Risk factors as the basis for triage in low-resource cervical cancer screening programs

2003 ◽  
Vol 80 (1) ◽  
pp. 41-47 ◽  
Author(s):  
L. Gaffikin ◽  
S. Ahmed ◽  
Y.Q. Chen ◽  
J.M. McGrath ◽  
P.D. Blumenthal
Author(s):  
Maria R. Young ◽  
Julia M. Kramer ◽  
Jeffrey B. Chu ◽  
Jeffrey V. Hong ◽  
Kathleen H. Sienko ◽  
...  

Each year, cervical cancer causes the death of over 275,000 women worldwide with eighty percent of these cases occurring in low or lower-middle income countries. Cervical cancer screening programs reduce cervical cancer occurrence by identifying and treating pre-cancerous cervical abnormalities before they develop to malignant stages. Standard methods of screening are inappropriate for use in low-resource settings and therefore screening is very limited.  Based on a design ethnography studyperformed over a two-month period in Ghana, a need was identified for a low-fidelity model to assist in training healthcare providers to screen for cervical cancer using visual inspection with acetic acid. The design presented in this paper is a box trainer with a simulated vaginal cavity that allows a user to insert cervical images displayed on plastic tabs or cards from the Jhpiego Visual Inspection of the Cervix Flash Card Set©. A modular electronic feedback mechanism trains the user to properly complete the steps of the screening procedure and to track the successes of their diagnoses. This paper describes the need for a cervical cancer screening trainer, the process used to design a trainer to support visual inspection with acetic acid, and the results of prototyping and preliminary usability tests.


2021 ◽  
Vol 8 (2) ◽  
pp. 150-157
Author(s):  
Jata Shanker Misra ◽  
Anand Narain Srivastava ◽  
Shivani Singh

This study was undertaken with aim to create awareness among rural women regarding hazards and risk factors of carcinoma cervix and offering single life time cytological screening for early detection of the disease. This was essential as majority of the rural women were illiterate and have poor personal genital hygiene. The present screening program was planned through organizing camps by counseling and motivating 100 women from each village for undergoing Pap smear examination. During last 7 years, a total of 186 camps have been organized in three Blocks of Lucknow, India and 2949 of the 5286 women attending the camps underwent Pap test. Cytological findings were analyzed in these 2949 women in relation to different risk factors of the disease.The squamous intraepithelial lesions of cervix (SIL) were seen in 498 cases (16.8%) while atypical squamous epithelial changes of unknown significance (ASCUS) were observed in only 234 (8.2%). The SIL incidence was found high for all risk factors of cervical cancer like young age, multiparity and vaginal discharge. Candida albicans was found more common and associated with inflammatory and SIL conditions of cervix.The organization of rural cervical cancer screening programs through camp approach and offering single life time cytological examination of cervical smears in rural women may prove very effective in the detection of large number of SIL cases, the adequate treatment of which will check the progression of the disease and minimize the incidence of carcinoma cervix and associated mortality in rural India.


2020 ◽  
Vol 31 (5) ◽  
pp. 417-429
Author(s):  
J. Andrew Dykens ◽  
Jennifer S. Smith ◽  
Margaret Demment ◽  
E. Marshall ◽  
Tina Schuh ◽  
...  

2018 ◽  
Vol 1 (1) ◽  
pp. 32-36
Author(s):  
Eleazar Ndabarora ◽  
Dariya Mukamusoni ◽  
Clarte Ndikumasabo ◽  
Védaste Ngirinshuti

Cervical cancer is one of the leading causes of morbidity and mortality globally and in Sub-Saharan Africa in particular. There is evidence that early detection and early management of cases are the best strategies to prevent and control this health threat, since treatment of the later stages of the diseases are very expensive. The objectives of the review were: (1) to identify and review studies on the prevalence of cervical cancer and determinants of early detection in Sub-Saharan Africa, and (2) to recommend further studies and interventions based on the findings of this review. Extensive literature search was conducted using the MeSH terms. Articles on cervical cancer and/or determinants of early detection which fulfilled inclusion criteria were reviewed independently by three reviewers. The prevalence of cervical cancer in Sub-Saharan Africa is increasing. Although there are evidences that cervical cancer screening programs are practical and feasible even in resource-limited settings in Sub-Saharan Africa, there is a very low uptake of cervical cancer screening and there are key factors that need to be addressed in order to make these programs established and effective.


2017 ◽  
Vol 6 (2) ◽  
pp. 51 ◽  
Author(s):  
Yan Dong ◽  
Jigeng Bai ◽  
Yuping Zhang ◽  
Guangjie Shang ◽  
Yan Zhao ◽  
...  

Purpose: In China the number of pathologists is far from being enough to meet the demands of ongoing population based cervical cancer screening programs. This article aims to present our experience with automated quantitative cytology imaging platform, a reading system with an artificial intelligence that we currently use routinely for cervical cancer screening in Shanxi province.Methods: From 2012-2016 a total of 40 178 women were screened. Women were divided into three groups and each group had two subgroups. Smear and liquid based technique were compared using manual and automated platform.Results: Detection rates of CIN2 + and positive rates of CIN2 were higher in all three groups when automated quantitative cytology platform was used compared with groups where reading was done by the pathologist using conventional microscope. Operator’s costs associated with automated quantitative cytology platform vs. conventional reading using light microscope were compared too. The overall costs of operations based on automated platform were proven to be lower.Conclusion: The use of automated platform and artificial intelligence as a means to overcome the lack of cytotechnologists and pathologists and to implement proper quality control in the large scale population based cervical cancer screening seems very promising.


2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Charlotte A. Brown ◽  
Johnannes Bogers ◽  
Shaira Sahebali ◽  
Christophe E. Depuydt ◽  
Frans De Prins ◽  
...  

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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