scholarly journals Protocol for the study of cervical cancer screening technologies in HIV-infected women living in Rwanda

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e020432 ◽  
Author(s):  
Gad Murenzi ◽  
Jean-Claude Dusingize ◽  
Theogene Rurangwa ◽  
Jean d’Amour Sinayobye ◽  
Athanase Munyaneza ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Sub Saharan Africa ◽  
Immunocytochemical Staining ◽  
Advisory Panel ◽  
Convenience Sample ◽  
Predictive Values ◽  
Screening Strategies ◽  
Study Results

IntroductionThe optimal method(s) for screening HIV-infected women, especially for those living in sub-Saharan Africa, for cervical precancer and early cancer has yet to be established.Methods and analysisA convenience sample of >5000 Rwandan women, ages 30–54 years and living with HIV infection, is being consented and enroled into a cross-sectional study of cervical cancer screening strategies. Participants are completing an administered short risk factor questionnaire and being screened for high-risk human papillomavirus (hrHPV) using the Xpert HPV assay (Cepheid, Sunnyvale, California, USA), unaided visual inspection after acetic acid (VIA) and aided VIA using the Enhanced Visual Assessment (EVA) system (Mobile ODT, Tel Aviv, Israel). Women positive for hrHPV and/or by unaided VIA undergo colposcopy, which includes the collection of two cervical specimens prior to undergoing a four-quadrant microbiopsy protocol. The colposcopy-collected specimens are being tested by dual immunocytochemical staining for p16INK4aand Ki-67 (CINtec PLUS Cytology, Ventana, Tucson, Arizona, USA) and for E6 or E7 oncoprotein for 8 hrHPV genotypes (HPV16, 18, 31, 33, 35, 45, 52 and 58) using the next-generation AV Avantage hrHPV E6/E7 test (Arbor Vita Corporation, Freemont, California, USA). Women with a local pathology diagnosis of cervical intraepithelial neoplasia grade 2 (CIN2) or more severe (CIN2+) or pathology review diagnosis of CIN grade three or more severe (CIN3+) will receive treatment. Clinical performance and cost-effectiveness (eg, sensitivity, specificity and predictive values) of different screening strategies and algorithms will be evaluated.Ethics and disseminationThe protocol was approved by local and institutional review boards for human subjects research. At the completion of the study, results will be disseminated to the scientific community through peer-reviewed publication and to the Rwandan stakeholders through an external advisory panel.

Systematic review of cervical cancer prevalence and determinants of early detection in Sub-Saharan Africa

2018 ◽  
Vol 1 (1) ◽  
pp. 32-36
Author(s):  
Eleazar Ndabarora ◽  
Dariya Mukamusoni ◽  
Clarte Ndikumasabo ◽  
Védaste Ngirinshuti
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Cervical Cancer Screening ◽  
Sub Saharan Africa ◽  
Extensive Literature ◽  
Early Management ◽  
Screening Programs ◽  
Mesh Terms ◽  
Sub Saharan

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.

Knowledge and Practice of Cervical Cancer Screening among Women in Orlu Local Government Area, Imo State, Nigeria.

2019 ◽  
Vol 1 (1) ◽  
pp. 55-65
Author(s):  
Jude Egwurugwu ◽  
S.D. Ejikunle ◽  
E.I. Dike ◽  
M.C. Ohamaeme ◽  
Jude Egwurugwu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Local Government ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
Local Government Area ◽  
Care Providers ◽  
Imo State ◽  
Study Results ◽  
Knowledge And Practice

