Passive smoke exposure and abnormal cervical cytology in a predominantly Hispanic population

Purpose. The purpose of this study was to gain insight into attitudes and perceptions about smoking during pregnancy, passive smoke exposure, barriers to quitting, and program preferences among women in a low-income, ethnically diverse setting. Design. Nine focus group discussions were conducted with African-American, Native American, and white women. Discussions were moderated by local residents who shared the same ethnic background as group participants. Setting. Discussions were held in neighborhood centers and clinics in an urban area. Subjects. A total of 57 women participated. Moderators recruited participants from within their social networks and from neighborhood programs. The informal process of recruitment did not allow calculation of response rates. Measures. A series of open-ended questions with selected probes was used to guide the conversation. Results. Participants were aware that smoking during pregnancy is harmful and were concerned to varying degrees about their smoking behavior. Most women who smoked took active steps to reduce the risks. Actions were frequently accompanied by beliefs that rationalized moderate levels of smoking. While concerned, women were uncertain about what constituted harmful, passive smoke exposure. Personal barriers to quitting included being around others who smoked, feelings of stress and boredom, addiction, and not believing smoking is dangerous enough. Participants tended to value pregnancy-related advice from female friends and relatives over advice from professionals. Conclusions. Results suggest that many women respond to warnings about smoking during pregnancy, but actions are not necessarily measured, in quit rates. Misconceptions about the risks may help to rationalize continued smoking. Subjects lacked knowledge about how best to reduce the risks of passive smoke. Educational efforts may be effective when directed at networks of women who share information. The nature of qualitative data collection prevents extrapolation of these results to a larger population.

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Cervical cytologic abnormalities and negative colposcopy: histologic assessment

International Journal of Gynecological Cancer ◽

10.1046/j.1525-1438.1994.04050348.x ◽

1994 ◽

Vol 4 (5) ◽

pp. 348-351 ◽

Cited By ~ 4

Author(s):

R. Chenoy ◽

S. Manohar ◽

C. W.E. Redman ◽

D. M. Luesley

Keyword(s):

Cervical Cytology ◽

Histologic Diagnosis ◽

Abnormal Cervical Cytology ◽

Accurate Definition ◽

Cone Biopsy ◽

Histologic Evaluation ◽

Simple Regression Analysis ◽

Definition Of ◽

Cytologic Abnormalities ◽

Intraepithelial Lesions

Colposcopic assessment may be normal in the presence of severe or persistent minor cytologic abnormality. To assess the significance of negative satisfactory colposcopy in patients with abnormal cervical smears, a retrospective review was carried out on 1170 patients who had undergone out-patient loop diathermy excision for abnormal cervical cytology. Of these, 69 patients were treated for abnormal cervical cytology, despite normal colposcopic findings. Cytologic abnormalities ranged from persistent borderline changes to severe dyskariosis. Histologic assessment of the excision specimens revealed cervical intraepithalial neoplasia (CIN) in 43 (62.3%) cases, of which high-grade CIN accounted for 24 (34.8%) cases. There was good correlation between cytologic and histologic diagnosis. Simple regression analysis showedr= 0.46,P< 0.0001. The cytologic abnormality was highly predictive of the corresponding histologic diagnosis. This analysis has shown that significant intraepithelial lesions may exist despite negative colposcopic examination and highlights the need for histologic evaluation in such cases. In these circumstances, loop cone biopsy permits accurate definition of lesion severity, avoids potential undertreatment of significant lesions and causes less morbidity than conventional cone biopsy.

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