scholarly journals Negative histology in cervical specimens obtained with the "see and treat" method among women at a referral center in Rio de Janeiro, Brazil: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Renata Pereira Teodoro ◽  
Danielle Scherer ◽  
Maria José de Camargo ◽  
Ana Carolina Carioca da Costa ◽  
Cecília Vianna de Andrade ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cross Sectional Study ◽  
Cervical Cancer Prevention ◽  
Low Grade ◽  
Sectional Study ◽  
Extensive Experience ◽  
Cross Sectional ◽  
Referral Center ◽  
Significant Downward Trend ◽  
Intraepithelial Lesion

Abstract Background According to the Brazilian Guidelines on Cervical Cancer Screening, women with cytopathologic diagnosis of high-grade intraepithelial lesion, abnormal colposcopic findings, fully visible squamocolumnar junction and age 25 years or older should be treated at the first visit (“see and treat—S&T”). The main limitation to this approach is the risk of overtreatment, identified by histology without preinvasive lesion. The objectives of this study were to identify the overtreatment rate in women undergoing S&T in cervical cancer prevention at a referral center with extensive experience with the method and to detect possible factors associated with this rate. Methods This was a cross-sectional study that analyzed records from a database with 616 women submitted to S&T from 1996 to 2017. Negative histology was defined as the following histopathologic results: human papillomavirus without cervical intraepithelial neoplasia (CIN), inflammatory, low-grade squamous intraepithelial lesion, and CIN 1. Results Of the 616 women, there were 52 (8.44%, 95%CI 6.25–10.64%) with a histopathologic report without preinvasive cervical lesion. No statistical association was found between this outcome and age or a significant downward trend over time. Conclusion The overtreatment rate in this study can be considered low and consistent with the acceptable rates reported in the literature, reinforcing the prevailing Brazilian guideline, in which the benefits of immediate treatment outweigh the risk of losses following biopsy.

scholarly journals Negative histology in cervical specimens obtained with the “see and treat” method in women at a referral center in Rio de Janeiro, Brazil – a cross-sectional study

2020 ◽  
Author(s):  
Renata Pereira Teodoro ◽  
Danielle Scherrer ◽  
Maria José de Camargo ◽  
Ana Costa ◽  
Cecília Vianna de Andrade ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cross Sectional Study ◽  
Cervical Cancer Prevention ◽  
Low Grade ◽  
Sectional Study ◽  
Extensive Experience ◽  
Cross Sectional ◽  
Referral Center ◽  
Significant Downward Trend ◽  
Intraepithelial Lesion

Abstract Background: According to the Brazilian Guidelines on Cervical Cancer Screening, women with cytopathologic diagnosis of high-grade intraepithelial lesion, abnormal colposcopic findings, fully visible squamocolumnar junction, and age 25 years or older should be treated at the first visit (“see and treat – S&T”). The main limitation to this approach is the risk of overtreatment, identified by histology without preinvasive lesion. The objectives of this study were to identify the overtreatment rate in women undergoing S&T in cervical cancer prevention at a referral center with extensive experience with the method and to detect possible factors associated with this rate.. Methods: This was a cross-sectional study that analyzed records from a database with 616 women submitted to S&T from 1996 to 2017. Negative histology was defined as the following histopathologic results: human papillomavirus (HPV) without Cervical Intraepithelial Neoplasia (CIN), inflammatory, low-grade squamous intraepithelial lesion (LSIL), and CIN 1. Results: Of the 616 women, there were 52 (8.44% - 95%CI 6.25 – 10.64%) with a histopathologic report without preinvasive cervical lesion. No statistical association was found between this outcome and age or a significant downward trend over time.Conclusion: The overtreatment rate in this study can be considered low and consistent with the acceptable rates reported in the literature, reinforcing the prevailing Brazilian guideline, in which the benefits of immediate treatment outweigh the risk of losses following biopsy.

scholarly journals Negative Histology in Cervical Specimens Obtained With the “see and Treat” Method in Women at a Referral Center in Rio De Janeiro, Brazil – A Cross-sectional Study

2020 ◽  
Author(s):  
Renata Pereira Teodoro ◽  
Danielle Scherrer ◽  
Maria José de Camargo ◽  
Ana Costa ◽  
Cecília Vianna de Andrade ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Low Grade ◽  
Statistical Association ◽  
Sectional Study ◽  
Squamous Intraepithelial Lesion ◽  
Cross Sectional ◽  
Significant Downward Trend ◽  
Intraepithelial Lesion ◽  
Preinvasive Lesion ◽  
Over Time