Background: Cervical cancer is the 2nd commonest cancer among women worldwide and the most common cancer among women in developing countries like Nigeria. Though preventable by screening for premalignant and early cervical lesions, this is predicated on the knowledge and practice of a cervical screening. Objective: To assess the knowledge and practice of cervical cancer screening among women in Orlu, Local Government Area(LGA) Imo State, Nigeria. Materials & Methods: A community based cross-sectional study with the use of 502 interviewer – administered questionnaires was conducted among women in Orlu LGA of Imo State. All the women in the communities attending the annual August Meeting who consented were recruited for this study. Results: The study showed that the mean age of the respondents was 42±2.8years. Furthermore, 82.3% of respondents attained postsecondary school educational level, 61.8% & 21.1% were multiparous and grand multiparous respectively. Also, 80.5% of respondents have heard about cervical cancer screening. Majority (67.5%) of these respondents heard it from health care providers. There was a positive statistically significant relationship between educational status and the likelihood of having knowledge of cervical cancer screening, (p< 0.01). The level of practice of cervical cancer screening was very low among the respondents(13.5%).Though majority of the respondents have high level of educational attainment this did not reflect their practice of cervical cancer screening. Conclusion: There was high knowledge of cervical cancer and cervical screening modalities among women in Orlu but their practice of cervical cancer screening was very low. There is an urgent need to educate and encourage women on the benefits of cervical cancer screening. Key words: cervical cancer, knowledge, Practice, Orlu women, Screening.

scholarly journals Performance of HPV16/18 in Triage of Cytological Atypical Squamous Cells of Undetermined Significance

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Xiaoqin Cao ◽  
Shuzheng Liu ◽  
Manman Jia ◽  
Hongmin Chen ◽  
Dongmei Zhao ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Predictive Value ◽  
Statistical Tests ◽  
Predictive Values ◽  
Squamous Cells ◽  
Link Type ◽  
Hpv Test ◽  
Undetermined Significance

Context. Human papillomavirus (HPV) testing is widely used in cervical cancer screening in women; however, its efficiency in triaging women with atypical squamous cells of undetermined significance (ASC-US) needs to be validated. Objective. To evaluate the performance of HPV16/18 in the triage of women with ASC-US. Methods. Women presenting for routine cervical cancer screening had cervical specimens collected, with which both liquid-based cytology (LBC) and hrHPVs were examined; those with ASC-US cytology underwent colposcopy. HPV16/18 and 12 other types were tested with domestic hybridization capture and chemiluminescence signal amplification (DH3). Performance characteristics of HPV test (sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) for identification of cervical intraepithelium neoplasma (CIN) grade 2 or worse (CIN2+), and CIN grade 3 or worse (CIN3+)) were determined using standard statistical tests. Results. 317 women with ASC-US were eligible for the study. HrHPV prevalence was 15.77% (50/317); HPV16/18 prevalence was 3.61% (20/317). Sensitivity and specificity of HPV16/18 for detection of CIN 2+ were 64.71% and 97% and 64.29% and 96.37% for detection of CIN 3+, respectively. The positive predictive values (PPVs) and negative predictive values (NPVs) of HPV16/18 were 55.00% and 97.98% for CIN2+ and 45.00% and 98.32% for CIN3+, respectively. Conclusion. HPV16/18 can be considered as an effective method to triage women with ASC-US as its good clinical performance. Trial Registration. This trial is registered with Henan Cancer Hospital Medical Ethics Committee on July 5, 2016 (http://www.anti-cancer.com.cn), with registry no.: 2016037.

scholarly journals Cervical cancer screening uptake in Sub-Saharan Africa: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Nigus Bililign Yimer ◽  
Mohammed Akibu Mohammed ◽  
Kalkidan Solomon ◽  
Mesfin Tadese ◽  
Stephanie Grutzmacher ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Meta Analysis ◽  
Cervical Screening ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Screening Uptake ◽  
Analytic Review ◽  
Sub Saharan

