Persistent Racial Disparities in Cervical Cancer Screening with Pap Test

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

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'Have a Pap smear!' – doctors, their clients, and opportunistic cervical cancer screening

International Journal of STD & AIDS ◽

10.1258/0956462053420266 ◽

2005 ◽

Vol 16 (3) ◽

pp. 233-236 ◽

Cited By ~ 7

Author(s):

L C Chingang ◽

U Bischof ◽

G Andall-Brereton ◽

O Razum

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Pap Smear ◽

Cervical Screening ◽

Pap Test ◽

Community Members ◽

Middle Income ◽

Middle Income Countries ◽

High Incidence

In many middle-income countries with a high incidence of cervical cancer, organized screening programmes with the Pap test are being planned. We assessed the knowledge of, and attitudes towards, cervical screening among 63 doctors and 102 randomly selected community members in Trinidad where screening is still opportunistic. Doctors were well informed about cervical cancer, but not all knew the approximate specificity of the Pap test. Many did not routinely discuss the benefits and disadvantages of screening with their clients. Most women had heard of the Pap test, but only 56% knew its purpose; 25% would not participate in screening, stating reasons such as being in menopause or not having symptoms. More information about the aim of screening and the purpose of the Pap test must be communicated. Doctors need to keep their knowledge on screening up-to-date, and offer counselling that helps women to make an informed decision whether or not to participate in screening.

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Cervical cytochemistry: a potential adjunct to cytomorphology for detection of abnormal cells in cervical cancer screening

Journal of Pathology of Nepal ◽

10.3126/jpn.v10i1.27880 ◽

2020 ◽

Vol 10 (1) ◽

pp. 1639-1644

Author(s):

Indrani Krishnappa ◽

Kalyani R. ◽

Raja Parthiban ◽

Abhishek Agrawal

Keyword(s):

Cervical Cancer ◽

Acid Phosphatase ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Cancer Detection ◽

Pap Smear ◽

Pap Test ◽

Low Grade ◽

Smear Examination ◽

Intraepithelial Lesion

Background: Pap smear examination has been universally used as an effective screening tool for early detection of cervical carcinoma. The aim of this study was to assess the utility of Cervical Acid Phosphatase staining as an adjunct to routine Pap smear testing to improvethe sensitivity and specificity of routine Pap smear examination for cervical cancer detection. Materials and Methods: Cervical smears were taken from patients attending the gynecology department and a few cervical cancer screening programmes. One set of slides were alcohol fixed and stained with rapid pap stain and another set of slides were fixed in a special fixative and stained with Cervical Acid Phosphatase -Pap stain. The nuclear features of these Cervical Acid Phosphatase stained dysplastic cells was studied on Pap stain to diagnose cervical intraepithelial lesion/ malignancy. Results: Out of 489 cases included in the study 6 cases were diagnosed with intraepithelial lesion/ malignancy. On Cervical Acid Phosphatase -Pap stain 2 of the cases diagnosed as inflammatory smears on pap stain showed Cervical Acid Phosphatase positivity and thus were re evaluated. Mild nuclear atypia was observed in the Cervical Acid Phosphatase positive cells and these cases were diagnosed as Low grade squamous intraepithelial lesion and later biopsy proven to be Cervical intraepithelial Neoplasia I. Therefore Cervical Acid Phosphatase -Pap test was 100% sensitive and specific for cervical cancer detection. Conclusions: With 100% sensitivity Cervical Acid Phosphatase -Pap test satisfies the criteria of an efficient screening test.

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Mapping Population Health Management Roadmap into Cervical Cancer Screening Programs

International Journal of Reliable and Quality E-Healthcare ◽

10.4018/ijrqeh.2015070101 ◽

2015 ◽

Vol 4 (3) ◽

pp. 1-18 ◽

Cited By ~ 6

Author(s):

Anastasius Moumtzoglou ◽

Abraham Pouliakis

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Population Health ◽

Cervical Cancer Screening ◽

Health Management ◽

Pap Test ◽

Population Health Management ◽

Personalized Care ◽

Screening Programs ◽

Care Gaps

Population Health Management (PHM) aims to provide better health outcomes for preventing diseases, closing care gaps and providing more personalized care. Since the inception of the Pap test, cervical cancer (CxCa) decreased in countries applying cervical cancer programs, involving both prevention and treatment. In this article, the authors map the PHM roadmap to the design of cervical cancer screening programs and examine the effect on the supporting information technology systems. Notwithstanding screening programs have a tight relation to PHM; the mapping reveals numerous interventions involving additional data sources, and timeless reconfiguration.

