanding the mutational spectrum of the gene. PMID:27173810

  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

    2008-01-01

    Full Text Available 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 31 st , 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. 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.

  19. 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%,

  20. Cervical premalignant lesions and their management

    OpenAIRE

    Köse, Faruk M.; Naki, Murat M.

    2014-01-01

    Cervical cancer is the tenth most common cancer in women in developed countries that have national screening programs, while it is in the second line in underdeveloped countries. According to Ministry of Health registry data, cervical cancer is the eighth most common cancer among female cancers in Turkey. Today, the most effective screening for cervical cancer is to obtain smears from the cervix. Therefore, periodic screening programs are of great importance in identifying preinvasive lesions...

  1. Determinants of Human Immunodeficiency Virus (HIV prevalence in homosexual and bisexual men screened for admission to a cohort study of HIV negatives in Belo Horizonte, Brazil: Project Horizonte

    Directory of Open Access Journals (Sweden)

    Carneiro Mariângela

    2003-01-01

    Full Text Available Project Horizonte, an open cohort of homosexual and bisexual human immunodeficiency virus (HIV-1 negative men, is a component of the AIDS Vaccine Program, in Belo Horizonte, Minas Gerais, Brazil. The objective of this study was to compare volunteers testing HIV positive at cohort entry with a sample of those who tested HIV negative in order to identify risk factors for prevalent HIV infection, in a population being screened for enrollment at Project Horizonte. A nested case-control study was conducted. HIV positive volunteers at entry (cases were matched by age and admission date to three HIV negative controls each. Selected variables used for the current analysis included demographic factors, sexual behavior and other risk factors for HIV infection. During the study period (1994-2001, among the 621 volunteers screened, 61 tested positive for HIV. Cases were matched to 183 HIV negative control subjects. After adjustments, the main risk factors associated with HIV infection were unprotected sex with an occasional partners, OR = 3.7 (CI 95% 1.3-10.6, receptive anal intercourse with an occasional partner, OR = 2.8 (95% CI 0.9-8.9 and belonging to the negro racial group, OR = 3.4 (CI 95% 1.1-11.9. These variables were associated with an increase in the risk of HIV infection among men who have sex with men at the screening for admission to an open HIV negative cohort.

  2. The significance of HPV genotypes in cervical cancer screening%HPV分型研究在宫颈癌筛查中的意义

    Institute of Scientific and Technical Information of China (English)

    张静; 刘晓英; 甘露; 刘波

    2016-01-01

    Objective:To study the epidemiological characteristics of different genotypes of human papillomavirus (HPV)and their relationship with cervical precancerous lesions. Methods:A total of 10 885 patients who had sex life and requested cervical screening were enrolled from the outpatient section of Gynec in the study. All the patients un-derwent cervical cytology tests(TCT),among them 2 677 patients had cervical HPV subtype screening. Results:TCT- positive rate(≥ASCUS)was 7. 6% . HPV infection rate was 34 . 8 % ,among which 76 . 93 % were high - risk, 23. 93% were low - risk,and 20. 28% were mixed infection(infected from two or more HPV subtypes). The high -risk HPV infections were mainly caused by HPV16,HPV52 and HPV58 while the low - risk infections were mainly caused by HPV6,HPV11 and HPV43. No infection was found caused by HPV26,HPV73 or HPV83. ≤29 years and≥50 years were peak ages of both HPV infection and cytology abnormality. HPV infection rates increased significantly as the deterioration of cytological and pathology diagnosis. Conclusion:HPV infection rate and TCT positive rate varied among different ages.HPV infection rate was significantly correlated with the severity of cervical lesion.%目的:探讨 HPV 分型流行病学特征及其与宫颈癌前病变的关系。方法:选择陕西省人民医院2014年1月-2014年12月在妇科门诊就诊、有性生活史并行宫颈液基细胞学( TCT)检查的患者10885例,其中2677例患者同时行宫颈感染人乳头瘤病毒(HPV)分型筛查。结果:TCT 异常率(≥ASCUS)7.6%;HPV感染率34.8%,其中高危型 HPV 占76.93%,低危型 HPV 占23.93%;混合感染(2种以上 HPV 亚型感染)占20.28%,高危型 HPV 感染主要型别为 HPV16、HPV52、HPV58;低危型 HPV 感染主要型别为 HPV6、HPV11、HPV43;未发现 HPV26、73、83型阳性病例;≤29岁及≥50岁年龄段为 HPV 感染及 TCT 异常的高峰年龄段;HPV 感染率随着细胞学诊

  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. Results of cervical cancer screening in 2986 rural women%2986例农村妇女宫颈癌筛查结果分析

    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.

  5. 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

  6. Occult Mediastinal Great Vessel Trauma: The Value of Aortography Performed During Angiographic Screening for Blunt Cervical Vascular Trauma

    International Nuclear Information System (INIS)

    Purpose. To determine the value of aortography in the assessment of occult aortic and great vessel injuries when routinely performed during screening angiography for blunt cerebrovascular injury (BCVI). Methods. One hundred and one consecutive patients who received both aortography and screening four-vessel angiography over 4 years were identified retrospectively. Angiograms for these patients were evaluated, and the incidence of occult mediastinal vascular injury was determined. Results. Of the 101 patients, 6 (6%) had angiographically documented traumatic aortic injuries. Of these 6 patients, one injury (17%) was unsuspected prior to angiography. Four of the 6 (67%) also had BCVI. One additional patient also had an injury to a branch of the subclavian artery. Conclusion. Routine aortography during screening angiography for BCVI is not warranted due to the low incidence (1%) of occult mediastinal arterial injury. However, in the setting of a BCVI screening study and no CT scan of the chest, aortography may be advantageous

  7. Investigation of CPD and HMDS Sample Preparation Techniques for Cervical Cells in Developing Computer-Aided Screening System Based on FE-SEM/EDX

    OpenAIRE

    2014-01-01

    This paper investigated the effects of critical-point drying (CPD) and hexamethyldisilazane (HMDS) sample preparation techniques for cervical cells on field emission scanning electron microscopy and energy dispersive X-ray (FE-SEM/EDX). We investigated the visualization of cervical cell image and elemental distribution on the cervical cell for two techniques of sample preparation. Using FE-SEM/EDX, the cervical cell images are captured and the cell element compositions are extracted for both ...

  8. Cancer screening

    OpenAIRE

    Krishna Prasad

    1987-01-01

    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.

  9. Clinical significance of Thinprep cytology test in screening of cervical lesions%液基薄层细胞学在筛查宫颈病变中的临床意义

    Institute of Scientific and Technical Information of China (English)

    张江菊; 黄寅虎; 郭建新; 李力; 郑秀惠

    2013-01-01

    Objective:To explore the clinical significance of Thinprep cytology test (TCT) in screening of cervical lesions.Methods:TCT screening was conducted among 18 904 patients from outpatient department of Daping Hospital Affiliated to the Third Military Medical University from January to December in 2012,and 688 patients were found with cytological abnormalities (diagnosis of TBS system ≥ ASC-US),then 416 patients underwent colposcopy and biopsy ; the clinical significance of TCT in screening of cervical lesions was evaluated with pathological examination as gold standard.Results:A total of 416 patients were found with cytological abnormalities,including 195 patients with ASC,65 patients with LSIL,138 patients with HSIL,and 52 patients with cervical cancer; 128 patients with cervicitis,106 patients with cervical intraepithelial neoplasia (CIN) Ⅰ,78 patients with CIN Ⅱ,52 patients with CIN Ⅲ,and 52 patients with cervical invasive carcinoma (including one patient with cervical adenocarcinoma) were found by pathological examination; the coincidence rates of diagnosis between pathological examination and TCT were 48.21% (ASC),81.54% (LSIL),89.13% (HSIL),and 100.00% (cervical cancer),respectively; the sensitivity and specificity of TCT for cervical lesions (≥ CIN Ⅱ) were 90.66% and 76.07%,respectively.Conclusion:TCT can improve the detection rate of cervical lesions and it has a high concordance with the histopathological results with high sensitivity,TCT is an effective method for screening cervical lesions and missed diagnosis can be reduced.%目的:探讨液基薄层细胞学在筛查子宫颈病变中的临床意义.方法:对2012年1月~12月第三军医大学大坪医院18 904例门诊患者进行TCT筛查,发现细胞学异常(TBS系统诊断≥ASC-US)的患者688例,其中416例进行了阴道镜检查并取活检,以病理学为标准,评价TCT筛查子宫颈病变的临床意义.结果:细胞学异常的416例患者中,ASC 195例,LSIL65

  10. Application research of HPV test in screening of cervical lesions%HPV检测在宫颈病变筛查中的应用价值研究

    Institute of Scientific and Technical Information of China (English)

    揭艳频

    2014-01-01

    目的:探讨HPV检测在宫颈病变筛查中的应用价值。方法选择2011年2月-2013年6月本院门诊及体检的500例女性HPV检测的患者,分别给予HPV的TCT和DNA检测,并于病理组织检查结果进行比较。结果随着病变等级的升高, HPV DNA感染率逐渐升高。 TCT检测的阳性率为15.4%,HPV DNA检测的阳性率为35.2%,病理检测的阳性率为19.6%;TCT检测的灵敏度为44.90%,HPV DNA检测的灵敏度为83.67%,两组间差异有统计学意义(P<0.05)。结论 HPV DNA检测的灵敏度高于TCT检测,但两者各有优势,在宫颈病变筛查中的应用价值较高。%Objective To explore the application of HPV test in screening of cervical lesions. Methods 500 cases of female pa-tients with HPV tested in our hospital outpatient service and the physical examination from February 2011 to June 2013were se-lected, they were given the HPV TCT and DNA tested respectively, the examination results was compared with histopathologic. Results With the increase of level of lesion, the HPV DNA infection rate increased. TCT detection positive rate was 15.4%, HPV DNA detection positive rate was 35.2%, the pathological d detection positive rate was 19.6%;TCT detection sensitivity of 44.90%, the HPV DNA sensitivity of 83.67%, the differences between the two groups was statistically significant (P<0.05). Conclusion HPV DNA detection sensitivity is higher than the TCT detection, but they have their own advantages and high application value in screening of cervical lesions.

  11. 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 disorders.

    NARCIS (Netherlands)

    Ham, M.A. van; Bakkers, J.M.J.E.; Harbers, G.; Quint, W.G.V.; Massuger, L.F.A.G.; Melchers, W.J.G.

    2005-01-01

    Certain high-risk (HR) human papillomavirus (HPV) types are a necessary cause for the development of cervical disorders. Women with persistent HR HPV infections have an increased risk of developing high-grade cervical lesions, compared with those who have no or low-risk HPV infections. Therefore, im

  12. 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…

  13. Trends in breast, ovarian and cervical cancer incidence in Mumbai, India over a 30-year period, 1976–2005: an age–period–cohort analysis

    OpenAIRE

    Dhillon, P.K.; Yeole, B. B.; Dikshit, R; Kurkure, A P; Bray, F.

    2011-01-01

    Background: Demographic, socioeconomic and cultural changes in India have increased longevity, delayed childbearing, decreased parity and resulted in a more westernised lifestyle, contributing to the increasing burden of cancer, especially among women. Methods: We evaluated secular changes in the incidence of breast, cervical and ovarian cancer in Mumbai women aged 30–64 between 1976 and 2005. Age-standardised incidence rates were calculated and presented by site and calendar period. An age–p...

  14. Magnetic resonance imaging analysis of the upper cervical spine extensor musculature in an asymptomatic cohort: an index of fat within muscle

    Energy Technology Data Exchange (ETDEWEB)

    Elliott, J.M. [Division of Physiotherapy, University of Queensland, Brisbane, QLD (Australia)]. E-mail: jimelliott@plbb.net; Galloway, G.J. [Center for Magnetic Resonance, University of Queensland, Brisbane, QLD (Australia); Jull, G.A. [Division of Physiotherapy, University of Queensland, Brisbane, QLD (Australia); Noteboom, J.T. [Department of Physical Therapy, Regis University, Denver, CO, USA (United States); Centeno, C.J. [Centeno Clinic, Westminster, CO, USA (United States); Gibbon, W.W. [Department of Radiology, School of Medicine, University of Queensland, Brisbane, QLD (Australia)

    2005-03-01

    AIM: To establish a simple method to quantify muscle/fat constituents in cervical muscles of asymptomatic women using magnetic resonance imaging (MRI), and to determine whether there is an age effect within a defined age range. MATERIALS AND METHODS: MRI of the upper cervical spine was performed for 42 asymptomatic women aged 18-45 years. The muscle and fat signal intensities on axial spin echo T1-weighted images were quantitatively classified by taking a ratio of the pixel intensity profiles of muscle against those of intermuscular fat for the rectus capitis posterior major and minor and inferior obliquus capitis muscles bilaterally. Inter- and intra-examiner agreement was scrutinized. RESULTS: The average relative values of fat within the upper cervical musculature compared with intermuscular fat indicated that there were only slight variations in indices between the three sets of muscles. There was no significant correlation between age and fat indices. There were significant differences for the relative fat within the muscle compared with intermuscular fat and body mass index for the right rectus capitis posterior major and right and left inferior obliquus capitis muscles (p=0.032). Intraclass correlation coefficients for intraobserver agreement ranged from 0.94 to 0.98. Inter-rater agreement of the measurements ranged from 0.75 to 0.97. CONCLUSION: A quantitative measure of muscle/fat constituents has been developed, and results of this study indicate that relative fatty infiltration is not a feature of age in the upper cervical extensor muscles of women aged 18-45 years.