AbstractBackgroundCervical cancer screening and prevention programs have been given considerable attention in high-income countries, while only receiving minimal effort in many African countries. This meta-analytic review aimed to estimate the pooled uptake of cervical cancer screening uptake and identify its predictors in Sub-Saharan Africa.MethodsPubMed, EMBASE, CINAHL, African Journals Online, Web of Science and SCOPUS electronic databases were searched. All observational studies conducted in Sub-Saharan Africa and published in English language from January 2000 to 2019 were included. The Newcastle-Ottawa Scale was applied to examine methodological quality of the studies. Inverse variance-weighted random-effects model meta-analysis was done to estimate the pooled uptake and odds ratio of predictors with 95% confidence interval. I2 test statistic was used to check between-study heterogeneity, and funnel plot and Egger’s regression statistical test were used to check publication bias. To examine the source of heterogeneity, subgroup analysis based on sample size, publication year and geographic distribution of the studies was carried out.ResultsOf 3,537 studies identified, 29 studies were included with 36,374 women. The uptake of cervical cancer screening in Sub-Saharan Africa was 12.87% (95% CI: 10.20, 15.54; I2= 98.5%). Meta-analysis of seven studies showed that knowledge about cervical cancer increased screening uptake by nearly 5-folds (OR: 4.81; 95% CI: 3.06, 7.54). Other predictors include educational status, age, HIV status, contraceptive use, perceived susceptibility, and awareness about screening locations.ConclusionCervical screening uptake is low in Sub-Saharan Africa and influenced by several factors. Health outreach and promotion targeting identified predictors are needed to increase uptake of screening service in the region.sProtocol registrationCRD42017079375

scholarly journals Knowledge, utilization and barriers of cervical cancer screening among women attending selected district hospitals in Kigali - Rwanda

2021 ◽  
Vol 31 (3) ◽  
pp. 266-274
Author(s):  
Gaudence Niyonsenga ◽  
Darius Gishoma ◽  
Ruth Sego ◽  
Marie Goretti Uwayezu ◽  
Bellancille Nikuze ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Knowledge Utilization ◽  
Sub Saharan Africa ◽  
Eastern Africa ◽  
Screening Rate ◽  
Effective Prevention ◽  
District Hospitals ◽  
Screening Services

Background: Cervical cancer is the third most common cancer attacking women globally, and the second in Eastern Africa where Rwanda is located. Regular screening is an effective prevention approach for cervical cancer. Despite that, the screening rate for cervical cancer in Africa is estimated between 10% and 70%, with a number of barriers. This is especially the case in sub-Saharan Africa. In Rwanda, there is limited literature on the rate of use of screening services or the barriers to cervical screening. Objective: To assess knowledge, utilization, and barriers of cervical cancer screening among women attending selected district hospitals in Kigali, Rwanda. Methods: A descriptive cross-sectional study with a structured questionnaire was used to collect data. Nominal ‘yes’ or ‘no’ questions were used to gather data on knowledge and utilisation of cervical cancer and its screening. Likert-type scale questions were used to identify different barriers to screening services. Data were analysed using descriptive and inferential statistics. Respondents were selected by systematic random sampling from the database of women attending gynaecology services at three district hospitals in Kigali, Rwanda. Results: Three hundred and twenty-nine women responded to the survey. Half of the respondents (n = 165) had high knowledge level scores on cervical cancer screening. The cervical cancer screening rate was 28.3%. Utilization of screening was associated with knowledge (P = 0.000, r = -0.392) and selected demographic factors (P = 0.000). Individual barriers included poor knowledge on availability of screening services, community barriers included living in a rural area, and health provider and systems barriers included lack of awareness campaigns, negative attitudes of healthcare providers toward clients, and long waiting times; all barriers limit the access to screening services. Conclusion: A low rate of cervical cancer screening was identified for women attending selected district hospitals in Kigali-Rwanda due to various barriers. On-going education on cervical cancer and its screening is highly recommended. It is important that trained health providers encourage their clients to have cervical cancer screening and work to reduce related barriers.

scholarly journals P824 Accuracy of cervical cancer screening using a self-collected vial for HPV DNA testing among adult women in sub-saharan africa

2019 ◽  
Author(s):  
Zita Aleyo Nodjikouambaye ◽  
Damtheou Sadjoli ◽  
Ralph Sydney Mboumba Bouassa ◽  
Hélène Péré ◽  
David Veyer ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Sub Saharan Africa ◽  
Adult Women ◽  
Dna Testing ◽  
Hpv Dna ◽  
Hpv Dna Testing ◽  
Sub Saharan