Abstract Background According to the Brazilian Guidelines on Cervical Cancer Screening, women with cytopathologic diagnosis of high-grade intraepithelial lesion, abnormal colposcopic findings, fully visible squamocolumnar junction, and age 25 years or older should be treated at the first visit (“see and treat – S&T”). The main limitation to this approach is the risk of overtreatment, identified by histology without preinvasive lesion. This study aimed to measure the negative histology rate in women submitted to S&T according to the Brazilian Guidelines. Methods This was a cross-sectional study that analyzed records from a database with 616 women submitted to S&T from 1996 to 2017. Negative histology was defined as the following histopathologic results: HPV without CIN, inflammatory, low-grade squamous intraepithelial lesion (LSIL), and CIN 1. Results Of the 616 women, there were 52 (8.44% − 95%CI 6.25–10.64%) with a histopathologic report without preinvasive cervical lesion. No statistical association was found between this outcome and younger ages or a significant downward trend over time. Conclusion The overtreatment rate in this study can be considered low and consistent with the acceptable rates reported in the literature, reinforcing the prevailing Brazilian guideline, in which the benefits of immediate treatment outweigh the risk of losses following biopsy.

scholarly journals Performance of OncoE6TMCervical Test in detecting cervical precancer lesions in HIV-positive women attending an HIV clinic in Bujumbura, Burundi: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029088
Author(s):  
Zacharie Ndizeye ◽  
Sonia Menon ◽  
Jean-Pierre Van Geertruyden ◽  
Catherine Sauvaget ◽  
Y Jacquemyn ◽  
...  
Keyword(s):  
Low Income ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Low Grade ◽  
Sectional Study ◽  
Squamous Intraepithelial Lesion ◽  
Cross Sectional ◽  
Predictive Values ◽  
Hiv Positive Women ◽  
Intraepithelial Lesion

ObjectiveNew rapid and low-cost molecular tests for cervical cancer screening, such as the OncoE6 Cervical Test, are emerging and could be alternatives for low-income and middle-income countries. To this end, we evaluated the clinical performance of the OncoE6 Cervical Test in detecting cervical intraepithelial neoplasia (CIN) among HIV-infected women in Bujumbura, Burundi.MethodsFrom June to December 2017, a cross-sectional study was conducted in 680 HIV-positive women at the University Hospital. Women aged 25–65 years who declared having had vaginal intercourse were consecutively recruited, and cervical specimens for OncoE6, liquid-based cytology and human papillomavirus (HPV) genotyping were obtained and visual inspection with acetic acid performed. Thereafter, participants underwent a colposcopic examination. The sensitivity, specificity, and positive and negative predictive values of the different tests were calculated with reference to ‘colposcopic-histological’ diagnoses, and areas under the receiver operating curves of OncoE6 and cytology tests were compared.ResultsThe prevalence of CIN was 4.9%, and OncoE6 positivity was 3.1%. OncoE6 sensitivity varied from poor to low with increasing disease severity (42.1%, 95% CI 19.9% to 64.3% at CIN2+ threshold; and 58.3%, 95% CI 30.4% to 86.2% at CIN3+ threshold). OncoE6 had the highest specificity compared with all other tests used together. The performance of the OncoE6 test was significantly lower compared with cytology at atypical squamous cell of undetermined significance (ASCUS+) cut-off (AUC=0.68 vs 0.85, p=0.03) and low-grade squamous intraepithelial lesion (LSIL+) cut-off (AUC=0.68 vs 0.83, p=0.04) for CIN2+ diagnoses. However, the performance of the OncoE6 test was similar to that of cytology at high-grade squamous intraepithelial lesion (HSIL+) cut-off (AUC=0.68 vs 0.76; p=0.30) for CIN2+ diagnoses and was also similar to that of cytology at all cut-offs (ASCUS+, LSIL+ and HSIL+) for CIN3+ diagnoses (p1=0.76, p2=0.95 and p3=0.50, respectively).ConclusionThe current OncoE6 test proved to be a point-of-care test. However, given its poor performance for CIN2+ diagnoses, we do not recommend it for primary screening. We recommend to enrich it with more oncogenic HPV types, which may improve the performance of the test akin to that of cytology.