  15. Magnetic resonance imaging analysis of the upper cervical spine extensor musculature in an asymptomatic cohort: an index of fat within muscle

    International Nuclear Information System (INIS)

    AIM: To establish a simple method to quantify muscle/fat constituents in cervical muscles of asymptomatic women using magnetic resonance imaging (MRI), and to determine whether there is an age effect within a defined age range. MATERIALS AND METHODS: MRI of the upper cervical spine was performed for 42 asymptomatic women aged 18-45 years. The muscle and fat signal intensities on axial spin echo T1-weighted images were quantitatively classified by taking a ratio of the pixel intensity profiles of muscle against those of intermuscular fat for the rectus capitis posterior major and minor and inferior obliquus capitis muscles bilaterally. Inter- and intra-examiner agreement was scrutinized. RESULTS: The average relative values of fat within the upper cervical musculature compared with intermuscular fat indicated that there were only slight variations in indices between the three sets of muscles. There was no significant correlation between age and fat indices. There were significant differences for the relative fat within the muscle compared with intermuscular fat and body mass index for the right rectus capitis posterior major and right and left inferior obliquus capitis muscles (p=0.032). Intraclass correlation coefficients for intraobserver agreement ranged from 0.94 to 0.98. Inter-rater agreement of the measurements ranged from 0.75 to 0.97. CONCLUSION: A quantitative measure of muscle/fat constituents has been developed, and results of this study indicate that relative fatty infiltration is not a feature of age in the upper cervical extensor muscles of women aged 18-45 years

  16. Prevent Cervical Cancer

    Science.gov (United States)

    ... Risk? What Are the Symptoms? What Should I Know About Screening? Statistics Related Links Inside Knowledge Campaign What CDC Is Doing Research AMIGAS Fighting Cervical Cancer Worldwide Stay Informed Printable Versions Standard quality PDF [PDF-877KB] High-quality PDF for professional ...

  17. Prevent Cervical Cancer!

    Centers for Disease Control (CDC) Podcasts

    2015-01-08

    Cervical cancer can be prevented. Listen as two friends—one a doctor—talk about screening tests and early detection. Learn what test you might need.  Created: 1/8/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 1/8/2015.

  18. Detecting cervical cancer by quantitative promoter hypermethylation assay on cervical scrapings : A feasibility study

    NARCIS (Netherlands)

    Reesink-Peters, N; Wisman, G.B.A.; Jeronimo, C; Tokumaru, CY; Cohen, Y; Dong, SM; Klip, HG; Buikema, HJ; Suurmeijer, AJH; Hollema, H; Boezen, HM; Sidransky, D; van der Zee, AGJ

    2004-01-01

    Current morphology-based cervical cancer screening is associated with significant false-positive and false-negative results. Tumor suppressor gene hypermethylation is frequently present in cervical cancer. It is unknown whether a cervical scraping reflects the methylation status of the underlying ep

  19. Coeliac screening in a Scottish cohort of children with type 1 diabetes mellitus: is DQ typing the way forward?

    OpenAIRE

    Mitchell, R T; Sun, A; Mayo, A; Forgan, M; Comrie, A; Gillett, P M

    2015-01-01

    Background Children with type 1 diabetes mellitus (T1DM) are at increased risk of coeliac disease (CD). Recent guidelines indicate coeliac screening should include HLA typing for CD predisposing (DQ2/DQ8) alleles and those negative for these alleles require no further coeliac screening. Methods Children (n=176) with T1DM attending clinics across two Scottish regions were screened for HLA DQ2/DQ8 as part of routine screening. Data collected included the frequency of DQ2/DQ8 genotypes and the a...

  20. Cervical Cancer

    Science.gov (United States)

    ... the place where a baby grows during pregnancy. Cervical cancer is caused by a virus called HPV. The ... for a long time, or have HIV infection. Cervical cancer may not cause any symptoms at first. Later, ...

  1. Hybrid capture vs. PCR screening of cervical human papilloma virus infections. Cytological and histological associations in 1270 women

    International Nuclear Information System (INIS)

    We evaluated two molecular methods of HPV detection and their correlation with cytological and histological diagnosis in a large sample of Greek women. All women with liquid-based cytology performed at a University Hospital between 2000 and 2003 were included. The Hybrid Capture 2 (HC2) kit and in house Polymerase Chain Reaction (PCR) were used for HPV DNA detection. Cervical biopsy was performed for women with ASCUS+ cytology, HPV detection, or abnormal colposcopy. Positive (PLR) and negative (NLR) likelihood ratios were calculated for cytology and HPV molecular testing for the prediction of CIN2 and greater histology. Of the 1270 women evaluated 241 (18.5%) had abnormal cytology. Cytology diagnosed high-grade squamous intraepithelial lesion (HSIL) or invasive carcinoma in 21(1.7%) cases whereas 26 (2%) women had CIN2+ or greater histology. PCR detected HPV in 397/1270 (31.3%) and HC2 in 260/1270 (20.4%) samples. Both molecular tests exhibited high reproducibility (Cohen's kappa value 0.691, 95% CI: 0.664 - 0.718). Positive likelihood ratios (PLR) of 9.4, 3.8 and 3.4 and negative likelihood ratios of 0.13, 0.21, and 0 were noted for ≥ LSIL, any positive HC2 or any positive PCR-HPV testing, for predicting CIN2+ histology, respectively. All CIN 3+ lesions harbored high risk oncogenic HPV type infections. HPV infection was found in a large proportion of this population and was associated with CIN 2/3 lesions and infiltrating carcinomas. Thin prep testing and HPV detection by HC2 or PCR performed very well with regards to identifying high grade lesions in an environment with experienced examiners

  2. Hybrid capture vs. PCR screening of cervical human papilloma virus infections. Cytological and histological associations in 1270 women

    Directory of Open Access Journals (Sweden)

    Tsivilika Angeliki

    2010-02-01

    Full Text Available Abstract Background We evaluated two molecular methods of HPV detection and their correlation with cytological and histological diagnosis in a large sample of Greek women. Methods All women with liquid-based cytology performed at a University Hospital between 2000 and 2003 were included. The Hybrid Capture 2 (HC2 kit and in house Polymerase Chain Reaction (PCR were used for HPV DNA detection. Cervical biopsy was performed for women with ASCUS+ cytology, HPV detection, or abnormal colposcopy. Positive (PLR and negative (NLR likelihood ratios were calculated for cytology and HPV molecular testing for the prediction of CIN2 and greater histology. Results Of the 1270 women evaluated 241 (18.5% had abnormal cytology. Cytology diagnosed high-grade squamous intraepithelial lesion (HSIL or invasive carcinoma in 21(1.7% cases whereas 26 (2% women had CIN2+ or greater histology. PCR detected HPV in 397/1270 (31.3% and HC2 in 260/1270 (20.4% samples. Both molecular tests exhibited high reproducibility (Cohen's kappa value 0.691, 95% CI: 0.664 - 0.718. Positive likelihood ratios (PLR of 9.4, 3.8 and 3.4 and negative likelihood ratios of 0.13, 0.21, and 0 were noted for ≥ LSIL, any positive HC2 or any positive PCR-HPV testing, for predicting CIN2+ histology, respectively. All CIN 3+ lesions harbored high risk oncogenic HPV type infections. Conclusions HPV infection was found in a large proportion of this population and was associated with CIN 2/3 lesions and infiltrating carcinomas. Thin prep testing and HPV detection by HC2 or PCR performed very well with regards to identifying high grade lesions in an environment with experienced examiners.

  3. Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2007-03-06

    Did you know that cervical cancer rates differ by race/ethnicity and region? Or that cervical cancer can usually be prevented if precancerous cervical lesions are found by a Pap test and treated? Find out how getting regular Pap tests can save a woman's life.  Created: 3/6/2007 by National Breast and Cervical Cancer Early Detection Program.   Date Released: 4/25/2007.

  4. 75 FR 7282 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Science.gov (United States)

    2010-02-18

    ... Force guidelines for breast and cervical cancer screening; Impact of the revised clinical screening recommendations for both breast and cervical cancer on the National Breast and Cervical Cancer Early Detection... HUMAN SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection...

  5. Diet, Screen Time, Physical Activity, and Childhood Overweight in the General Population and in High Risk Subgroups: Prospective Analyses in the PIAMA Birth Cohort

    Directory of Open Access Journals (Sweden)

    Alet H. Wijga

    2010-01-01

    Full Text Available Objective. To prospectively identify behavioral risk factors for childhood overweight and to assess their relevance in high risk sub groups (children of mothers with overweight or low education. Methods. In the PIAMA birth cohort (=3963, questionnaire data were obtained at ages 5 and 7 on “screen time”, walking or cycling to school, playing outside, sports club membership, fast food consumption, snack consumption and soft drink consumption. Weight and height were measured at age 8 years. Results. Screen time, but none of the other hypothesized behavioral factors, was associated with overweight (aOR 1.4 (CI: 1.2–1.6. The adjusted population attributable risk fraction for screen time > 1 hr/day was 10% in the high risk and 17% in the low risk sub groups. Conclusion. Reduction of screen time to < 1 hr/day could result in a reduction of overweight prevalence in the order of 2 percentage points in both high and low risks sub groups.

  6. 农村妇女宫颈癌和乳腺癌筛查的实践与探讨%The rural women cervical cancer and breast cancer screening practices and discussion

    Institute of Scientific and Technical Information of China (English)

    史少东; 赵方辉; 张永贞; 李旭亮; 乔友林

    2013-01-01

      Objective To practice two cancer screening for rural women. Methods From 2009 to 2011 in Xiangyuan County,the County Maternal and Child Health Hospital of women of childbearing age in cervical and breast cancer screening. Results Complete cervical cancer screening of 27 517 women,breast cancer screening of 6 122 women,including cervical intraepithelial neoplasia grade 2(CIN2)and the disease prevalence rate was 0.49%,the early diagnosis rate was 91.2%.Benign breast tumor in 33 cases(0.53%);2 cases of breast cancer(0.03%),the early diagnosis rate of 50%.Conclusion Cervical cancer screening with screening,screening and early diagnosis and early treatment effect is obvious.Screening for breast cancer still needs the specification,strengthen technology training,improve the screening level. Screening system and the technical team construction is the base of women's health service guarantee. At the same time,cervical cancer,breast cancer screening is better than a single project screening for rural women.%  目的通过对农村妇女宫颈癌和乳腺癌的筛查实践,探讨宫颈癌和乳腺癌联合筛查的模式及效果。方法2009年—2011年襄垣县妇幼保健院对该县适龄农村妇女开展宫颈癌和乳腺癌筛查。结果此次筛查共完成27517名妇女的宫颈癌筛查,6122名妇女的乳腺癌筛查,其中宫颈上皮内瘤变Ⅱ级(CINⅡ)及以上病变的患病率为0.49%,早诊率为91.2%。乳腺良性肿瘤33例(0.53%);乳腺癌2例(0.03%),早诊率为50%。结论宫颈癌检查有筛查基础,筛查及早诊、早治效果明显。乳腺癌筛查仍需规范,须加强技术培训,提高筛查水平。筛查体系和技术队伍建设是基层妇女保健服务的保证,对农村妇女同时进行宫颈癌、乳腺癌联合筛查优于单一项目筛查。

  7. Priority Setting for Improvement of Cervical Cancer Prevention in Iran

    OpenAIRE

    Azam Majidi; Reza Ghiasvand; Maryam Hadji; Azin Nahvijou; Azam-Sadat Mousavi; Minoo Pakgohar; Nahid Khodakarami; Mehrandokht Abedini; Farnaz Amouzegar Hashemi; Marjan Rahnamaye Farzami; Reza Shahsiah; Sima Sajedinejhad; Mohammad Ali Mohagheghi; Fatemeh Nadali; Arash Rashidian

    2016-01-01

    Background Cervical cancer is the fourth most common cancer among women worldwide. Organized cervical screening and vaccination against human papilloma virus (HPV) have been successful interventions for prevention of invasive cervical cancer (ICC). Because of cultural and religious considerations, ICC has low incidence in Iran and many other Muslim countries. There is no organized cervical screening in these countries. Therefore, ICC is usually diagnosed in advanced stages with poor progn...

  8. Infant Stool Color Card Screening Helps Reduce the Hospitalization Rate and Mortality of Biliary Atresia: A 14-Year Nationwide Cohort Study in Taiwan.

    Science.gov (United States)

    Lee, Min; Chen, Solomon Chih-Cheng; Yang, Hsin-Yi; Huang, Jui-Hua; Yeung, Chun-Yan; Lee, Hung-Chang

    2016-03-01

    Biliary atresia (BA) is a significant liver disease in children. Since 2004, Taiwan has implemented a national screening program that uses an infant stool color card (SCC) for the early detection of BA. The purpose of this study was to examine the outcomes of BA cases before and after the launch of this screening program. The objectives of this study were to evaluate the rates of hospitalization, liver transplantation (LT), and mortality of BA cases before and after the program, and to examine the association between the hospitalization rate and survival outcomes.This was a population-based cohort study. BA cases born during 1997 to 2010 were identified from the Taiwan National Health Insurance Research Database. Sex, birth date, hospitalization date, LT, and death data were collected and analyzed. The hospitalization rate by 2 years of age (Hosp/2yr) was calculated to evaluate its association with the outcomes of LT or death.Among 513 total BA cases, 457 (89%) underwent the Kasai procedure. Of these, the Hosp/2yr was significantly reduced from 6.0 to 6.9/case in the earlier cohort (1997-2004) to 4.9 to 5.3/case in the later cohort (2005-2010). This hospitalization rate reduction was followed by a reduction in mortality from 26.2% to 15.9% after 2006. The Cox proportional hazards model showed a significant increase in the risk for both LT (hazard ratio [HR] = 1.14, 95% confidence interval [CI] = 1.10-1.18) and death (HR = 1.05, 95% CI = 1.01-1.08) for each additional hospitalization. A multivariate logistic regression model found that cases with a Hosp/2yr >6 times had a significantly higher risk for both LT (adjusted odds ratio [aOR] = 4.35, 95% CI = 2.82-6.73) and death (aOR = 1.75, 95% CI = 1.17-2.62).The hospitalization and mortality rates of BA cases in Taiwan were significantly and coincidentally reduced after the launch of the SCC screening program. There was a significant association between the hospitalization rate and final

  9. The effect of human papillomavirus DNA testing and cervical cytology for screening of cervical precancerous lesions%人乳头瘤病毒DNA检测和宫颈细胞学检查对宫颈癌前病变筛查的效果

    Institute of Scientific and Technical Information of China (English)

