Pathways to Early Detection of Cervical Cancer for a Multiethnic, Indigent, Emergency Department Population

1996 ◽  
Vol 23 (1_suppl) ◽  
pp. 89-104 ◽  
Author(s):  
Linda Engelstad ◽  
Katherine Bedeian ◽  
Kimberley Schorr ◽  
Susan Stewart
Keyword(s):  
Cervical Cancer ◽  
Early Detection ◽  
Low Income ◽  
Pap Smear ◽  
Screening Program ◽  
Alternative Pathway ◽  
Cervical Screening ◽  
High Risk Population ◽  
Pap Smears ◽  
Access To Primary Care

When access to primary care is limited, low-income women of all races and ethnicities seek care in public hospital emergency departments (EDs) in which preventive services are often unavailable. This project implemented and evaluated a cervical screening program in an inner-city ED. Clinicians were asked to offer Pap smears to women undergoing diagnostic pelvic examinations. Women with abnormal results were randomized to follow-up in one of two settings. Women with normal results received an intervention promoting annual rescreening. In 12 months, 1,523 Pap smears were performed on 1,442 women; 58% were African American; 21%, Hispanic; and 7%, Asian. Among these women, more than 22 languages were spoken, and 26% did not recall having a prior Pap smear. Preliminary findings suggest that cervical cancer screening can be incorporated into routine ED care, creating an important alternative pathway to early detection for a high-risk population.

“A Pap smear saved my life”: Personal experiences of cervical abnormalities shape attitudes to cervical screening renewal

2019 ◽  
Vol 27 (4) ◽  
pp. 223-226 ◽  
Author(s):  
Helena M Obermair ◽  
Kirsten J McCaffery ◽  
Rachael H Dodd
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Screening Program ◽  
Cervical Screening ◽  
Personal History ◽  
Pap Smears ◽  
Increased Risk ◽  
Women's Lives ◽  
History Of ◽  
Screening Intervals

Objective In 2017, the Australian National Cervical Screening Program changed from two-yearly Pap smears between ages 18 and 69, to five-yearly human papillomavirus screening between ages 25 and 74 (the “Renewal”). This study investigated attitudes towards the changes, among individuals previously affected by cervical abnormalities/cervical cancer, personally or through a friend/relative. Methods We conducted a thematic analysis of comments expressing personal history or a family/friend history of cervical abnormalities/cervical cancer as a reason for opposing changes to the cervical screening program. The comments were taken from a 20% random sample of 19,633 comments posted on the “Change.org” petition “Stop May 1st Changes to Pap Smears – Save Women's Lives” in February–March 2017. Results There were 831 (20.8%) commenters who reported that they were concerned about a change in screening due to: feelings of increased personal vulnerability to cervical cancer due to their own personal history of cervical abnormalities; comparison of extended screening intervals and later age of first screening to their own experiences; and a perception of increased personal risk due to family history. Conclusion Women previously affected by cervical abnormalities or cervical cancer, personally or through a friend/relative, expressed concern about changes to cervical screening due to perceived increased risk and feeling vulnerable due to personal history.

scholarly journals Present potential of exfoliative cytology in detection of cervix cancer

2013 ◽  
Vol 1 (1) ◽  
pp. 17
Author(s):  
Sushila Jain ◽  
Anuj Paudel ◽  
S K Jain
Keyword(s):  
Epithelial Cell ◽  
Pap Smear ◽  
Screening Program ◽  
Cervical Screening ◽  
National Policy ◽  
Cross Sectional Study ◽  
Pap Smears ◽  
Low Grade ◽  
Cross Sectional ◽  
Epithelial Lesions

  Introduction: Conventional Pap smear is the mainstay for cervical cancer screening in developing countries and women should be motivated for cervical screening program to detect early dysplastic cells. This study was carried out to find out the prevalence of abnormalities in Pap smears, particularly pattern of epithelial cell abnormality in women attending Lumbini Medical College in western Nepal.   Methods: A cross-sectional study was carried out and 1066 Pap smears were studied to look for epithelial cell abnormality according to revised Bethesda system 2001.   Results: Out of 1066 patients who underwent Pap smear examination, 71 (6.6%) revealed epithelial cell abnormality; most were low grade squamous intra-epithelial lesions (LSIL) occupying 4.59% at the age between 23 to 29 years. Squamous cell carcinoma was found in 0.37 % of patients at the age 40 years and above. In our scenario, per vaginal discharge was the major finding of the patients who showed premalignant features.   Conclusions: Women above 40 years are at a risk of premalignant as well as malignant lesions and these women should undergo screening for abnormal cells at the age of 18 or when sexual activity starts and as per recommendations to look for early dysplastic cells. Cervical screening program should be motivated by the national policy makers and also by health professionals.