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Racial Disparities in Cervical Cancer Screening

Cancer Nursing ◽

10.1097/ncc.0000000000000642 ◽

2019 ◽

Vol 42 (6) ◽

pp. 458-467

Author(s):

Hee Yun Lee ◽

Raiza Beltran ◽

Nam Keol Kim ◽

Do Kyung Lee

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Racial Disparities ◽

Cervical Cancer Screening

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A community based study to determine incidence of cervical cancer and willingness of women to participate in cervical cancer screening program in Navsari, Gujarat, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20194361 ◽

2019 ◽

Vol 8 (10) ◽

pp. 3954

Author(s):

Parth H. Vyas ◽

Kanchan Dhadwe ◽

Harsha A. Shah ◽

Hiral M. Dave ◽

Ashwin A. Shah

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Pap Smear ◽

Screening Program ◽

Pap Test ◽

Health Seeking ◽

Positive Health ◽

Cytological Examination ◽

Major Health Problem

Background: Carcinoma of the uterine cervix is a major health problem faced by the Indian women. Regular cervical cytological examination by all sexually active women can prevent the occurrence of carcinoma cervix. Early detection of cervical cancer is possible with Pap smear tests. Methods: Women above 25 years of age, living in study area and want to participate in study were included. Total 2352 women were enrolled in study. House to house visits were conducted in all the village area by using simple random sampling method. Information about cervical cancer was given. Pap test for cervical cancer screening was carried out by gynaecologist. Cytological examination and confirmation was done by pathologists.Results: A total of 3001 women had attended village level IEC session and out that, 2352 (78.4%) women took part in the screening program. Out of these 2352 women, 2007 women (85.3% compliance) had given consent for physical cervical examination and Pap smear. The incidence of cervical cancer was 0.2% on the basis of clinical examination and biopsy.Conclusions: Higher compliance for undergoing vaginal examination and Pap test shows the positive health seeking behaviour of the women but for that, strong IEC and sensitization about the disease must be done to improve the participation. Sensitivity of Pap test was poor and couldn’t find true positive cases.

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Impact of human papillomavirus (HPV) self-collection on subsequent cervical cancer screening completion among under-screened US women: MyBodyMyTest-3 protocol for a randomized controlled trial

Trials ◽

10.1186/s13063-019-3959-2 ◽

2019 ◽

Vol 20 (1) ◽

Author(s):

Lisa P. Spees ◽

Andrea C. Des Marais ◽

Stephanie B. Wheeler ◽

Michael G. Hudgens ◽

Sarah Doughty ◽

...