    梁瑜; 彭华丽

    2015-01-01

    Objective To investigate the effect of human papillomavirus (HPV) DNA testing and cervical cytology screening of cervical precancerous lesions. Methods 1100 patients admitted to our hospital who were carried out screening cervical precancerous lesions from January 2013 to June 2014 were selected,all were carried out HPV DNA testing,cervical cytology,colposcopy and cervical biopsy,pathological diagnosis was as the standard,the test results were analyzed. Results Positive rate of HPV DNA testing was 23.00% in 1100 patients,in which,positive rate of cervical cancer was 83.33%,positive rate of cervical intraepithelial neoplasia (CIN) Ⅰ was 44.44%,CIN II testing was 86.67%, CINⅢ positive rate was 94.12%.Cervical cytology results showed that there were 851 cases (77.36%) with no CIN,139 cases (12.64%) were atypical squamous cells,78 cases (7.09%) were low-grade squamous intraepithelial lesion,29 cases (2.64%) of high-grade squamous intraepithelial cells lesions,3 cases (0.27%) of squamous cell carcinoma.The compli-ance rate of colposcopy examination and pathological diagnosis was 62.79% (54/86). Conclusion The suitable cervical lesions screening method for patients can help to improve the detection rate,reduce the incidence rate of cervical cancer.%目的:探讨人乳头瘤病毒(HPV)DNA检测和宫颈细胞学检查对宫颈癌前病变筛查的效果。方法选取2013年1月~2014年6月来本院就诊并进行宫颈癌前病变筛查的1100例患者,均进行HPV DNA检测、宫颈细胞学检查、阴道镜检查与宫颈活检,以病理诊断为标准,对检测结果进行分析。结果1100例患者中,HPV DNA阳性率为23.00豫,其中宫颈癌阳性率为83.33豫,宫颈上皮内瘤变(CIN)Ⅰ阳性率为44.44豫,CINⅡ阳性率为86.67豫,CINⅢ阳性率为94.12豫。宫颈细胞学检查无CIN 851例(77.36豫),非典型鳞状上皮细胞139例(12.64豫),低度鳞状上皮细胞内病变78例(7.09豫),高度鳞状上皮细胞内病变29

  10. Self-assessed health, perceived stress and non-participation in breast cancer screening: A Danish cohort study

    DEFF Research Database (Denmark)

    Jensen, Line Flytkjær; Pedersen, Anette Fischer; Andersen, Berit;

    2015-01-01

    Dette studie undersøger sammenhængen mellem selvvurderet helbred og opfattet stres vurderet i 2006 og sammenhængen med ikke-deltagelse i brystkræft screening. Studiet inkluderer 4512 kvinder som blev inviteret til første screeningsrunde i Region Midtjylland i 2008-2009 og som besvarede ”hvordan h...... helbred som middel. Kvinder der vurderede deres mentale helbred som dårligt og kvinder som oplevede høj stress var ligeledes mindre tilbøjelige til at deltage i screening. Studiet indikerer at kvinders egen opfattelse af sundhed påvirker deltagelse i screening....

  11. 宫颈薄层液基细胞学检查联合高危型HPV检测在宫颈病变筛查中的临床应用%CLINICAL APPLICATION OF CERVICAL THIN PREP CYTOLOGIC-TEST AND HIGH-RISK HPV TYPE TESTING IN SCREENING OF CERVICAL LESIONS

    Institute of Scientific and Technical Information of China (English)

    朱华洁

    2012-01-01

    目的 研究宫颈薄层液基细胞学检查(thin prep cytologic test,TCT)联合高危型人乳头瘤病毒(human papilloma virus,HPV)检测在子宫颈病变筛查中的诊断价值.方法对2010年1-12月行宫颈病变筛查的患者680例,进行TCT和高危型HPV检测,同时行阴道镜下组织活检.结果 680例患者中宫颈TCT检查结果异常180例,对宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)诊断的敏感性为85.57%,特异性为97.12%,漏诊率为4.12%.TCT与HPV联合检查,诊断敏感性为89.69%,特异性为85.80%,漏诊率1.62%.HPV感染率为26.91%,随着细胞学和组织学诊断级别的升高,HPV感染率不断上升.结论 TCT与高危型HPV联合检测是筛查宫颈癌及癌前病变的有效方法,可防止漏诊,有利于提高宫颈上皮内瘤变的诊断率.%Objective To explore the diagnostic value of cervical thin prep cytologic test ( TCT ) combined with high - risk human papilloma virus ( HPV ) detection in the screening of cervical lesions. Methods A total of 680 patients for cervical lesions screeing underwent TCT and high - risk HPV type detection in gynecology outpatient from January 2010 to December 2010, meanwhile, biopsy was performed under colposcopy. Results Among 680 cases,the result of cervical TCT was abnormal in 180 cases. The sensitivity, specificity and the rate of missed diagnosis of TCT for the diagnosis of cervical intraepithelial neoplasia ( CIN ) was 85.57% , 97. 12% and 4. 12% , respectively, while thoses of combination of TCT and HPV was 89. 69% ,85. 80% and 1. 62%. The infection rate of HPV was 26. 91%. With the increase of cytological and histological grading, the infection rate of HPV increased. Conclusion TCT combined with high risk HPV detection is an effective method in screening cervical cancer and precancerous lesions. It helps to prevent missed diagnosis and improve the diagnosis rate of CIN.

  12. 18356例宫颈液基细胞学与活检组织病理学结果分析%Analysis the Results of 18 356 Cases of Liquid-based Cervical Cytology and the Histopathology of Colposcopic Biopsy in Cervical Screening/

    Institute of Scientific and Technical Information of China (English)

    江淑萍; 孔友明; 陈冰

    2013-01-01

      目的:探讨宫颈液基细胞学与活检组织病理学在宫颈病变筛查中的价值.方法:对18356例经宫颈液基细胞学检查发现异常者在阴道镜下活检的患者临床及病理资料进行回顾性分析.结果:LCT 显示:18356例中,ASCUS 以上的有1256例,阳性率为6.8%,其中 ASCUS 占51.8%,LSIL占29.5%,HSIL 占10.6%.宫颈活检:慢性炎症占39.7%,CIN Ⅰ占37.3%,CIN Ⅱ占13.6%,CIN Ⅲ占8.9%,宫颈癌占0.4%.结论:LCT 液基细胞学检测系统是一种有效的宫颈癌前病变筛查方法.对 LCT 阳性病例行阴道镜下活检,能大大提高宫颈癌前病变及宫颈癌早期检出率,减少漏诊的发生.%Objective:To evaluate the value of liquid-based cytology (LCT) and histopathology of colposcopic biopsy in cervical screening.Methods:The cervical LCT results of 18 356 cases were analyzed,follow up diagnoses of colposcopic biopsy were available for those cytological abnormalities,then we performed a retrospective analysis of those clinical and pathological data.Results:Among 18 356 patients receiving LCT,1256 patients were diagnosed as Above-ASCUS pathological changes,the positive detection rate was 6.8%.Among these,ASCUS,LSIL and HSIL were 51.8%,29.5% and 10.6%,respectively. Among 1256 patients receiving colposcopic biopsy,39.7% were diagnosed as chronic inflammation,and cervical intraepithelial neoplasiaⅠ(CINⅠ) were 37.3%, CIN Ⅱ were 13.6%,CIN Ⅲ were 8.9% and cervical cancer were 0.4%.Conclusion:LCT liquid-based cytology technology is an effective method in screening of cervical precancerous disease.Combining with colposcopic biopsy among patients with abnormal LCT results,can not only improve the detection rate of cervical precancerous lesions and early stage of cervical cancer,but also reduce the incidence of missed diagnosis,significantly.

  13. System Design and Implementation for Cervical Cancer and Breast Cancer Screening%宫颈癌与乳腺癌筛查信息系统设计与实现

    Institute of Scientific and Technical Information of China (English)

    王朝; 武明辉; 韩历丽; 张娣

    2014-01-01

    Objective The application of modern information technology will be expected to improve the quality and management of cervical cancer, breast cancer screening in Beijing. Method Improved and reconstructed sub-system of cervical cancer and breast cancer screening based on the second phase development of the Beijing MCH information system. Results The screening information system is able to digitize the whole process of cervical cancer and breast cancer screening, including basic information collection, medical recording of screening and suspicious patients diagnosis, treatments and follow-ups which enables information sharing, management improving and data availability as well. Conclusion It is necessary to apply information technology to cervical cancer and breast cancer screening. The information system plays an important role to optimize the work flow, enhance the MCH information, and improve its efficiency and quality.%目的将现代信息技术引入宫颈癌、乳腺癌筛查工作,以提高两癌筛查工作的服务和管理水平。方法基于北京市妇幼保健信息系统二期开发建设,对两癌筛查子系统进行升级改造。结果两癌筛查信息系统可以实现从个人基本信息采集、筛查及诊断结果录入,到可疑病例确诊、治疗、随访等全过程的信息化,实现信息共享,提高了工作效率,提升了两癌筛查系统管理水平,为各级管理者提供及时有效的信息数据。结论将信息技术引入两癌筛查工作领域有其必要性,两癌筛查信息管理系统可以优化工作流程,提升妇幼保健信息管理层次,提高工作效率和质量。

  14. Effect Observation of Nursing Intervention in Early Screening for Cervical Cancer%对宫颈癌早期筛查患者实施护理干预的效果观察

    Institute of Scientific and Technical Information of China (English)

    何燕; 卢丽娜; 区露婷; 马彩桃

    2014-01-01

    目的:探讨对接受宫颈癌早期筛查后的宫颈炎患者实施护理干预的效果。方法选取2013年6月至9月294例在我院妇产科门诊首次接受宫颈液基细胞学检查(thinprep cytologic test,TCT)+人乳头瘤样病毒(HPV)检查、年龄<50岁的宫颈炎患者。采用自制问卷对患者接受干预措施前后对宫颈癌早期筛查的认知进行对比。结果患者接受干预措施前后对宫颈癌早期筛查的认知的差异有统计学意义(P<0.01或P<0.05)。结论护士以健康信念模式为指导的个性化健康教育,利用各种宣传方式和途径做好患者宫颈癌防治知识普及和指引,能有效提高患者对宫颈癌早期筛查的认知程度,使患者树立健康的信念并改善患者参与宫颈癌早期筛查行为,最终达到及时发现、及时诊断、及时治疗的宫颈癌防治目的。%Objective To discuss the effect of nursing intervention in early screening for cervical cancer in patients with cervicitis. Methods 294 cases less than 50 years old with cervicitis received the TCT and HPV check for the first time in obstetrics and gynecology clinic of our hospital from June to September in 2013 year were chosen. All cases were asked to complete a questionnaire about the early screening of cervical cancer, and the cognition before and after intervention accepted were compared. Results The difference was statistically significant in cognition before and after intervention (P <0.01 or P<0.05). Conclusions The knowledge and point about prevention and treatment of cervical cancer by nurses using a variety of means including health belief model and individual health education can effectively improve the cognition of early screening for cervical cancer. Establishing health belief and improving participation in early screening for cervical cancer can achieve the aim on timely detection, timely diagnosis and timely treatment of preventing cervical cancer.

  15. Implementation of cervical cancer screening using visual inspection with acetic acid in rural Mozambique: successes and challenges using HIV care and treatment programme investments in Zambézia Province

    Directory of Open Access Journals (Sweden)

    Alberto J Baptista

    2012-06-01

    Full Text Available Background: In order to maximize the benefits of HIV care and treatment investments in sub-Saharan Africa, programs can broaden to target other diseases amenable to screening and efficient management. We nested cervical cancer screening into family planning clinics at select sites also receiving PEPFAR support for antiretroviral therapy (ART rollout. This was done using visual inspection with acetic acid (VIA by maternal child health nurses. We report on achievements and obstacles in the first year of the program in rural Mozambique. Methods: VIA was taught to clinic nurses and hospital physicians, with a regular clinical feedback loop for quality evaluation and retraining. Cryotherapy using carbon dioxide as the refrigerant was provided at clinics; loop electrosurgical excision procedure (LEEP and surgery were provided at the provincial hospital for serious cases. No pathology services were available. Results: Nurses screened 4651 women using VIA in Zambézia Province in year one of the program, more than double the Ministry of Health service target. VIA was judged positive for squamous intraepithelial lesions in 8% (n=380 of the women (9% if age ≥30 years (n=3154 and 7% if age <30 years (n=1497; p=0.02. Of the 380 VIA-positive women, 4% (n=16 had lesions (0.3% of 4651 total screened requiring referral to Quelimane Provincial Hospital. Fourteen (88% of these 16 women were seen at the hospital, but records were inadequate to judge outcomes. Of women screened, 2714 (58% either had knowledge of their HIV status prior to VIA or were subsequently sent for HIV testing, of which 583 (21% were HIV positive. Conclusions: Screening and clinical services were successfully provided on a large scale for the first time ever in these rural clinics. However, health manpower shortages, equipment problems, poor paper record systems and a limited ability to follow-up patients inhibited the quality of the cervical cancer screening services. Using prior HIV

  16. A comparative study of faecal occult blood kits in a colorectal cancer screening program in a cohort of healthy construction workers.

    LENUS (Irish Health Repository)

    Shuhaibar, M

    2012-02-01

    BACKGROUND: The incidence of colorectal cancer (CRC) has been increasing. We evaluated uptake rates and outcomes of faecal immunochemical test (FIT) and Guaiac test (gFOBT) kits as part of a two-step CRC screening. METHODS: A 3-year CRC screening program for a defined population of construction workers was conducted. Those satisfying the inclusion criteria were provided with gFOBT or FIT kits. Individuals testing positive were invited for a colonoscopy. RESULTS: A total of 909 faecal testing kits were distributed. Age range was 53-60 years. Compliance rate was higher for FIT (58.3%) as compared to gFOBT (46.7%) (p = 0.0006). FIT detected adenomatous polyps and CRC in 37.5 and 25%, respectively, whereas; gFOBT detected 23.5 and 18%. Colonoscopies were normal in 53 and 25% tested positive by gFOBT and FIT, respectively (p = 0.016). CONCLUSION: The FIT was more cost-effective when compared with gFOBT with higher return rate, sensitivity and specificity. A comparative study of faecal occult blood kits in a CRC screening program in a healthy cohort of construction workers.