scholarly journals Onkogenesis, Morfologi, dan Modalitas Deteksi Dini Karsinoma Serviks

2021 ◽  
Vol 3 (1) ◽  
pp. 47
Author(s):  
Elsani P. L. Rapar ◽  
Maria K. Sambuaga ◽  
Meilany F. Durry
Keyword(s):  
Cervical Cancer ◽  
High Risk ◽  
Early Detection ◽  
Cervical Carcinoma ◽  
Pap Smear ◽  
Morphological Changes ◽  
Screening Tests ◽  
Pap Smears ◽  
Hpv Dna ◽  
E6 And E7

Abstract: The incidence and mortality rates of cervical cancer in developing countries are relatively high compared to developed countries. The main risk factor for cervical cancer is high risk human papilloma virus (HPV) infection, such as types 16 and 18. Types of high-risk HPV expresses oncoproteins E6 and E7 which play an essential role in the pathogenesis of cervical carcinoma through inhibition of the activity of gene group expression products that play a role in suppressing tumor growth, such as p53 and pRB. This process will cause morphological changes in the squamous epithelium from precancerous lesions to cancer. The development of squamous epithelial cell cancer can be prevented through screening tests in order to detect cervical cancer early. This study was aimed to obtain the oncogenesis, morphology, and early detection modality of cervical carcinoma. This was a literature review study using three databases, as follows: ClinicalKey, PubMed, and Google Scholar. The results explained that p53 and pRB suppression by high-risk HPV oncoproteins E6 and E7 played an important role in the pathogenesis of cervical carcinoma. The most common histological type is squamous cell carcinoma. Screening tests such as visual inspection with acetic acid (VIA), Pap smears and HPV DNA have an important role as modalities for early detection of malignancy. More specifically VIA and Pap smears are suitable for Indonesia which is a developing country, especially when implemented in peripheral areas.Keywords: oncogenesis; morphological changes; early detection; cervical carcinoma  Abstrak: Insidens dan mortalitas kanker serviks di negara berkembang relatif tinggi dibandingkan negara maju. Faktor risiko utama dari kanker serviks adalah infeksi human papilloma virus (HPV) risiko tinggi yaitu tipe 16 dan 18. HPV tipe risiko tinggi mengekspresikan onkoprotein E6 dan E7, yang berperan penting dalam patogenesis karsinoma serviks melalui inhibisi terhadap aktivitas produk-produk ekspresi kelompok gen yang berperan dalam menekan pertumbuhan tumor, seperti p53 dan pRB. Proses ini akan menyebabkan perubahan morfologik pada epitel skuamosa mulai dari lesi prakanker sampai kanker. Perkembangan kanker sel epitel skuamosa dapat dicegah melalui pemeriksaan skrining guna mendeteksi dini kanker serviks. Penelitian ini bertujuan untuk mengetahui onkogenesis, morfologi, dan modalitas deteksi dini karsinoma serviks. Jenis penelitian ialah literature review menggunakan tiga basis data yaitu ClinicalKey, PubMed, dan Google Scholar. Hasil penelitian mendapatkan bahwa penekanan p53 dan pRB oleh onkoprotein HPV risiko tinggi E6 dan E7 sangat berperan penting dalam patogenesis karsinoma serviks. Tipe histologik tersering ialah tipe karsinoma sel skuamosa. Pemeriksaan skrining seperti pemeriksaan inspeksi visual dengan asam asetat (IVA), Pap smear dan HPV DNA memiliki peran penting sebagai modalitas deteksi dini keganasan. Lebih khusus IVA dan Pap smear cocok untuk negara Indonesia yang merupakan negara berkembang, terutama bila diimplementasikan di daerah perifer.Kata kunci: onkogenesis; perubahan morfologik; deteksi dini; karsinoma serviks

Early diagnosis program for cervical cancer in Tanzania: The “Vanda Project”.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5594-5594
Author(s):  
Patrizia Serra ◽  
Dino Amadori ◽  
Oriana Nanni ◽  
Alessandra Gennari ◽  
Sara Bravaccini ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Early Diagnosis ◽  
Pap Smear ◽  
Screening Program ◽  
Precancerous Lesions ◽  
Age Distribution ◽  
Sub Saharan Africa ◽  
High Risk Population ◽  
Lake Area ◽  
Breast Examination