Identification of ideal strategy of cervical cancer screening in Japan based on Fukui cervical cancer screening study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17025-e17025
Author(s):  
Tetsuji Kurokawa ◽  
Akiko Shinagawa ◽  
Yoko Chino ◽  
Motohiro Kobayashi ◽  
Yoshio Yoshida
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Positive Predictive Value ◽  
Cervical Cancer Screening ◽  
Predictive Value ◽  
Screening Method ◽  
Hpv Testing ◽  
Abnormal Cytology ◽  
Predictive Values ◽  
Hpv Status

e17025 Background:The estimated age-standardized incidence rate for cervical cancer is higher in Japan than in North America and the UK. It is important to improve cancer screening. The introduction of HPV testing with cytology for triage of those that test positive for cervical cancer screening has been challenging. The Fukui Cervical Cancer Screening (FCCS) study was designed to determine the best cervical cancer screening method in the Japanese population. We performed a subanalysis using baseline data of FCCS study to determine the performance of cytology, the human papillomavirus (HPV) testing and cotesting with cytology and HPV testing, and to evaluate whether the stratification of HPV16, HPV18, and 12 other hrHPV types appropriately balances risks and harms in the Japanese cancer screening population. Methods:The study enrolled 7,584 women aged 25 years or older undergoing routine screening. All women underwent liquid-based cytology (LBC) and cobas HPV testing. Women with abnormal cytology regardless of the HPV status, women with positive hrHPV results regardless of cytology results, and women randomly selected from among those with normal cytology and negative hrHPV results were referred for colposcopy. Results:The prevalence of hrHPV, HPV16, and HPV18 was 6.8%, 1.2%, and 0.5%, respectively. The estimated sensitivities for cervical intraepithelial neoplasia (CIN) 2 or worse for cytology, HPV testing, and cotesting with cytology and HPV testing were 71%, 92%, and 100%, respectively. The estimated positive predictive values for cytology, HPV testing, and cotesting with cytology and HPV testing were 33%, 21% and 21%, respectively. Using a strategy whereby those with abnormal cytology or positive HPV16 genotype undergo colposcopy and biopsy results in a sensitivity of 85% and a positive predictive value of 33%. This strategy results in improved sensitivity while at the same time maintains the positive predictive value compared to screening with cytology alone. Conclusions:Baseline data from the FCCS study suggests that strategy of using colposcopy for women with abnormal cytology and/or HPV16 positivity appropriately balances risks and harms for Japanese women. Clinical trial information: UMIN000025977.

Cervical cancer screening in sub-Saharan Africa: A randomized trial of VIA versus cytology for triage of HPV-positive women

2014 ◽  
Vol 137 (1) ◽  
pp. 127-134 ◽  
Author(s):  
Jérôme Bigoni ◽  
Mélissa Gundar ◽  
Pierre-Marie Tebeu ◽  
Adamo Bongoe ◽  
Sonja Schäfer ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Randomized Trial ◽  
Cervical Cancer Screening ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Costs and cost-effectiveness of cervical cancer screening strategies in women living with HIV in Burkina Faso: The HPV in Africa Research Partnership (HARP) study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248832
Author(s):  
Angela Devine ◽  
Alice Vahanian ◽  
Bernard Sawadogo ◽  
Souleymane Zan ◽  
Fadima Yaya Bocoum ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Burkina Faso ◽  
Cervical Cancer Screening ◽  
Visual Inspection ◽  
Screening Tests ◽  
Research Partnership ◽  
Women Living With Hiv ◽  
Screening Strategies ◽  
Living With Hiv