  17. The Screening Performance of Serum 1,3-Beta-D-Glucan in Patients with Invasive Fungal Diseases: A Meta-Analysis of Prospective Cohort Studies.

    Directory of Open Access Journals (Sweden)

    Tie-Ying Hou

    Full Text Available The serum 1,3-beta-D-glucan (BG assay aids in the early diagnosis of invasive fungal diseases (IFDs and has been approved for their diagnosis. However, reports on the screening performance of BG are scarce. We performed a meta-analysis of data extracted from only prospective cohort studies to evaluate the screening performance of the BG assay in the diagnosis of IFDs. We specifically searched 4 databases (the PubMed, Web of Science, Elsevier, and Cochrane Collaboration databases according to EORTC-MSG criteria. A total of 1068 patients in 11 studies were analyzed. Deeks' funnel plot asymmetry test suggested a low likelihood of publication bias for the included studies (p = 0.055. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the summary receiver operating characteristic curve, with 95% confidence intervals, were 0.75(0.63,0.84, 0.87(0.81,0.92, 5.85(3.96,8.63, 0.30(0.20,0.45, 19.53(11.16,34.18, and 0.89(0.86,0.91, respectively. The findings of this meta-analysis suggest that the BG assay is a useful screening tool with high sensitivity and specificity for discriminating between patients with and without IFDs. In clinical practice, BG assay results should be evaluated together with clinical and microbiological findings.

  18. An analysis of free screening of cervical cancer and breast cancer in Xicheng district, Beijing%西城区"免费子宫颈癌乳腺癌筛查"情况分析

    Institute of Scientific and Technical Information of China (English)

    李晓哲; 金英楠; 侯力

    2011-01-01

    Objective To compare detectable rates of free two gynecological cancers ( cervical cancer and breast cancer) screening and past gynecopathy screening for cervical cancer and breast cancer, and to explore a new mode to prevent and treat gynecopathies. Methods The results of free two gynecological cancers screening were compared with those of past gynecopathy screening in three years of 2005, 2006 and 2007. The residents who received free two gynecological cancers screening were investigated with a questionnaire. And the attitudes of residents and doctors to free two gynecological cancers screening were investigated through group visiting. Results The detectable rates of cervical cancer and breast cancer in free two gynecological screening were higher than those in past gynecopathy screening. The ages of women who volunterily received free two gynecological cansers screening were almost all centralized in a span of 45 to 60 years of age. The residents had positive attitudes to screening flow sheet, health education, doctor' s service manner and screening skills of investigators. The investigators considered that the free two gynecological cancers screening enhanced their techniques and personal comprehensive abilities.Conclusion Free two gynecological cancers screening poses positive effects in service mode, screening method and service outcome, which provides reference basis for orientation of prevention and treatment of gynecopathy. In prevention and treatment of gynecopathy, the key steps should include paying more attention to community residents, adopting advanced screening method, improving multiple department cooperation and doing well services after screening.%目的 比较免费两癌(子宫颈癌、乳腺癌)筛查与既往妇女病普查对子宫颈及乳腺癌的检出效果,探讨妇女病防治工作新思路.方法 免费两癌筛查与2005、2006、2007年妇女病普查结果相比较;对参加免费两癌筛查的居民进行问卷调查;应用定

  19. A Prospective Cohort Study to Compare Treatment Results Between 2 Fractionation Schedules of High-Dose-Rate Intracavitary Brachytherapy (HDR-ICBT) in Patients With Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Eng-Yen [Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Taiwan (China); Sun, Li-Min [Department of Radiation Oncology, Zuoying Armed Forces General Hospital, Kaohsiung, Taiwan (China); Lin, Hao [Department of Gynecologic Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Lan, Jen-Hong [Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Chanchien, Chan-Chao [Department of Gynecologic Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Huang, Yu-Jie; Wang, Chang-Yu [Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Wang, Chong-Jong, E-mail: cjw1010@adm.cgmh.org.tw [Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China)

    2013-01-01

    Purpose: To compare the treatment results of 2 fractionation schedules for high-dose-rate intracavitary brachytherapy (HDR-ICBT) in patients with cervical cancer. Methods and Materials: From June 2001 through January 2008, 267 patients with stage IB-IVA cervical cancer were enrolled in the study. All patients underwent 4-field pelvic irradiation and HDR-ICBT. The median central and parametrial doses were 39.6 Gy and 45 Gy, respectively. Patient underwent either 6 Gy Multiplication-Sign 4 (HDR-4) (n=144) or 4.5 Gy Multiplication-Sign 6 (HDR-6) (n=123) to point A of ICBT using {sup 192}Ir isotope twice weekly. The rates of overall survival, locoregional failure, distant metastasis, proctitis, cystitis, and enterocolitis were compared between HDR-4 and HDR-6. Results: There were no significant differences in the demographic data between HDR-4 and HDR-6 except for total treatment time. The 5-year proctitis rates were 23.0% and 21.5% in HDR-4 and HDR-6 (P=.399), respectively. The corresponding rates of grade 2-4 proctitis were 18.7% and 9.6% (P=.060). The corresponding rates of grades 3-4 proctitis were 5.2% and 1.3% (P=.231). Subgroup analysis revealed that HDR-4 significantly increased grade 2-4 proctitis in patients aged {>=}62 years old (P=.012) but not in patients aged <62 years (P=.976). The rates of overall survival, locoregional failure, distant metastasis, cystitis, and enterocolitis were not significantly different between HDR-4 and HDR-6 schedules. Conclusion: The small fraction size of HDR-ICBT is associated with grade 2 proctitis without compromise of prognosis in elderly patients. This schedule is suggested for patients who tolerate an additional 2 applications of HDR-ICBT.

  20. Low-dose CT screening in an Asian population with diverse risk for lung cancer: A retrospective cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Chin A. [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); Lee, Kyung Soo [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Shin, Myung-Hee; Cho, Yun Yung [Sungkyunkwan University School of Medicine, Department of Social and Preventive Medicine, Seoul (Korea, Republic of); Choi, Yoon-Ho [Sungkyunkwan University School of Medicine, Center for Health Promotion, Seoul (Korea, Republic of); Kwon, O. Jung [Sungkyunkwan University School of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Shin, Kyung Eun [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); Kyung Hee University Hospital, Department of Diagnostic Radiology, Seoul (Korea, Republic of)

    2015-08-15

    To evaluate the performance of low-dose CT (LDCT) screening for lung cancer (LCA) detection in an Asian population with diverse risks for LCA. LCA screening was performed in 12,427 symptomless Asian subjects using either LDCT (5,771) or chest radiography (CXR) (6,656) in a non-trial setting. Subjects were divided into high-risk and non-high-risk groups. Data were collected on the number of patients with screening-detected LCAs and their survival in order to compare outcomes between LDCT and CXR screening with the stratification of risks considering age, sex and smoking status. In the non-high-risk group, a significant difference was observed for the detection of lung cancer (adjusted OR, 5.07; 95 % CI, 2.72-9.45) and survival (adjusted HR of LCA survival between LDCT vs. CXR group, 0.08; 95 % CI, 0.01-0.62). No difference in detection or survival of LCA was noticed in the high-risk group. LCAs in the non-high-risk group were predominantly adenocarcinomas (96 %), and more likely to be part-solid or non-solid compared with those in the high-risk group (p = 0.023). In the non-high-risk group, LDCT helps detect more LCAs and offers better survival than CXR screening, due to better detection of part solid or non-solid lung adenocarcinomas. (orig.)

  1. Low-dose CT screening in an Asian population with diverse risk for lung cancer: A retrospective cohort study

    International Nuclear Information System (INIS)

    To evaluate the performance of low-dose CT (LDCT) screening for lung cancer (LCA) detection in an Asian population with diverse risks for LCA. LCA screening was performed in 12,427 symptomless Asian subjects using either LDCT (5,771) or chest radiography (CXR) (6,656) in a non-trial setting. Subjects were divided into high-risk and non-high-risk groups. Data were collected on the number of patients with screening-detected LCAs and their survival in order to compare outcomes between LDCT and CXR screening with the stratification of risks considering age, sex and smoking status. In the non-high-risk group, a significant difference was observed for the detection of lung cancer (adjusted OR, 5.07; 95 % CI, 2.72-9.45) and survival (adjusted HR of LCA survival between LDCT vs. CXR group, 0.08; 95 % CI, 0.01-0.62). No difference in detection or survival of LCA was noticed in the high-risk group. LCAs in the non-high-risk group were predominantly adenocarcinomas (96 %), and more likely to be part-solid or non-solid compared with those in the high-risk group (p = 0.023). In the non-high-risk group, LDCT helps detect more LCAs and offers better survival than CXR screening, due to better detection of part solid or non-solid lung adenocarcinomas. (orig.)

  2. The Problems and Experience of Breast and Cervical Cancer Screening of Ping Yi County in Shandong Province%山东省平邑县"两癌筛查"问题及经验浅析

    Institute of Scientific and Technical Information of China (English)

    孙庆玲

    2015-01-01

    Objective The results of breast and cervical cancer screening were analyzed from 2012 to 2014, and the prob-lems and experience were summarized to guide the work of "two cancer screening" in primary hospitals. Methods In ac-cordance with the "two cancer screening"technology program, the work has been carried out to check the physical condi-tion of rural women (35 to 64 years old) in 2012 to 2014. Results 93,015 cervical cancer screening cases and 97,542 breast cancer screening cases are carried out. The detection rates of cervical precancerous lesions and cervical cancer are 0.98 ‰and 3.88/100,000. The detection rates of breast abnormalities and breast cancer are 23.65%and 35.88/100,000. Conclusion The detection rates of two cancer disease are low, but there is a tendency increased year by year. Advocacy and education are the key to promote the self-health awareness of rural women.%目的 对平邑县2012—2014年"两癌筛查"工作进行汇总分析,找出筛查工作中存在的问题,总结成功经验,以指导基层医院顺利开展"两癌筛查"工作. 方法 按照山东省"两癌筛查"检查项目技术方案,于2012—2014年对平邑县35~64岁农村妇女开展了宫颈癌、乳腺癌项目检查. 结果 开展宫颈癌检查93015例,其中宫颈癌前病变检出率为0.98‰,宫颈癌检出率为3.88/10万;乳腺癌筛查97542例,其中乳腺异常检出率为23.65%,乳腺癌检出率为35.88/10万.结论 两癌疾病检出率较低,但存在逐年升高的趋势;深入农村宣传,开展健康教育是农村妇女自我保健意识提升的关键.

  3. Important Variables When Screening for Students at Suicidal Risk: Findings from the French Cohort of the SEYLE Study

    OpenAIRE

    Jean-Pierre Kahn; Alexandra Tubiana; Cohen, Renaud F.; Vladimir Carli; Camilla Wasserman; Christina Hoven; Marco Sarchiapone; Danuta Wasserman

    2015-01-01

    Due to early detection of mental ill-health being an important suicide preventive strategy, the multi-centre EU funded “Saving and Empowering Young Lives in Europe” (SEYLE) study compared three school-based mental health promotion programs to a control group. In France, 1007 students with a mean age of 15.2 years were recruited from 20 randomly assigned schools. This paper explores the French results of the SEYLE’s two-stage screening program (ProfScreen) and of the cross-program suicidal eme...

  4. Cervical radiculopathy.

    Science.gov (United States)

    Iyer, Sravisht; Kim, Han Jo

    2016-09-01

    Cervical radiculopathy is a common clinical scenario. Patients with radiculopathy typically present with neck pain, arm pain, or both. We review the epidemiology of cervical radiculopathy and discuss the diagnosis of this condition. This includes an overview of the pertinent findings on the patient history and physical examination. We also discuss relevant clinical syndromes that must be considered in the differential diagnosis including peripheral nerve entrapment syndromes and shoulder pathology. The natural history of cervical radiculopathy is reviewed and options for management are discussed. These options include conservative management, non-operative modalities such as physical therapy, steroid injections, and operative intervention. While the exact indications for surgical intervention have not yet been elucidated, we provide an overview of the available literature regarding indications and discuss the timing of intervention. The surgical outcomes of anterior cervical decompression and fusion (ACDF), cervical disc arthroplasty (CDA), and posterior cervical foraminotomy (PCF) are discussed. PMID:27250042

  5. A screen of a large Czech cohort of oligodontia patients implicates a novel mutation in the PAX9 gene

    Czech Academy of Sciences Publication Activity Database

    Šerý, Omar; Bonczek, Ondřej; Hloušková, A.; Černochová, P.; Vaněk, J.; Míšek, Ivan; Krejčí, J.; Izakovičová Hollá, L.