5594 Background: In Sub-Saharan Africa cervical cancer represents 24% of all cancers and accounts for 23% of all cancer deaths in women. An early diagnosis program for breast and cervical cancer (Vanda Project) is ongoing in Mwanza and the surrounding lake area (12 districts with a population of 14,000,000). The aim of this project was to screen women aged 15-64 years living in the 12 districts. Methods: Women were invited to participate through local media and a mobile unit operating within the districts. A multidisciplinary team including medical oncologists was involved. Interventions consisted in Pap smear, clinical breast examination, breast self-examination training and training of district physicians to perform Pap smear and breast examination. Results: From May to December 2012, 2155 women from the districts of Shinyanga, Bukumbi, Kibara, Serengema and Musoma took part in the program: of these 91 (4%) had clinically evident cervical cancer. Age distribution classes were: < 18 years, 12% ; 18-35, 38%; 36-50, 41%; > 50, 9%. As expected a high stage distribution at diagnosis was observed: 30% stage III and 20% stage IV. Among the women with no clinical evidence of cancer, 408 samples were analyzed by cytology and 4% consisted of inadequate material. Of the remaining 392 samples, 85 (22%) were normal, 216 (55%) were infections (chiefly mycotic), 72 (18%) were precancerous lesions (50% H-SIL according to Bethesda classification) and 19 (5%) were positive for cancer (mainly stages III-IV). Precancerous lesions turned out to be cancer at histology in 44% of cases. 22% of precancerous lesions and 8% of clinically evident cancer were HIV-positive. Conclusions: This experience shows the high feasibility, good compliance and usefulness of a screening program for the early detection of cervical cancer in this high-risk population. [Table: see text]

Prevalence and Predictors of Cervical Cytological (Pap Smear) Abnormalities Among HIV-infected Women at the HIV Treatment Center of Jos University Teaching Hospital Jos, Nigeria.

2020 ◽  
Author(s):  
Olugbenga Akindele Silas ◽  
Philip O. Akpa ◽  
Tolulope O. Afolaranmi ◽  
Samuel Robsam Ohayi ◽  
Jonah Musa ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Teaching Hospital ◽  
Pap Smear ◽  
Screening Program ◽  
Cervical Screening ◽  
University Teaching ◽  
Treatment Center ◽  
Adult Women ◽  
Pap Smear Screening ◽  
Women With Hiv

Abstract Introduction: Cervical cancer is the most common cancer among women living with HIV with the highest burden in sub-Sahara African countries with the highest prevalence of HIV. Early detection of precursor cervical lesions through routine Pap smear screening is central to cervical cancer prevention. This study was aimed at determining the prevalence and predictors of abnormal Pap smear findings among women with HIV in our cervical cancer screening program. Methodology: We carried out a cross sectional study of adult women with HIV who presented for Pap smear test for the first time at the Jos University Teaching Hospital, Jos, North Central Nigeria between November2018 and January 2020. Prevalence of abnormal cervical finding was reported in percentage and also expressed per 100 population of women. The effects of the characteristics of the women of the abnormal pap smear finding was determined using the logistic regression model where 95% confidence interval and adjusted odds were used as point and interval estimates respectively while a probability value of < 0.05 was considered statistically significant. Results: A total of 949 women with HIV participated in the cervical screening program with mean age 43.3 ± 8.1 years. Abnormal smear findings were observed among 183 (19.3%: 19 cases per 100 women) with ASCUS, ASC-H, LSIL, HSIL, HSIL with suspicion of invasion and AGUS accounting for 96 (10.1%), 50(5.3%), 27 (2.9%), 6 (0.6%), 2 (0.2%) and 2(0.2%) respectively. Of the abnormal smear findings, 125 (68.3%) were adjudged to have mild cytological feature while the complementing proportion adjudged to have severe cytological features. Unadjusted odds of abnormal Pap smear result was associated with increasing age, OR 1.15(95% CI 1.127, 1.186; p = 0.001); parity, OR1.08 (95% CI 1.019, 1.141; p = 0.009). In the adjusted model, increasing age remained the only factor predicting abnormal Pap smear finding. Conclusion: Prevalence of abnormal Pap smear results remains high in HIV- infected women and is associated with increasing age. Advocacy to institutionalize screening at earlier age is therefore key to improving dismal outcomes.

scholarly journals Enhanced Detection of Cervical Cancer and Precancer Through Use of Imaged Liquid-Based Cytology in Routine Cytology and HPV Cotesting