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Cancer Incidence ◽

Perceived Risk ◽

Pap Test ◽

Hpv Testing ◽

Cervical Cancer Incidence ◽

Incidence And Mortality

Abstract Background Screening substantially reduces cervical cancer incidence and mortality. More than half of invasive cervical cancers are attributable to infrequent screening or not screening at all. The current study, My Body My Test (MBMT), evaluates the impact of mailed kits for self-collection of samples for human papillomavirus (HPV) testing on completion of cervical cancer screening in low-income, North Carolina women overdue for cervical cancer screening. Methods/design The study will enroll at least 510 US women aged 25–64 years who report no Pap test in the last 4 years and no HPV test in the last 6 years. We will randomize participants to an intervention or control arm. The intervention arm will receive kits to self-collect a sample at home and mail it for HPV testing. In both the intervention and control arms, participants will receive assistance in scheduling an appointment for screening in clinic. Study staff will deliver HPV self-collection results by phone and assist in scheduling participants for screening in clinic. The primary outcome is completion of cervical cancer screening. Specifically, completion of screening will be defined as screening in clinic or receipt of negative HPV self-collection results. Women with HPV-negative self-collection results will be considered screening-complete. All other participants will be considered screening-complete if they obtain co-testing or Pap test screening at a study-affiliated institution or other clinic. We will assess whether the self-collection intervention influences participants’ perceived risk of cervical cancer and whether perceived risk mediates the relationship between HPV self-collection results and subsequent screening in clinic. We also will estimate the incremental cost per woman screened of offering at-home HPV self-collection kits with scheduling assistance as compared to offering scheduling assistance alone. Discussion If mailed self-collection of samples for HPV testing is an effective strategy for increasing cervical cancer screening among women overdue for screening, this method has the potential to reduce cervical cancer incidence and mortality in medically underserved women at higher risk of developing cervical cancer. Trial registration ClinicalTrials.gov NCT02651883, Registered on 11 January 2016.

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PP62 Cost-Effectiveness Of Cervical Cancer Screening In Estonia

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462319002137 ◽

2019 ◽

Vol 35 (S1) ◽

pp. 49-49

Author(s):

Triin Võrno ◽

Kaja-Triin Laisaar ◽

Terje Raud ◽

Kai Jõers ◽

Doris Meigas-Tohver ◽

...

Keyword(s):

Cervical Cancer ◽

Cost Effectiveness ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Screening Program ◽

Pap Test ◽

Cancer Screening Program ◽

Hpv Test ◽

Cervical Cancer Screening Program ◽

The Cost

IntroductionIn Estonia, organized cervical cancer screening program is targeted at women aged 30–55(59) years and Pap-tests are taken every five years. Since cervical cancer is associated with human papillomavirus (HPV), a number of countries have introduced the HPV-test as the primary method of screening. The objective of this study was to evaluate the cost-effectiveness of organized cervical cancer screening program in Estonia by comparing HPV- and Pap-test based strategies.MethodsFor the cost-effectiveness analysis, a Markov cohort model was developed. The model was used to estimate costs and quality-adjusted life-years (QALYs) of eight screening strategies, varying the primary screening test and triage scenarios, upper age limit of screening, and testing interval. Incremental cost-effectiveness ratios (ICERs) were calculated in comparison to current screening practice as well as to the next best option. Sensitivity analysis was performed by varying one or more similar parameter(s) at a time, while holding others at their base case value. The analysis was performed from the healthcare payer perspective adopting a five percent annual discount rate for both costs and utilities.ResultsIn the base-case scenario, ICER for HPV-test based strategies in comparison to the current screening practice was estimated at EUR 8,596–9,786 per QALY. For alternative Pap-test based strategies ICER was estimated at EUR 2,332–2,425 per QALY. In comparison to the next best option, HPV-test based strategies were dominated by Pap-test based strategies. At the cost-effectiveness threshold of EUR 10,000 per QALY Pap-testing every three years would be the cost-effective strategy for women participating in the screening program from age 30 to 63 (ICER being EUR 3,112 per QALY).ConclusionsDecreasing Pap-test based screening interval or changing to HPV-test based screening can both improve the effectiveness of cervical cancer screening program in Estonia, but based on the current cost-effectiveness study Pap-test based screening every three years should be preferred.

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Cervical cancer screening : evolution from Pap test to molecular markers

10.5353/th_b4654046 ◽

2011 ◽

Author(s):

Nga-yin, Annie Cheung

Keyword(s):

Cervical Cancer ◽

Molecular Markers ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Pap Test

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Correlates of Cervical Cancer Screening among Vietnamese American Women

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/2012/617234 ◽

2012 ◽

Vol 2012 ◽

pp. 1-11 ◽

Cited By ~ 8

Author(s):

Grace X. Ma ◽

Carolyn Y. Fang ◽

Ziding Feng ◽

Yin Tan ◽

Wanzhen Gao ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Healthcare Access ◽

Pap Test ◽

Prior History ◽

American Women ◽

Knowledge And Beliefs ◽

Vietnamese American ◽

Vietnamese Women

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.

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