    2015-01-01

    Roč. 123, č. 2 (2015), s. 65-71. ISSN 0909-8836 R&D Projects: GA ČR GB14-37368G; GA MZd(CZ) NT11420 Institutional support: RVO:67985904 Keywords : monozygotic twins * mutation screening * oligodontia Subject RIV: FF - HEENT, Dentistry Impact factor: 1.488, year: 2014

  6. Age-specific prevalence of HPV16/18 genotypes in cervical cancer: A systematic review and meta-analysis.

    Science.gov (United States)

    Hammer, Anne; Rositch, Anne; Qeadan, Fares; Gravitt, Patti E; Blaakaer, Jan

    2016-06-15

    The prevalence of HPV16/18 in cervical cancer has been reported to decline with age in some papers. However, whether this decline in proportion of cancers positive for HPV16/18 is consistently observed across studies remains to be elucidated. Thus, the aim of this study was to identify papers reporting data on age-specific prevalence of HPV16/18 in cervical cancer and to summarize the results. We employed MEDLINE and Embase for a systematic literature search and thereby identified a total of 644 papers published in the period 1999-2015, of which 15 papers, reporting cross-sectional data, were included for review (11,526 cervical cancers). The prevalence of HPV16/18 in cervical cancer declined significantly with age (ρ = -0.83, p = 0.04) from 74.8% (95% CI 67.6-80.8) in women aged 30-39 years to 56.8% (95% CI 43.9-68.8) in women aged ≥70 years. As the HPV16/18 positive cancers are prevented in fully vaccinated cohorts, the age-specific epidemiology of cervical cancer is anticipated to change, with a shift in peak incidence rate to older ages. It will be important for integrated vaccination and screening strategies to consider predicted change in the age-specific epidemiology of cervical cancer. PMID:26661889

  7. Human papillomavirus genotyping by multiplex pyrosequencing in cervical cancer patients from India

    Indian Academy of Sciences (India)

    Cheryl M Travasso; Mona Anand Mansi; Mansi Samarth; Aditi Deshpande; Chandan Kumar-Sinha

    2008-03-01

    Cervical cancer is a leading cause of cancer-related deaths among women in India. Human papillomavirus (HPV) infection is the causative agent of cervical cancer; and infection with the high-risk genotypes, predominantly HPV16 and 18, is the biggest risk factor. Vaccines targeting HPV16 and 18 have been found to confer protection in large-scale clinical trials. HPV genotyping has traditionally been carried out to screen the population “at risk” using indirect methods based on polymerase chain reaction (PCR) using consensus primers combined with various DNA hybridization techniques, and often followed by the sequencing of candidate products. Recently, a high-throughput and direct method based on DNA sequencing has been described for HPV genotyping using multiplex pyrosequencing. We present a pilot study on HPV genotyping of cervical cancer and non-malignant cervical samples using multiplex pyrosequencing. Using genomic DNA from cell lines, cervical biopsies, surgical tissues or formalin-fixed, paraffin-embedded tissue samples, we could successfully resolve 6 different HPV types out of the 7 tested, with their prevalence found to be in agreement with earlier reports. We also resolved coinfections with two different HPV types in several samples. An HPV16 genotype with a specific and recurrent sequence variation was observed in 8 cancer samples and one non-malignant sample. We find this technique eminently suited for high-throughput applications, which can be easily extended to large sample cohorts to determine a robust benchmark for HPV genotypes prevalent in India.

  8. Rastreamento anterior para câncer de colo uterino em mulheres com alterações citológicas ou histológicas Previous screening for cervical cancer among women with cytological and histological abnormalities

    Directory of Open Access Journals (Sweden)

    C Rama

    2008-06-01

    do último exame citológico anterior.OBJECTIVE: To examine previous Pap smear history in women screened for cervical cancer with cytological or histological abnormalities. METHODS: Cross-sectional study in a sample of 5,485 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. A behavioral questionnaire was applied and cervical specimens were obtained for testing by Pap smears or liquid-based cytology. Women who had abnormal cytology were referred for colposcopic examination and, if abnormal, for cervical punch biopsy. To explore factors associated to cervical abnormalities Pearson's chi-was conduted square test at a 5% significance level. RESULTS: Cytological abnormalities were found in 354 women (6.4% and included 41 high-grade squamous intra-epithelial lesions and 3 carcinomas; 92.7% were normal results. Colposcopy was performed in 289 women, and 145 (50.2% showed abnormal results. Punch biopsies showed 14 cervical intraepithelial neoplasias grade 3 and 4 carcinomas. Previous Pap smears were reported in all women who had cytology suspected of carcinoma, 97.6% of those with high-grade squamous intra-epithelial lesions, all women with histological diagnosis of carcinoma and 92.9% of those who had cervical intraepithelial neoplasias grade 3 histologically. Previous Pap smear in the last tree years was reported by 86.5% and 92.8% of women with abnormal cytology and biopsy, respectively. CONCLUSIONS: There was no statistically significant difference regarding the number of Pap tests and time since their last test between women with histologically diagnosed carcinoma and cervical intraepithelial neoplasia grade 3 compared with those with normal cytology.

  9. Application of thinprep cytology test and cervical smear combined with colposcope in screening of cervical lesions%液基细胞学、宫颈刮片联合阴道镜在宫颈病变筛查中的应用

    Institute of Scientific and Technical Information of China (English)

    江明珠

    2015-01-01

    目的 探讨液基细胞学(TCT)、宫颈刮片联合阴道镜在宫颈病变筛查中的应用价值. 方法 选取2014年1月~2015年4月来我所妇科门诊行TCT筛查的1726例妇女(门诊组)和在乡镇行宫颈刮片细胞学筛查的26 021例妇女(乡镇组)作为研究对象,两组均行TBS分级诊断,将细胞学阳性者进一步行阴道镜及镜下活组织病理学检查,分析两组不同取材方法的细胞学筛查结果,并观察细胞学阳性者的阴道镜和病理组织学检查结果. 结果 两组细胞学检出阳性率差异有统计学意义(X2=86.56,P0.05). 以病理组织学诊断为金标准,宫颈癌前病变和宫颈癌(CIN+SCC)两者合计,阴道镜诊断符合率为90.14%(128/142), 细胞学诊断符合率为70.73%(87/123). 结论 TCT筛查法优于传统刮片细胞学筛查法,联合应用阴道镜及镜下活检组织病理学检查,可明显提高宫颈癌前病变及宫颈癌的检出.%Objective To discuss the application value of thinprep cytology test(TCT) and cervical smear combined with colposcope in screening of cervical lesions. Methods 1726 cases of female patients (outpatient group) visited outpatient clinic in our hospital from January 2014 to April 2015 and 26 021 cases of rural women (rural group) receiving cervical cancer screening were selected as research object.Two groups were diagnosed by TBS classification,and those with pos-itive cytologic results were further examined by colposcope and histopathological examination.The cytologic screening results in two groups were analyzed by different methods, the colposcope and histopathologic results of patients with positive cytologic results were observed. Results There was significant difference in positive rate of cytologic results be-tween two groups (X2=86.56,P0.05).The gold standard was diagnosed by histopathology.The total of cervical precancerous lesions and cervical cancer (CIN+SCC),colposcope diagnosis coincidence rate was 90.14%(128/142),and cytology

  10. Epidemiology and Early Detection of Cervical Cancer.

    Science.gov (United States)

    Hillemanns, Peter; Soergel, Phillip; Hertel, Hermann; Jentschke, Matthias

    2016-01-01

    The new German S3 guideline 'Prevention of Cervical Cancer' published in 2016 is based on the latest available evidence about cervical cancer screening and treatment of cervical precancer. Large randomized controlled trials indicate that human papillomavirus (HPV)-based screening may provide better protection against cervical cancer than cytology alone through improved detection of premalignant disease in the first screening round prior to progression. Therefore, women aged 30 years and older should preferably be screened with HPV testing every 3-5 years (cytology alone every 2 years is an acceptable alternative). Co-testing is not recommended. Screening should start at 25 years using cytology alone every 2 years. The preferred triage test after a positive HPV screening test is cytology. Women positive for HPV 16 and HPV 18 should receive immediate colposcopy. Another alternative triage method is p16/Ki-67 dual stain cytology. The mean yearly participation rate in Germany is between 45 and 50%. Offering devices for HPV self-sampling has the potential to increase participation rates in those women who are at higher risk of developing cervical cancer. Regarding primary prevention, the 9-valent vaccine may provide protection against up to 85% of cervical intraepithelial neoplasia (CIN) 3 and 90% of cervical cancer, and is available in Europe as a 2-dose schedule from May 2016. PMID:27614953

  11. Screening for psychopathology in a national cohort of 8- to 15-year-old children with cerebral palsy

    DEFF Research Database (Denmark)

    Rackauskaite, Gija; Bilenberg, Niels; Bech, Bodil Hammer;

    2015-01-01

    Cerebral palsy (CP) is often accompanied by psychopathology and learning disability. AIMS: (1) to evaluate the prevalence of psychopathology as estimated by the Child Behavior Checklist (CBCL) parental questionnaire in 8- to 15-year-old Danish children with CP and to analyze its association...... the CBCL. The cutoff for psychopathology was the Total CBCL score or DSM-oriented scores above the 93rd percentile in an age- and gender-stratified population. RESULTS: The psychopathology screening was positive in 46.2% (CI 41.6-50.8%) against 15.1% in general population. Cognitive disability...... for psychopathology should be a part of multidisciplinary follow-up of CP. The CBCL can be used as a screening instrument in children with CP without severe motor and cognitive disability....

  12. Comparison of three methods for screening cervical cancer in Southeast Shandong Province%三种方法在鲁西南地区宫颈癌筛查中的可用性分析

    Institute of Scientific and Technical Information of China (English)

    郝延凤

    2012-01-01

    Objective To understand the prevalelnce of cervical cancer in southwest area of Shandong province and compare 3 popular screening tests for cervical cancer. Methods Totally 890 women in southwest area of Shandong were screened for cervical cancer, colposcopy histopathological findings were taken as a golden standard, the Pap smears, liquid-based cytology and naked eye observation supplemented by acetic acid white stain were used and compared. Results The sensitivity, specificity, positive predictive value and negative predictive value of Pap smears for screening cervical intraepithelial lesions were 27.8%, 87.5%, 29.9%, 98.1%; that of liquid based cytology were 79.6%, 91.2%, 38.4%, 99.3% and that of the naked eye observation supplemented by acetic acid white staining were 67.2% , 78.5% , 9.2% , 99.6% . Conclusion Liquid-based cytology possessed the highest value for diagnosis and it can be used as the priority for cervical cancer screening,while macroscopic observation supplemented by acetic acid white staining is simple and suitable for cervical cancer screening in impoverished area.%目的 了解鲁西南地区的宫颈癌流行状况,比较3种流行筛查方法的优劣,为宫颈癌的防治提供依据.方法 鲁西南地区选取890名适龄妇女进行宫颈癌筛查,以阴道镜检查的病理组织学结果为金标准,比较巴氏涂片、液基细胞学、肉眼观察辅以醋酸白染色3种方法的可用性.结果 三种方法对宫颈上皮内高度病变的敏感度、特异度、阳性预测值、阴性预测值分别为:巴氏涂片:27.8%,87.5%,29.9%,98.1%;液基细胞学:79.6%,91.2%,38.4%,99.3%;肉眼观察辅以醋酸白染色:67.2%,78.5%,9.2%,99.6%.结论 液基细胞学的诊断价值最高,可作为首选的宫颈癌筛查方法;肉眼观察辅以醋酸白染色简单易行,适用于贫困地区的宫颈癌筛查工作.

  13. Case Studies - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2010-10-15

    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 several case studies for cervical cancer screening and management.  Created: 10/15/2010 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  14. Future Directions - Cervical Cancer

    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 possible changes in 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.

  15. Cervical Cancer

    Science.gov (United States)

    ... to see your doctor. www.cdc.gov/cancer/knowledge 1-800-CDC-INFO Are there tests that can prevent cervical cancer or find it early? There are two tests that can either help prevent cervical cancer or find it early: • The Pap test (or Pap smear)looks for precancers, cell changes, on the cervix ...

  16. 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; Katzenstein, Terese Lea; Johansen, Isik Somuncu; Pedersen, Gitte; Junge, Jette; Helleberg, Marie; Storgaard, Merete; Obel, Niels; Lebech, Anne-Mette

    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 in...... 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/ICC in the...... 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...

  17. 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...

  18. Comparative study of visual inspection of the cervix by 3% acetic acid (VIA versus Pap smear by Bethesda method in sexually active women aged 25-50 years as an equally or more effective cervical cancer screening method in a low resource setup

    Directory of Open Access Journals (Sweden)

    Mohit Rajendra Saraogi

    2014-06-01

    Full Text Available Background: Cervical cancer is the most common cancer in Indian women and is a preventable cancer. Pap smear being an expensive screening test, increased emphasis is being laid on the development of a reliable and cost effective screening method for cervical cancer. This study aims at early detection of cervical dysplastic lesions using a simple and cost-effective screening test like visual inspection of cervix with 3% acetic acid (VIA and comparing its diagnostic efficacy with the more expensive Pap screening by Bethesda method. Methods: Ours was a prospective study carried out on a 100 sexually active women aged 25-50 years, coming to our OPD. The women were subjected to both a VIA and Pap smear. All Pap and VIA positive women were subjected to a cervical biopsy, whose histopathological report was taken as the gold standard. Results: In our study the sensitivity of VIA was more than that of cytology (100% versus 66.67% but the specificity was significantly lesser (47.83% compared to the 73.91%. The negative predictive value of VIA was comparable with Pap smear (100% and 85% respectively as was the positive predictive value (42.86% and 50%. However the diagnostic accuracy of VIA was lower than that of Pap smear (66.67% and 81.25% in our study. Conclusions: In this study VIA was found to have efficacy comparable to Pap smear in screening cervical cancer. Thus we recommend that VIA could be used as an alternative screening tool to detect early cervical dysplasia - especially in poor resource settings. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 688-691

  19. Usefulness of three-dimensional CT angiography (3D-CTA) with a single bolus injection of contrast material for the examination of intracranial and cervical arteries in cerebrovascular disease screening

    International Nuclear Information System (INIS)

    Three-dimensional CT angiography (3D-CTA) has been gaining wide acceptance as a clinically useful tool in the field of neurosurgery. The great diagnostic value of 3D-CTA for cerebral aneurysm or other cerebrovascular diseases has been well established. However, images of the intracranial and cervical arteries have not been obtained simultaneously because of the limitation of the scanning area and the need for contrast material. In order to use 3D-CTA to screen for cerebrovascular disease, we used a helical CT scan with an intravenous single bolus injection of contrast material to perform 3D-CTA of the intracranial and cervical arteries simultaneously. A spiral computed tomographic scan was performed with a Hispeed Advantage RP (General Electric). After injection of 150 ml of nonionized contrast material at a rate of 3 mm/sec in an antecubital vein, an axial computed tomographic scan (120 kV, 200 mA) of the cranial region was performed with a delay of 20-25 seconds after starting the injection. Section thickness was 1 mm with table increments of 1 mm per rotation. The scan volume included 20-30 mm above and below the sella turcica. An axial computed tomographic scan (120 kV, 190 mA) of the cervical region was performed with a delay of 30 seconds after completion of cranial CTA. Section thickness was 3 mm with table increments of 3 mm per rotation. Image reconstruction was carried out through surface rendering and maximum intensity projection processing. From November 1995 to August 1998, we used this technique to screen 218 consecutive outpatients for cerebrovascular disease. Unruptured cerebral aneurysms were found in 20 cases (9.2%). Atherosclerotic diseases of the cervical carotid artery were found in 58 cases (26.6%), as follows: carotid artery occlusion in 2 cases, carotid bifurcation stenosis in 22 cases, and intramural calcification of the internal carotid artery in 50 cases. Atherosclerotic diseases of the intracranial artery were found in 99 cases (45