2018 ◽  
Vol 150 (5) ◽  
pp. 385-392 ◽  
Author(s):  
R Marshall Austin ◽  
Agnieszka Onisko ◽  
Chengquan Zhao
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Cervical Screening ◽  
Intraepithelial Neoplasia ◽  
Pap Smears ◽  
Adenocarcinoma In Situ ◽  
Hpv Testing ◽  
Liquid Based Cytology ◽  
Positive Results

AbstractObjectivesCervical screening strives to prevent cervical cancer (CxCa), minimizing morbidity and mortality. Most large US reports on cytology and human papillomavirus (HPV) cotesting of women aged 30 years and older are from one laboratory, which used conventional Papanicolaou (Pap) smears from 2003 to 2009.MethodsWe quantified detection of CxCa and precancer (cervical intraepithelial neoplasia 3/adenocarcinoma in situ [CIN3/AIS]) in 300,800 cotests at Magee Womens Hospital since 2005. Screening histories preceding CxCa and CIN3/AIS diagnoses were examined to assess the contribution of cytology and HPV testing. Cotesting utilized Food and Drug Administration-approved imaged liquid-based cytology (LBC) and from-the-vial HPV tests.ResultsLBC identified more women subsequently diagnosed with CxCa and CIN3/AIS than HPV testing. HPV-negative/cytology-positive results preceded 13.1% of CxCa and 7.2% of CIN3/AIS diagnoses.ConclusionsLBC enhanced cotesting detection of CxCa and CIN3/AIS to a greater extent than previously reported with conventional Pap smear and HPV cotesting.

scholarly journals Opportunistic cervical cancer screening by papanicolaou stain Pap smear among women: a pilot study at urban health training centre of All India Institute of Medical Sciences, Patna, Bihar, India

2020 ◽  
Vol 9 (7) ◽  
pp. 2714
Author(s):  
Ruchi Sinha ◽  
Pragya Kumar ◽  
Geetika Singh ◽  
Rubina Saha
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Pap Smear ◽  
Screening Program ◽  
Cervical Screening ◽  
Locally Advanced ◽  
Sampling Technique ◽  
Training Centre ◽  
Tertiary Center ◽  
Associated Risk Factors

Background: Cancer of the uterine cervix is the second most common cancer among women world-wide and accounts for 17% of all cancer deaths among females aged 30-69 years in India. Locally advanced cervical cancer is rampant in Bihar because of the high prevalence of associated risk factors. However, there is lack of organized screening programmes and treatment facilities for these patients. Thus, the study aimed at screening women for cervical cancer opportunistically during their visit to the health centres and to assess the various socio-demographic and other risk factors associated with positive screening test results.Methods: Using purposive sampling technique, all women aged 18-59 years who visited the centre for any purpose were interviewed using a pre-designed questionnaire. All eligible women were screened using the conventional Pap Smear and evaluation was done using the 2014 Bethesda system. This study is still underway and 71 women have been screened so far. An interim analysis was done.Results: Only 4.23% of the women ever had Pap smear testing in their life earlier. Mean age was 35.3±9.12 years and majority of the women were married and multi-parous. Vaginal discharge (55.74%) was the most common perceived gynecological morbidity. Most (36.62%) smears were reported as inflammatory cervical smears while epithelial cell abnormalities were seen in 4 (5.63%) cases.Conclusions: This study reiterates the need to start organized cervical screening program not only at tertiary center but also at primary health centers which will definitely help to reduce the burden to some extent

scholarly journals Nurses’ Attitude About Pap Smear As An Early Screening Method For Cervical Cancer In The Private Hospital

2020 ◽  
Vol 16 (2) ◽  
pp. 90
Author(s):  
Belet Lydia Ingrit ◽  
Martina Elfrida Sinaga ◽  
Puji Astutik ◽  
Fransiska Ompusunggu
Keyword(s):  
Cervical Cancer ◽  
Early Detection ◽  
Positive Attitude ◽  
Pap Smear ◽  
Screening Method ◽  
Negative Attitude ◽  
Sampling Technique ◽  
Pap Smears ◽  
Early Screening ◽  
Nurses Attitude