Introduction This study estimated the costs and incremental cost per case detected of screening strategies for high-grade cervical intraepithelial neoplasia (CIN2+) in women living with HIV (WLHIV) attending HIV clinics in Burkina Faso. Methods The direct healthcare provider costs of screening tests (visual inspection with acetic acid (VIA), VIA combined visual inspection with Lugol’s iodine (VIA/VILI), cytology and a rapid HPV DNA test (careHPV)) and confirmatory tests (colposcopy, directed biopsy and systematic four-quadrant (4Q) biopsy) were collected alongside the HPV in Africa Research Partnership (HARP) study. A model was developed for a hypothetical cohort of 1000 WLHIV using data on CIN2+ prevalence and the sensitivity of the screening tests. Costs are reported in USD (2019). Results The study enrolled 554 WLHIV with median age 36 years (inter-quartile range, 31–41) and CIN2+ prevalence of 5.8%. The average cost per screening test ranged from US$3.2 for VIA to US$24.8 for cytology. Compared to VIA alone, the incremental cost per CIN2+ case detected was US$48 for VIA/VILI and US$814 for careHPV. Despite higher costs, careHPV was more sensitive for CIN2+ cases detected compared to VIA/VILI (97% and 56%, respectively). The cost of colposcopy was US$6.6 per person while directed biopsy was US$33.0 and 4Q biopsy was US$48.0. Conclusion Depending on the willingness to pay for the detection of a case of cervical cancer, decision makers in Burkina Faso can consider a variety of cervical cancer screening strategies for WLHIV. While careHPV is more costly, it has the potential to be cost-effective depending on the willingness to pay threshold. Future research should explore the lifetime costs and benefits of cervical cancer screening to enable comparisons with interventions for other diseases.

scholarly journals Psycho-Social Factors Influencing Cervical Cancer Screening and Human Papilloma Virus Vaccination Acceptance Among Female Civil Servants in Delta State, Nigeria

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 21s-21s ◽  
Author(s):  
B. Ohaeri ◽  
P. Ebunu ◽  
C. Ndikom
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Human Papilloma Virus ◽  
Cervical Cancer Screening ◽  
Social Factors ◽  
Hpv Vaccination ◽  
Civil Servants ◽  
Sub Saharan Africa ◽  
Screening Tests ◽  
Papilloma Virus

Background: Cervical cancer is the fourth most common cancer affecting women worldwide and most notable in low and middle income countries of sub-Saharan Africa. There are 528000 new cases estimated globally every year. The crude incidence rate of cervical cancer is 5.8% worldwide, 19% in West Africa, and 19.3% in Nigeria. In Nigeria, uptake of cervical cancer screening and HPV vaccination has been demonstrated in different studies to be very low, out of thirteen studies, nine show cervical cancer screening uptake of less than 5.3%. Psycho-social factors such as anxiety, stigmatization, poor health seeking behaviors and lack of family and social support among others, have been implicated. Therefore, this study assessed the psycho-social barriers to utilization of cervical cancer screening services and uptake of vaccination among female civil servants in Delta state. Aim: To assess the psycho-social factors that impede the utilization of cervical cancer screening and HPV vaccination among female civil servants in Delta state. Methods: A descriptive, cross-sectional, nonexperimental design was used for this study. Multi-stage sampling technique was used in selecting 437 women who consented, based on a calculated sample size. Thereafter, 437 self-administered structured questionnaires with a reliability coefficient of 0.7, were administered to participants, out of which 435 were retrieved. This gave a response rate of 99.5%. Data collected were analyzed with the aid of Statistical Package for Social Sciences (SPSS) using descriptive statistics and χ2. Results: Many participants (55.4%) knew about cervical cancer; 93.6% had never been screened for cervical cancer, while 94.7% had not vaccinated their teenage girls against human papilloma virus. Among the psycho-social factors highlighted that impeded the utilization of services were, costs of the screening tests (54.5%) and HPV vaccine (51.3%), while 58.2% reported inaccessibility. However, majority (73.6%) were willing to go for the cervical cancer screening and vaccination of their teenagers (68%). Conclusion: Cervical cancer screening and subsequent vaccination are strategies focused at ensuring reduction in the incidence of cervical cancer in the society to the barest minimum. Creating awareness about cervical cancer could be a means to help tackle the lack of knowledge issue, thereby increasing knowledge. In addition, subsidization will go a long way in lessening the financial burden, as well as increase utilization. Subsequently, global burden of cervical cancer will be reduced, with a consequent reduction in mortality.

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