  20. Usefulness of three-dimensional CT angiography (3D-CTA) with a single bolus injection of contrast material for the examination of intracranial and cervical arteries in cerebrovascular disease screening

    Energy Technology Data Exchange (ETDEWEB)

    Takamura, Yukio [Sapporo National Hospital (Japan); Tanooka, Atsushi; Morimoto, Shigefumi

    2001-05-01

    Three-dimensional CT angiography (3D-CTA) has been gaining wide acceptance as a clinically useful tool in the field of neurosurgery. The great diagnostic value of 3D-CTA for cerebral aneurysm or other cerebrovascular diseases has been well established. However, images of the intracranial and cervical arteries have not been obtained simultaneously because of the limitation of the scanning area and the need for contrast material. In order to use 3D-CTA to screen for cerebrovascular disease, we used a helical CT scan with an intravenous single bolus injection of contrast material to perform 3D-CTA of the intracranial and cervical arteries simultaneously. A spiral computed tomographic scan was performed with a Hispeed Advantage RP (General Electric). After injection of 150 ml of nonionized contrast material at a rate of 3 mm/sec in an antecubital vein, an axial computed tomographic scan (120 kV, 200 mA) of the cranial region was performed with a delay of 20-25 seconds after starting the injection. Section thickness was 1 mm with table increments of 1 mm per rotation. The scan volume included 20-30 mm above and below the sella turcica. An axial computed tomographic scan (120 kV, 190 mA) of the cervical region was performed with a delay of 30 seconds after completion of cranial CTA. Section thickness was 3 mm with table increments of 3 mm per rotation. Image reconstruction was carried out through surface rendering and maximum intensity projection processing. From November 1995 to August 1998, we used this technique to screen 218 consecutive outpatients for cerebrovascular disease. Unruptured cerebral aneurysms were found in 20 cases (9.2%). Atherosclerotic diseases of the cervical carotid artery were found in 58 cases (26.6%), as follows: carotid artery occlusion in 2 cases, carotid bifurcation stenosis in 22 cases, and intramural calcification of the internal carotid artery in 50 cases. Atherosclerotic diseases of the intracranial artery were found in 99 cases (45

  1. Investigation of the outpatients cognition of cervical cancer screening and human papilloma virus vaccine%门诊患者对宫颈癌筛查、人乳头瘤病毒疫苗认知情况的调查

    Institute of Scientific and Technical Information of China (English)

    杨建清

    2016-01-01

    目的:探讨门诊患者对宫颈癌筛查、人乳头瘤病毒疫苗的认知情况。方法:收治宫颈癌患者200例作为调查对象,分成A、B两组。两组患者填写调查问卷。结果:两组对感染人乳头瘤病毒的认知度比较,差异具有统计学意义(P<0.05)。A组愿意接受疫苗66例(66.0%),B组愿意接受疫苗93例(93.0%),两组比较,差异具有统计学意义(P<0.05)。结论:临床对人乳头瘤病毒的了解度相对较低,但接受该疫苗率较高。宫颈癌疾病的筛查、人乳头瘤病毒疫苗需大力推广。%Objective:To explore the outpatients cognition of cervical cancer screening and human papilloma virus vaccine. Methods:200 cases of patients with cervical cancer were as the investigation object and were divided into group A and group B.The patients of two groups filled out the questionnaire.Results:There was statistically significant difference of the cognition of human papilloma virus vaccine between groups(P<0.05).66 cases in group A were willing to accept the vaccine(66%),and 93 cases in group B were willing to accept vaccine(93%),with statistically significant difference between groups(P < 0.05). Conclusion:The cognition of cervical cancer screening and human papilloma virus vaccine in clinic was relatively low,but the receiving the vaccine rate was higher.The screening of cervical cancer and human papilloma virus vaccine should be promoted vigorously.

  2. Comprehensive evaluation of early screening of cervical cancer cytological examination%宫颈癌早期筛查细胞学检查方法综合评价

    Institute of Scientific and Technical Information of China (English)

    刘玉瑰

    2015-01-01

    Objective To appraise the comprehensive evaluation of early screening of cervical cancer cytological examination.Methods From October 2012 to October 2014, 1000 cases of gynecology clinic admissions were selected, and they were randomly divided into group A and group B, with 500 cases in each group, group A was given Pap cytology, while B group was given ThinPrep cytology (TCT), comparative analysis of test results, while the colposcopic biopsy histology results were analyzed.Results CIN and cervical cancer diagnostic sensitivity and specificity was significantly higher in group B than those in group A (P < 0.05).Conclusions Early cervical cancer screening to take ThinPrep cytology diagnosis can be achieved relatively good sensitivity and specificity, it is worth learning from.%目的 综合评价宫颈癌早期筛查细胞学检查方法.方法 抽取2012年10月至2014年10月妇科门诊接诊的患者1000例,随机分为A组与B组,每组500例,其中A组采取巴氏细胞学检查,而B组采取液基薄层细胞学检查(TCT),对比分析检查结果,同时与阴道镜组织学活检结果进行对比分析.结果 B组诊断CIN及宫颈癌的敏感性与特异性皆高于A组(P<0.05).结论 宫颈癌早期筛查采取液基薄层细胞学检查诊断可取得比较好的敏感性与特异性,值得借鉴.

  3. Prevalence, Predictors, and Same Day Treatment of Positive VIA Enhanced by Digital Cervicography and Histopathology Results in a Cervical Cancer Prevention Program in Cameroon

    Science.gov (United States)

    DeGregorio, Geneva A.; Bradford, Leslie S.; Manga, Simon; Tih, Pius M.; Wamai, Richard; Ogembo, Rebecca; Sando, Zacharie; Liu, Yuxin; Schwaiger, Constance; Rao, Sowmya R.; Kalmakis, Karen; Kennedy Sheldon, Lisa; Nulah, Kathleen; Welty, Edith; Welty, Thomas; Ogembo, Javier Gordon

    2016-01-01

    Background In 2007, the Cameroon Baptist Convention Health Services (CBCHS) implemented a screen-and-treat cervical cancer prevention program using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC). Methods We retrospectively analyzed 46,048 medical records of women who received care through the CBCHS Women’s Health Program from 2007 through 2014 to determine the prevalence and predictors of positive VIA-DC, rates of same day treatment, and cohort prevalence of invasive cervical cancer (ICC). Results Of the 44,979 women who were screened for cervical cancer, 9.0% were VIA-DC-positive, 66.8% were VIA-DC-negative, 22.0% were VIA-DC-inadequate (normal ectocervix, but portions of the transformation zone were obscured), and 2.2% were VIA-DC-uncertain (cervical abnormalities confounding VIA-DC interpretation). Risk factors significantly associated with VIA-DC-positive screen were HIV-positivity, young age at sexual debut, higher lifetime number of sexual partners, low education status and higher gravidity. In 2014, 31.1% of women eligible for cryotherapy underwent same day treatment. Among the 32,788 women screened from 2007 through 2013, 201 cases of ICC were identified corresponding to a cohort prevalence of 613 per 100,000. Conclusions High rate of VIA-DC-positive screens suggests a significant burden of potential cervical cancer cases and highlights the need for expansion of cervical cancer screening and prevention throughout the 10 regions of Cameroon. VIA-DC-inadequate rates were also high, especially in older women, and additional screening methods are needed to confirm whether these results are truly negative. In comparison to similar screening programs in sub-Saharan Africa there was low utilization of same day cryotherapy treatment. Further studies are required to characterize possible program specific barriers to treatment, for example cultural demands, health system challenges and cost of procedure. The prevalence of ICC among

  4. 76 FR 30723 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Science.gov (United States)

    2011-05-26

    ... for breast and cervical cancer screening; updates on the National Breast and Cervical Cancer Early... 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...

  5. External validation of the Prostate Cancer Prevention Trial and the European Randomized Study of Screening for Prostate Cancer risk calculators in a Chinese cohort

    Institute of Scientific and Technical Information of China (English)

    Yao Zhu; Ding-Wei Ye; Jin-You Wang; Yi-Jun Shen; Bo Dai; Chun-Guang Ma; Wen-Jun Xiao; Guo-Wen Lin; Xu-Dong Yao; Shi-Lin Zhang

    2012-01-01

    Several prediction models have been developed to estimate the outcomes of prostate biopsies.Most of these teels were designed for use with Western populations and have not been validated across different ethnic groups.Therefore,we evaluated the predictive value of the Prostate Cancer Prevention Trial (PCPT) and the European Randomized Study of Screening for Prostate Cancer (ERSPC) risk calculators in a Chinese cohort.Clinicopathological information was obtained from 495 Chinese men who had undergone extended prostate biopsies between January 2009 and March 2011.The estimated probabilities of prostate cancer and high-grade disease (Gleason >6) were calculated using the PCPT and ERSPC risk calculators.Overall measures,discrimination,calibration and clinical usefulness were assessed for the model evaluation.Of these patients,28.7% were diagnosed with prostate cancer and 19.4% had high-grade disease.Compared to the PCPT model and the prostate-specific antigen (PSA) threshold of 4 ng ml-1,the ERSPC risk calculator exhibited better discriminative ability for predicting positive biopsies and high-grade disease (the area under the curve was 0.831 and 0.852,respectively,P<0.01 for both).Decision curve analysis also suggested the favourable clinical utility of the ERSPC calculator in the validation dataset.Both prediction models demonstrated miscalibration:the risk of prostate cancer and high-grade disease was overestimated by approximately 20% for a wide range of predicted probabilities.In conclusion,the ERSPC risk calculator outperformed both the PCPT model and the PSA threshold of 4 ng ml-1 in predicting prostate cancer and high-grade disease in Chinese patients.However,the prediction tools derived from Western men significantly overestimated the probability of prostate cancer and high-grade disease compared to the outcomes of biopsies in a Chinese cohort.

  6. Effect of screening mammography on breast cancer survival in comparison to other detection methods. A retrospective cohort study

    International Nuclear Information System (INIS)

    The effectiveness of screening mammography (SMG) on mortality has been established in randomized controlled trials in Western countries, but not in Japan. This study evaluated the effectiveness by comparing the survival based on detection methods. The survivals were estimated by the Kaplan-Meier method. Breast cancer patients diagnosed from 1 January 1989 to 31 December 2000 were determined using the Miyagi Prefectural Cancer Registry and follow-up was performed from the date of the diagnosis until the date of death or the end of follow-up, 31 December 2005. The hazard ratios (HR) and 95% confidence interval (CI) of breast cancer death based on the detection methods were estimated by the Cox proportional-hazard regression model. The mean age of the 7513 patients was 55.7 years (range, 15.0-99.3). The 5-year survival associated with the SMG group, the clinical breast examination (CBE) group, and the self-detection group was 98.3%, 94.3%, and 84.8%, respectively. The HR (95% CI) of deaths from breast cancer was 2.50 (1.10-5.69) for patients in the CBE group and 6.57 (2.94-14.64) for the self-detection group in comparison to the SMG group. In women aged 50-59, the HRs were 1.64(0.58-4.62) among the CBE group and 3.74 (1.39-10.03) among the self-detection group, and the HRs for the CBE and self-detection groups in women aged 60-69 were 2.96 (0.68-12.83) and 9.51 (2.36-38.26), respectively. After adjusting for stage, the HRs dropped remarkably. Screening mammography may be more effective in the elderly group and be able to reduce the mortality of breast cancer in Japan. (author)

  7. GENETIC INSTABILITY IN CERVICAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    赵旻; 伍欣星; 邱小萍; 李晖; 戴天力; 谭云

    2002-01-01

    Objective: The role of human papillomavirus (HPV) in the development of cervical carcinoma has been clearly established but other factors could be involved in cervical tumorigenesis such as loss of heterozygosity (LOH) and microsatellite instability (MI). The aim of the present study was to investigate the genetic instability in cervical carcinoma tissues and provide evidence for discoveringnew tumor suppressor genes and screening diagnostic molecular marker of cervical carcinoma. Methods: Fifty primary cervical carcinoma samples from high-incidence area were analyzed by PCR for HPV16 infection, LOH and microsatellite instability. Results: HPV16 was detected in 88% of the cases. Sixty-six percent of total cases showed LOH with no more than 3 different loci per case. The highest frequency of the allelic loss was found in D18S474 (18q21, 40.5%). MI was detected in 4 cases (8%) only. Conclusion: Different percentages of LOH on specific chromosomal regions were found and MI was very infrequent in cervical carcinoma. The putative suppressor gene(s) could be located on specific chromosome regions such as 18q, and genetic instability could be involved in cervical tumorigenesis.

  8. Inflammatory Bowel Disease and Cervical Neoplasia

    DEFF Research Database (Denmark)

    Rungoe, Christine; Simonsen, Jacob; Riis, Lene; Frisch, Morten; Langholz, Ebbe; Jess, Tine

    2015-01-01

    BACKGROUND & AIMS: We examined the risk of cervical neoplasia (dysplasia or cancer) in women with ulcerative colitis (UC) or Crohn's disease (CD). We also calculated the reverse, the risk for diagnosis with cervical neoplasia before development of inflammatory bowel disease (IBD). METHODS: We...... with IBD were assessed by Cox proportional hazards regression analysis. Odds ratios (ORs) of cervical neoplasia before diagnosis of IBD were calculated by using conditional logistic regression. RESULTS: Women with CD underwent cervical cancer screening as often as women in the general population (IRR...

  9. Non-participation in screening

    DEFF Research Database (Denmark)

    Dugué, Pierre-Antoine; Lynge, Elsebeth; Bjerregaard, Beth;

    2012-01-01

    To determine the impact of comprehensiveness of cytology registration on the proportion of cervical cancer patients without a recent screening history.......To determine the impact of comprehensiveness of cytology registration on the proportion of cervical cancer patients without a recent screening history....