The prevalence of cervical cancer in Indonesia is very high, which it is estimated that every day 40-45 new cases appear. The purpose of this study was to describe nurses’ attitude about pap smear as an early detection of cervical cancer in a hospital in western Indonesia. The research method was used descriptive quantitative with purposive sampling technique. The results of this study shows that most of the respondents have the positive attitude in performing pap smears in the Western Indonesia hospitals with the percentage of 97,5% and the rest indicate negative attitude. The conclusion of this study is that the positive attitude of nurses towards early detection of pap smears is expected to be maintained and furthermore the hospital continues to provide health facilities for female nurses to carry out early detection of cervical cancer as an annual program from hospital.

scholarly journals Correlation of cervical pap smears with histopathological diagnosis in cervical lesions

2021 ◽  
Vol 10 (12) ◽  
pp. 4478
Author(s):  
Ruksana Farooq ◽  
Azhar-un-Nisa Quraishi ◽  
Shahida Mohammad
Keyword(s):  
Cervical Cancer ◽  
Predictive Value ◽  
Pap Smear ◽  
Screening Program ◽  
Tertiary Care ◽  
Histopathological Diagnosis ◽  
Pap Smears ◽  
Care Hospital ◽  
Incidence And Mortality ◽  
Chronic Cervicitis

Background: Cervical cancer is the most common genital cancer in India. In India alone,almost,130000 new cases occur with the death toll of 70000 everywhere. Objective of current study was correlation of pap smear with histopathological diagnosis.Methods: A retrospective study was conducted in tertiary care hospital in 130 sexually active women. Pap smears were taken and histopathological diagnosis was performed in all such patientsResults: From pap smear findings, out of 130 patients, maximum number of cases, 74 (56.9%) were categorized as. Out of epithelial cell abnormality, ASCUS was seen in 25 patients (10.2%), LSIL in 17 patients (13.1%), HSIL in 11 patients (8.5%). SCC was seen in 2 patients (1.5%) and adenocarcinoma in 1 patient (0.8%). From cervical biopsy reports, 51 cases(39.2%) were diagnosed as chronic cervicitis, 34 cases (26.2%) were diagnosed as chronic cervicitis with squamous metaplasia, CIN I in 31 patients (23.8%), CIN II in 8 patients (6.2%) and CIN III in 3 patients (2.3%), squamous cell carcinoma in 2 patients (1.5%) and adenocarcinoma in 1 patient (0.8%). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pap smear test was 91.1%, 82.4%,73.2%, 94.6% and 85.4%, respectively.Conclusions: Pap smear has excellent correlation with histopathological diagnosis. Therefore it should be encouraged as effective tool for cervical cancer screening program to reduce incidence and mortality caused by cervical cancer. 

scholarly journals KARAKTERISTIK WANITA USIA SUBUR DENGAN TINDAKAN PENCEGAHAN KANKER SERVIKS

2020 ◽  
Vol 3 (2) ◽  
pp. 100
Author(s):  
Supatmi Supatmi
Keyword(s):  
Cervical Cancer ◽  
Early Detection ◽  
Cancer Prevention ◽  
Pap Smear ◽  
Cervical Cancer Prevention ◽  
Pap Smears ◽  
Prevention Measures ◽  
Childbearing Age ◽  
Cross Sectional ◽  
Significance Level

AbstractBackground:  The awareness of Indonesian women to carry out early detection of cervical cancer on a regular basis have been still low. Cervical cancer can be prevented and cured by taking early detection measures because it has a long preinfassive phase. Cervical cancer prevention measures are influenced by several factors including age, education level, occupation and parity, Aims:   analyze the characteristics of women of childbearing age with cervical cancer prevention measures (HPV, IVA and Pap smear immunization) Methods: Quantitative analytic research design with cross sectional approach. The population was 193 women of fertile age in RW 9 Kelurahan Kapasan Surabaya with n Cluster Samples, the sample was 130 WUS. The research instrument used a characteristic questionnaire and cervical cancer prevention measures with a Dichotomy Question. The research variables were WUS cataristic and cervical cancer prevention behavior. Analysis with Chi-Square with a significance level of 0.05Results:  There was a relationship between age and HPV immunization (p = 0.066) and pap smear (p = 0.058), IVA action had not relationship (p = 0.770), education was related to HPV immunization (p = 0.346). IVA (0.005) was not related to pap smears = 0.603) Occupation was related to HPV immunization (p = 0.280), IVA (p = 0.000) and pap smears (p = 0.216), parity was related to HPV immunization (p = 0.003) ) and Pap smear (p = 0.117) meanwhile parity had not relationship with IVA (p = 0.839). Studying the characteristics of WUS is a first step to increase preventive efforts for cervical cancer both primary and secondary prevention   Keyword:  Characteristics of WUS, Prevention, Cervical Cancer

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