  10. 北辰区30~65岁妇女宫颈癌筛查分析%Analysis of Beichen District in 30~65 Years Old Women Cervical Cancer Screening

    Institute of Scientific and Technical Information of China (English)

    李燕

    2015-01-01

    Objective Through to the beichen district 30~65 years old, 9365 cases of women TCT detection, understand the women cervical cancer incidence in beichen district,do early detection, early diagnosis, early treatment. Methods Liquid thin-layer cytology for detection, with cervical brush cervical surface and cervical exfoliated cel s, covered in "cel preservation solution, filtered to make cel s randomly dispersed homogeneously, the dyeing under light microscopy analysis the typical thin clear layer of cel s, cytological diagnosis using cervical cytology report system (TBS) diagnostic criteria. Results 9365 cases, 9365 cases of specimens of abnormal detection rate of 1.43%, among them meaning of atypical squamous cel s (ASC-US) of 109 cases (1.16%), not except for advanced squamous intraepithelial lesions (ASC-H),4 cases(0.04%),low-grade squamous intraepithelial lesions (LSIC), 20 cases (0.21%), advanced squamous intraepithelial lesion (HSIL) 3 cases, accounting for 0.03%. Conclusion To understand the women cervical cancer screening in beichen district situation, can prevent early cervical cancer incidence, improve the rate of early cervical lesions, improve women's survival rates in beichen district.%目的通过对北辰区30~65岁9365例妇女进行TCT检测,了解北辰区妇女宫颈癌的发病率,做到早发现,早诊断,早治疗。方法液基薄层细胞学检测,用宫颈刷取宫颈表面及宫颈内脱落细胞,侵泡于"细胞保存液"中,经过滤使细胞随机均匀分散,经染色在光镜下分析具有代表性的清晰薄层细胞,细胞学诊断采用子宫颈细胞学报告系统(TBS)的诊断标准报告结果。结果9365例标本发现异常137例,检出率1.43%,其中意义不明的非典型鳞状细胞(ASC-US)109例,占1.16%,不除外高级鳞状上皮内病变(ASC-H)4例,占0.04%,低级鳞状上皮内病变(LSIC)20例,占0.21%,高级鳞状上皮内病变(HSIL)3例,占0.03%。结论

  11. Cervical spondylosis

    Science.gov (United States)

    ... Past neck injury (often several years before) Past spine surgery Ruptured or slipped disk Severe arthritis Small fractures ... Kshettry VR. Cervical spondylosis. In: Benzel EC, ed. Spine Surgery . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap ...

  12. Cervical Cancer

    Science.gov (United States)

    ... 162 KB) This information in Spanish (en español) Female reproductive system Select image to view larger Related ... D., FACS, Captain, U.S. Public Health Service Medical Director, National Breast and Cervical Cancer Early Detection Program, ...

  13. Cervical Stenosis

    Science.gov (United States)

    ... Accumulation of pus in the uterus is called pyometra. Symptoms Before menopause, cervical stenosis may cause menstrual ... present but not cause symptoms. A hematometra or pyometra can cause pain or cause the uterus to ...

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

    NARCIS (Netherlands)

    Bosgraaf, R.P.; Verhoef, V.M.; Massuger, L.F.A.G.; Siebers, A.G.; Bulten, J.; Kuyper-de Ridder, G.M. de; Meijer, C.J.W.; Snijders, P.J.L.M.; Heideman, D.A.; Hout, J. in't; Kemenade, F.J. van; Melchers, W.J.G.; Bekkers, R.L.M.

    2015-01-01

    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 intrae

  15. Transition from film to digital mammography: Impact for breast cancer screening through the national breast and cervical cancer early detection program

    NARCIS (Netherlands)

    N.T. van Ravesteyn (Nicolien); L. Van Lier (Lisanne); C.B. Schechter (Clyde); D.U. Ekwueme (Donatus U.); J. Royalty (Janet); J.W. Miller (Jacqueline W.); A.M. Near (Aimee); K.A. Cronin (Kathleen); E.A.M. Heijnsdijk (Eveline); J.S. Mandelblatt (Jeanne); H.J. de Koning (Harry)

    2015-01-01

    textabstractIntroduction The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides mammograms and diagnostic services for low-income, uninsured women aged 40-64 years. Mammography facilities within the NBCCEDP gradually shifted from plain-film to digital mammography. The pur

  16. 上海地区女性宫颈癌筛查意识及行为的现状调查%Status of women′s perception on and participation in cervical cancer screening in Shanghai

    Institute of Scientific and Technical Information of China (English)

    陶花; 丁焱

    2014-01-01

    The self-designed questionnaire related to cervical cancer screening was distributed to 4 882 patients in two women′s hospitals in Shanghai from March to June 2010.Results Only 46.0% of the participants had ever taken the cervical cancer screening test , of which, 8.0% took the pap smear test three years ago and 8.0%were not sure about the exact time of the latest pap smear test they took .27.0%of the participants had never heard about it and 15.0%had not known about it .Logistic regression analysis showed that having ever heard a-bout cervical cancer screening or not , age, having sexual life or not , employed or not , and family income were four significant predictors for participation in cervical cancer screening .Face-to-face education from medical professionals , printed education brochures and media advertisements for cervical cancer screening were regarded as three most effective methods to improve women′s participation in cervical cancer screening .Conclusion If the medical professionals could effectively take advantage of the chances that the women visit hospitals to provide oral and printed information , the women are most likely to take the subsequent pap smear test .Meanwhile , the public education via media advertisements is also regarded as a useful method to arouse women ′s awareness of the existence and importance of cervical cancer screening , thereby urging them to take the screening test .%目的:了解上海地区女性对宫颈癌筛查的认知及参加情况,探索阻碍女性参加宫颈癌筛查的影响因素。方法选择2010年3—6月上海市2所3级甲等妇产科医院就诊的女性4882例,采用自制调查问卷表进行有关宫颈癌筛查意识和行为的问卷调查。结果4882例女性中,46.0%曾经参加过宫颈癌筛查,但其中8.0%距上次筛查时间已超过3年,不确定上一次行宫颈涂片检查时间的占8.0%;27.0%女性未听说过宫颈癌筛查;另有15.0%就

  17. Screening of the DNA mismatch repair genes MLH1, MSH2 and MSH6 in a Greek cohort of Lynch syndrome suspected families

    International Nuclear Information System (INIS)

    Germline mutations in the DNA mismatch repair genes predispose to Lynch syndrome, thus conferring a high relative risk of colorectal and endometrial cancer. The MLH1, MSH2 and MSH6 mutational spectrum reported so far involves minor alterations scattered throughout their coding regions as well as large genomic rearrangements. Therefore, a combination of complete sequencing and a specialized technique for the detection of genomic rearrangements should be conducted during a proper DNA-testing procedure. Our main goal was to successfully identify Lynch syndrome families and determine the spectrum of MLH1, MSH2 and MSH6 mutations in Greek Lynch families in order to develop an efficient screening protocol for the Greek colorectal cancer patients' cohort. Forty-two samples from twenty-four families, out of which twenty two of Greek, one of Cypriot and one of Serbian origin, were screened for the presence of germline mutations in the major mismatch repair genes through direct sequencing and MLPA. Families were selected upon Amsterdam criteria or revised Bethesda guidelines. Ten deleterious alterations were detected in twelve out of the twenty-four families subjected to genetic testing, thus our detection rate is 50%. Four of the pathogenic point mutations, namely two nonsense, one missense and one splice site change, are novel, whereas the detected genomic deletion encompassing exon 6 of the MLH1 gene has been described repeatedly in the LOVD database. The average age of onset for the development of both colorectal and endometrial cancer among mutation positive families is 43.2 years. The mutational spectrum of the MMR genes investigated as it has been shaped by our analysis is quite heterogeneous without any strong indication for the presence of a founder effect

  18. 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......, which contains nationwide records of all pathology specimens. The cumulative incidence and hazard ratios (HRs) for time from inclusion to first cervical intraepithelial neoplasia (CIN)/ICC and time from first normal cervical cytology result to first CIN/ICC were estimated. Sensitivity analyses were...... in both groups were adherent to the national ICC screening programme and had a normal baseline cytology, incidences of CIN and ICC were comparable. CONCLUSIONS: Overall, WLWH developed more cervical disease than controls. Yet, in WLWH and controls adherent to the national ICC screening programme...

  19. HPV-DNA Detection and Its Differential Diagnosis's Applicationin Cervical Cancer Screening%HPV-DNA的检测及分型诊断在宫颈癌筛查中的应用

    Institute of Scientific and Technical Information of China (English)

    何金凤

    2013-01-01

    目的::探讨人乳头瘤病毒(HPV)基因检测及分型诊断在宫颈癌筛查中的应用及意义。方法:选取宫颈癌高危患者1626例,设为高危组;另选取同期健康体检女性300例,作为对照组。参照宫颈癌“三阶梯筛查法”进行检测,先行细胞学检查和HPV-DNA分型检测,检测结果异常时行阴道镜下宫颈活组织病理检查,比较各组HPV感染及HPV-DNA分型情况。结果:高危组HPV检出率为40.34%,对照组检出率为8.00%,差异具有统计学意义(P0.05)。结论:对于年龄大于50岁的妇女,特别是高危人群,应开展HPV-DNA的检测及分型诊断,对判断宫颈病变发展趋势、处理癌前病变、阻断病程、预防宫颈癌的发生都具有积极的临床意义。%Objective:To explore the application and significance of human papilloma virus (HPV) gene detection and differential diagnosis in cervical cancer screening.Methods:1626 cases with high risk of cervical cancer were selected as high risk group,and 300 healthy women were selected as control group.“Three step screening method” was referred to test,and cytology with HPV-DNA differential diagnosis were performed firstly,and colposcopic cervical biopsy was performed when above results was abnormal.HPV's infection and HPV-DNA classification in two groups were compared.Results:HPV's positive rate in high-risk group and control group were 40.34%and 8.00%(P0.05).Conclusion:For women more than 50 years,especially with high-risk,it should carry out HPV-DNA detection and its differential diagnosis, and it has positive clinical significance to judge lesion's development,handle precancerous lesions,block lesions and prevent cervical cancer's occur.

  20. Comparative analysis of DNA quantitative cytology and TCT in cervical cancer screening%宫颈癌筛查中DNA定量分析与薄层液基细胞学检查对比分析

    Institute of Scientific and Technical Information of China (English)

    钟萍萍; 顾依群; 王军; 周秋立; 王爱春

    2014-01-01

    Objective To compare the cytology diagnostic accuracy of DNA quantitative cytology and thinprep cytology test(TCT) in cervical cancer screening for exploring effective method in cervical cancer screening.Methods TCT and DNA quantitative cytology were carried out in 7 470 women.Women with positive results additionally underwent high risk human papillomavirus (HPV) detection.Positive cytologic diagnosis included atypical squamous cells(ASC) or above in TCT and DNA index 2.5 or above in DNA quantitative cytology.Results The positive rate was 13.0% in method of DNA quantitative cytology and 13.7% in method of TCT in 7 470 cases.Positive rate of the two methods had no significant difference in cervical cancer screening(x2 =1.813,P =0.178).There was significant difference in positive rate of TCT between cases with DNA index≥2.5,<4.5,heteroploid cells more than 3 or DNA index≥4.5 and cases with DNA index≥2.5,<4.5,heteroploid cells less than 3.Every grade of TCT abnormality had abnormal DNA index.Abnormality of DNA index had an increasing trend with the severity of TCT.Infection rate of high risk HPVs had significant difference in different grades of DNA index (x2 =62.648,P =0.000).Conclusion Combination of DNA quantitative cytology and TCT is an effective method in cervical cancer screening,which can reduce misdiagnosis,guide cervical biopsy and suggest infection of high risk of HPVs.%目的 比较DNA定量分析与薄层液基细胞学(TCT)检查在宫颈癌中的应用价值,以提高细胞学诊断的准确性.方法 对7 470例妇女行宫颈薄层液基细胞学(TCT)及DNA定量分析,结果异常者用二代基因杂交捕获法(HC2)检测高危型人乳头状瘤病毒(HPV),TCT在ASC及以上病变为阳性,DNA指数≥2.5为阳性.结果 7470例患者,用DNA定量分析法检测阳性率为13.0%,TCT检查阳性率为13.7%,两种检查方法差异无统计学意义(x2 =1.813,P=0.178);≥3个细胞2.5≤DNA指数<4.5者及DNA指数≥4.5

  1. The effect evaluation of three different methods in screening of cervical cancer in 170 thousands of rural women%武汉市17万农村妇女宫颈癌筛查方法效果评价

    Institute of Scientific and Technical Information of China (English)

    周爱芬; 张斌; 罗欣; 杜玉开

    2013-01-01

    Objective: To evaluate the application effect of TCT, quantitative analysis of cervical cellular DNA and HPV genoty-ping detection in screening of cervical cancer. Methods; More than 170 thousands of rural women accepted the screening of cervical cancer in 2011 through quantitative analysis of cellular 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 cervix and accept a HPV genotyping detection. Results; Defining histological diagnosis of CIN Ⅱ and CIN Ⅱ above as a positive threshold, to calculate the sensitivity and specificity of TCT, quantitative analysis of cellular DNA and HPV genotyping detection were 68. 35% , 52. 02% and 81.40% , 40. 12% and 92. 18% , 56.73% ; the positive predictive value and negative predictive value were 35. 18% , 81. 19% and 35. 30% , 84. 94% and 45. 47% , 94. 88%. Conclusion; The sensitivity of quantitative analysis of cellular DNA is far higher than TCT, and combined application of these two methods can greatly reduce the missed cases. HPV genotyping detection and cytological test can be used in screening of cervical cancer, can maximally reduce the missed cervical cancer cases, improve the efficiency of screening.%目的:评价液基薄层细胞技术(TCT)、DNA倍体定量分析和HPV分型检测在宫颈癌和宫颈病变筛查诊断中的应用价值.方法:对武汉市17万农村妇女采用TCT、TBS诊断及DNA倍体定量分析筛查宫颈癌,对细胞学诊断高于低度鳞状上皮内病变或细胞DNA分析有≥3个异倍体细胞,建议做阴道镜下病理组织学活检并进行HPV检测.结果:以组织学诊断CINⅡ及以上级别病变作为评价两种筛查方法的标准,计算出TCT检查和DNA倍体定量分析及HPV检测方法的敏感度和特异度分别为68.35%、52.02%和81.40%、40.12%及92.18%、56.73%;阳性预

  2. Clinical Application of Colposcopy Cervical Biopsy and Liquid-based Cytology Test in the Screening of Cervical Lesions%阴道镜宫颈活检与 TCT 联合检测在宫颈病变中的应用

    Institute of Scientific and Technical Information of China (English)

    冷海娜; 孙名芳

    2013-01-01

    Objective To explore the clinical application value of colposcopy cervical biopsy and liquid -based cytology test in the screening of cervical lesions .Methods Four hundred and eighty-three patients who udergone the TCT examination from January to December in gynecological clinic were chosen for pathological colposcopy cervical biopsy To select 483 gynecological clinic patients who had the TCT examination and were inspected to be abnormal in Care Hospital from January to December ,2012 ,have pathological colposcopy cervical biopsy for them and retrospective a-nalysis fwas carried out .or their entire clinical datum .Among which the TBS diagnostic system wasis used in the TCT in-spection report ,which contributed to the diagnosis ,as well as combined with the pathological examination report to make the diagnosis.Results Among the patients with the TCT result being ASC-US351,CINⅠ~CINⅢ223 patients(63. 53%) were detected with the pathological colposcopy cervical biopsy;CINⅠ~CINⅢ75 patients(91.46%) were de-tected with the pathological colposcopy cervical biopsy;CINⅠ~CIMⅢ41 patients were detected with the pathological colposcopy cervical biopsy and among the 6 SCC patients ,SCC 6 patients were detected with the colposcopy cervical bi-opsy .Conclusion The diagnose accordance rate of TCT examination and cervical biopsy diagnosis is high ;the diagnose accordance rate of cervical cancer with CIN of higher level is high .Precancerous lesions of uterine cervix can be found at an earlier age with the adoption of colposcopic cervical biopsy combined with TCT examination and stopped or slowed down ,which is the safe ,reliable and accurate examination method for the screening of cervical cancer .%目的:探讨阴道镜宫颈活检与宫颈薄层液基细胞学( TCT )在宫颈病变筛查中的临床应用价值。方法选取2012年1月~12月在妇科门诊行宫颈薄层液基细胞学( TCT)检查异常的483例患者,并同时行阴道镜宫颈活检

  3. Detection of Cervical Liquid Based Cytology in the Meaning of the Lotus Pond Town Women Cervical Cancer Screening%宫颈液基细胞学检测在荷塘镇妇女宫颈癌筛查中的意义

    Institute of Scientific and Technical Information of China (English)

    霍喜兰

    2014-01-01

    目的:探讨宫颈液基细胞学检查技术(TCT)在荷塘镇宫颈癌筛查中的应用价值。方法:对1328例本镇及外来务工已婚妇女使用液基细胞学检测(LCT)进行宫颈癌筛查。采用TBS诊断系统选择TCT报告ASCUS以上患者428例行电子阴道镜检并活检病理,将两者结果进行比对分析。结果:宫颈液基细胞学检查1328例中428例阳性,阳性率32.2%。ASCUS 128例,LSIL 86例,ASC-H 90例,HSIL 124例。对TCT检查阳性的428例进行阴道镜病理检查,正常164例,CIN Ⅰ级102例,CIN Ⅱ/Ⅲ级154例,鳞癌8例。宫颈液基细胞学检查结果与组织病理结果符合率,LSIL与CINⅠ级符合率84.3%(86/102),HSIL与CINⅡ/Ⅲ级符合率80.5%(124/154)。结论:基层医院积极开展宫颈癌筛查LCT检测,有助于癌前病变的早发现、早诊断、早治疗。%Objective:To study the cervical liquid based cytology examination technology (TCT) in the lotus pond,the value of cervical cancer screening. Method:The town and migrant workers,1328 cases of married women with a Liquid based cytology test (Liquid-based cytology test,LCT) for cervical cancer screening. Patients with ASCUS by TBS diagnosis system choice TCT report 428 routine electron microscopic examination of the vagina and biopsy pathology,to compare the two results were analyzed. Result:In 1328 patients with cervical liquid based cytology,428 cases of positive,positive rate was 32.2%. ASCUS 128 example, LSIL 86,ASC-H 90,HSIL 124 cases. For TCT examination of 428 patients with colposcope pathologic examination,the result:164 patients with normal,CINⅠgrade 102 cases,CINⅡ/Ⅲlevel of 154 cases squamous carcinoma,8 cases of cervical liquid based cytology examination results and the histopathological results coincidence rate,LSIL and CINⅡ/Ⅲlevel coincidence rate 84.3%(86/102),HSIL and CINⅡ/Ⅲlevel coincidence rate 80.5%(124/154). Conclusion:Basic-level hospital actively carry out cervical cancer

  4. Sociodemographic and reproductive risk factors in cervical cancer

    OpenAIRE

    Tajinder Kaur; Shaveta Garg; Sunita Mor

    2016-01-01

    Background: Cervical cancer is the leading cause of cancer deaths in women. In India, cervical cancer is the most common cancer in women followed by breast cancer. A numbers of risk factors reproductive as well as sociodemographic have been widely studied for cervical cancer. The countries where universal screening is restricted because of various reasons economical, lack of resources etcetera, a modified screening procedure which is targeted on the high risk population can help solve the pro...

  5. Chlamydial cervicitis: a research study from general practice

    OpenAIRE

    Fox, Harold

    1983-01-01

    Chlamydia trachomatis was isolated from the cervix in five out of 294 women at routine cervical cytology screening. Significant sera antibody titres were obtained from six out of 115 isolate-negative women similarly screened. The antibody response increased in proportion to the past frequency and severity of cervical pathology and sexually transmitted disease.

  6. Análisis costo beneficio del Programa de Detección Oportuna del Cáncer Cervicouterino Cost benefit analysis of the Cervical Cancer Screening Program

    Directory of Open Access Journals (Sweden)

    PATRICIA HERNÁNDEZ-PEÑA

    1997-07-01

    Full Text Available Objetivo. Determinar el costo beneficio de la reorganización del Programa de Detección Oportuna del Cáncer Cervicouterino (PDOC mediante intervenciones de garantía de calidad. Material y métodos. Se siguieron tres etapas: a identificación y cuantificación de costos; b identificación y cuantificación de beneficios, y c evaluación económica del costo beneficio. Resultados. El costo unitario de operación por citología -obtención, fijación, el traslado al centro de lectura, su tinción e interpretación y la notificación de resultados- se estimó en USD$ 11.6. En conjunto, las intervenciones en calidad al PDOC elevarían el costo de cada citología en 32.7%. Sin embargo, la nueva organización generaría una razón beneficio/costo de 2 y un beneficio neto de 88 millones de dólares para los próximos cinco años. Conclusiones. La operación del programa propuesto resulta socialmente deseable, siempre y cuando las modificaciones se lleven a cabo, particularmente la capacitación, la notificación personalizada de los casos positivos, el incremento de cobertura, la introducción de mecanismos de control de calidad, el monitoreo contínuo y el tratamiento en mujeres con anormalidades detectadas.Objective. Previous researches pointed out the critical changes needed to increase the efficiency of the National Screening Programme of Cervical Cancer in Mexico. These changes were assessed through a cost-benefit analysis. This paper presents the results of that appraisal. Figures are presented as USDollars of 1996 valued as 7.5 pesos for each dollar. Results. The operational unitary cost of the integral process of the cytology –the obtention of the Pap smear, its transportation to the interpretation centre, its analysis, and the notification of results to users– was estimated in US$ 11.6. If the proposed changes are operated, the cost of each citology would increase by 32.7%. The benefit/cost ratio would be 2 and the net benefit of 88

  7. Impact of immunosuppression and region of birth on risk of cervical intraepithelial neoplasia among migrants living with HIV in Sweden.

    Science.gov (United States)

    Carlander, Christina; Wagner, Philippe; Svedhem, Veronica; Elfgren, Kristina; Westling, Katarina; Sönnerborg, Anders; Sparén, Pär

    2016-10-01

    Little is known about the incidence and risk of cervical intraepithelial neoplasia (CIN) grade 3, adenocarcinoma in situ and invasive cervical cancer (CIN3+) among migrants living with HIV in a European setting. We assessed the cumulative incidence (CuI) and hazard ratio (HR) of CIN2+ and CIN3+ in a cohort of women living with HIV (WLWH) (n = 893) identified from the Swedish national HIV register and HIV-negative women (n = 205,842) identified from the Swedish Population Register, matched on region of birth and age. Data was collected between 1993 and 2011 by linking our cohort with the Swedish National Cervical Screening Registry, collecting all cytological and histological results since 1993. The CuI of CIN3+ was 13.1% [95% confidence interval (CI) 8.9-17.2] for WLWH and 2.1% (95% CI 2.0-2.2) for HIV-negative after 18 years of follow-up. WLWH had more than eight times higher, age and region of birth matched, risk of CIN3+ than HIV-negative (HR 8.8: 95% CI 6.9-11.3). WLWH born in the East region, dominated by Thai women, had a two times higher risk of CIN3+ compared with WLWH born in Sweden (HR 2.47: 95% CI 1.2-5.0), which remained after adjusting for immunosuppression. Our results showed a substantially increased risk of CIN3+ among WLWH, which differed depending on birth region. Early HIV diagnosis and attendance to cervical cancer screening, with focus on migrants, is of crucial importance to minimize the incidence of cervical intraepithelial neoplasia. PMID:27177207

  8. Cervical Cancer Risk Prediction Models

    Science.gov (United States)

    Developing statistical models that estimate the probability of developing cervical cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

  9. General Information about Cervical Cancer

    Science.gov (United States)

    ... Research Cervical Cancer Treatment (PDQ®)–Patient Version General Information About Cervical Cancer Key Points Cervical cancer is ... the NCI website . Cervical Cancer During Pregnancy General Information About Cervical Cancer During Pregnancy Treatment of cervical ...

  10. Risk of cervical cancer after completed post-treatment follow-up of cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Helmerhorst, Theo; Habbema, Dik;

    2012-01-01

    To compare the risk of cervical cancer in women with histologically confirmed cervical intraepithelial neoplasia who returned to routine screening after having completed post-treatment follow-up with consecutive normal smear test results with women with a normal primary smear test result....

  11. Analysis of digitized cervical images to detect cervical neoplasia

    Science.gov (United States)

    Ferris, Daron G.

    2004-05-01

    Cervical cancer is the second most common malignancy in women worldwide. If diagnosed in the premalignant stage, cure is invariably assured. Although the Papanicolaou (Pap) smear has significantly reduced the incidence of cervical cancer where implemented, the test is only moderately sensitive, highly subjective and skilled-labor intensive. Newer optical screening tests (cervicography, direct visual inspection and speculoscopy), including fluorescent and reflective spectroscopy, are fraught with certain weaknesses. Yet, the integration of optical probes for the detection and discrimination of cervical neoplasia with automated image analysis methods may provide an effective screening tool for early detection of cervical cancer, particularly in resource poor nations. Investigative studies are needed to validate the potential for automated classification and recognition algorithms. By applying image analysis techniques for registration, segmentation, pattern recognition, and classification, cervical neoplasia may be reliably discriminated from normal epithelium. The National Cancer Institute (NCI), in cooperation with the National Library of Medicine (NLM), has embarked on a program to begin this and other similar investigative studies.

  12. A cost-utility analysis of cervical cancer vaccination in preadolescent Canadian females

    Directory of Open Access Journals (Sweden)

    Merid Maraki

    2009-10-01

    Full Text Available Abstract Background Despite the fact that approximately 70% of Canadian women undergo cervical cancer screening at least once every 3 years, approximately 1,300 women were diagnosed with cervical cancer and approximately 380 died from it in 2008. This study estimates the effectiveness and cost-effectiveness of vaccinating 12-year old Canadian females with an AS04-adjuvanted cervical cancer vaccine. The indirect effect of vaccination, via herd immunity, is also estimated. Methods A 12-health-state 1-year-cycle Markov model was developed to estimate lifetime HPV related events for a cohort of 12-year old females. Annual transition probabilities between health-states were derived from published literature and Canadian population statistics. The model was calibrated using Canadian cancer statistics. From a healthcare perspective, the cost-effectiveness of introducing a vaccine with efficacy against HPV-16/18 and evidence of cross-protection against other oncogenic HPV types was evaluated in a population undergoing current screening practices. The base-case analysis included 70% screening coverage, 75% vaccination coverage, $135/dose for vaccine, and 3% discount rate on future costs and health effects. Conservative herd immunity effects were taken into account by estimated HPV incidence using a mathematical model parameterized by reported age-stratified sexual mixing data. Sensitivity analyses were performed to address parameter uncertainties. Results Vaccinating 12-year old females (n = 100,000 was estimated to prevent between 390-633 undiscounted cervical cancer cases (reduction of 47%-77% and 168-275 undiscounted deaths (48%-78% over their lifetime, depending on whether or not herd immunity and cross-protection against other oncogenic HPV types were included. Vaccination was estimated to cost $18,672-$31,687 per QALY-gained, the lower range representing inclusion of cross-protective efficacy and herd immunity. The cost per QALY-gained was most

  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

    Directory of Open Access Journals (Sweden)

    Luís Felipe Leite Martins

    2009-04-01

    Full Text Available 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 smear test in Fortaleza and Rio de Janeiro was 19.1% (95% CI: 16.1;22.1 and 16.5% (95% CI: 14.1;18.9, respectively. Higher prevalence ratios of cervical cancer screening failure in both cities were seen among women with low education and low per capita income, old age, unmarried, who never underwent mammography, clinical breast examination, and blood glucose and cholesterol level testing. Smokers also had lower screening rates compared to non-smoker women and this difference was only statistically significant in Rio de Janeiro. CONCLUSIONS:The study findings point to the need of intervention focusing particularly women in worse socioeconomic conditions and access to healthcare, old-aged and unmarried. Education activities must prioritize screening of asymptomatic women and early diagnosis for symptomatic women and access to adequate diagnostic methods and treatment should be provided.OBJETIVO:Analizar factores asociados a la no realización del examen de Papanicolaou. MÉTODOS: Estudio transversal, de base poblacional, con