Downregulation of IL-2 and IL-23 in Cervical Biopsies of Cervical Intraepithelial Lesions: A Cross-Sectional Study

2020 ◽  
Vol 64 (5) ◽  
pp. 442-451
Author(s):  
Caetano Galvão Petrini ◽  
Larissa Brito Bastos ◽  
Geraldo Duarte ◽  
Patricia Pereira Dos Santos Melli ◽  
José Carlos Alves-Filho ◽  
...  
Keyword(s):  
Immune Response ◽  
Cross Sectional Study ◽  
Low Grade ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cervical Biopsy ◽  
Biopsy Specimens ◽  
Cytokine Levels ◽  
Intraepithelial Lesion ◽  
Intraepithelial Lesions

Introduction: Persistent infection with high-risk human papillomavirus (HPV) types is associated with high-grade intraepithelial lesions (HSILs) and invasive cervical cancer. The host immune response plays a key role in whether HPV clears or persists. Most studies on local immune response to HPV collect cervical mucus in order to quantify secreted cytokines; however, cells located inside the tissue can release different cytokines associated with HPV infection. Objective: This study compared the cytokine levels in cervical biopsy specimens of women with abnormal colposcopic findings according to the histopathological results: low-grade intraepithelial lesion (LSIL), HSIL, and no intraepithelial lesion (NSIL). Methods: A cross-sectional study enrolling 141 cervical biopsy specimens examined the cytokine profile for interleukin (IL-) 2, IL-4, IL-10, IL-12, IL-17, and IL-23 and interferon-γ, using the Luminex assay/ELISA. Differences in cytokine levels among the cervical lesion groups were assessed using the Kruskal-Wallis test. Results: The 141 specimens included 90 HSILs, 22 LSILs, and 29 NSILs. IL-2 levels were significantly higher in NSIL samples than in LSIL or in HSIL samples (p = 0.0001) and IL-23 levels were significantly higher in NSIL than in HSIL samples (p = 0.003). Conclusions: Our study shows that in samples from the lesion site point, 2 important pro-inflammatory cytokines, IL-2 and IL-23, are downregulated in HPV lesions.

scholarly journals Women's Knowledge and Attitude towards Cervical Cancer Preventive Measures and associated factors In South Gondar Zone, Amhara Region, North Central Ethiopia: A Cross-Sectional Study

2020 ◽  
Author(s):  
Yilkal Tafere ◽  
Tezera Jemere ◽  
Tsion Desalegn ◽  
Addisu Melak
Keyword(s):  
Cervical Cancer ◽  
Cross Sectional Study ◽  
Cervical Cancer Prevention ◽  
Prevention Measures ◽  
Sectional Study ◽  
Cross Sectional ◽  
Knowledge And Attitude ◽  
Women's Knowledge ◽  
Women’S Knowledge ◽  
South Gondar

Abstract Background The aim of the current research was to assess women's knowledge and attitudes towards cervical cancer preventions in South Gondar zone. Methods A community-based cross-sectional study was carried out in South Gondar zone, Ethiopia. A total of 844 women aged 18 and above have participated in the current study. Binary and multivariable logistic models were used to assess predictors of women’s knowledge and attitude towards cervical cancer. Results About 66% of the women had heard about cervical cancer. The percentage of women who heard about cervical cancer was 66%. Regarding the main source of information of respondents, 75.4% were heard from health professionals. Sixty two point four percent of women knew at least one preventive measure and 82.6% of participants knew at least one symptom or sign. Among study participants, 25% and 64% had good knowledge, and favorable attitude towards cervical cancer prevention measures, respectively. Being reside in rural (AOR = .21, 95%CI; .18, .34), not attending formal education (AOR = 0.50, 95% CI: 0.3, 0.75), low income (AOR = .57, 95% CI: .43, .81) and having < 4 children ((AOR = .8, 95% CI: .60–.86) were negatively associated with knowledge toward cervical cancer prevention measures

scholarly journals Analysis of Cervical Cancer Screening at Patan Hospital Nepal

2018 ◽  
Vol 8 (1) ◽  
pp. 1-4
Author(s):  
Laxmi RC ◽  
Prashanti Shrestha ◽  
Binita Pradhan
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Lower Abdominal Pain ◽  
Population Based ◽  
Cross Sectional Study ◽  
Low Grade ◽  
Cross Sectional ◽  
Pap Smear Screening ◽  
Glandular Cells ◽  
Intraepithelial Lesion

Background: Cervical cancer is among the most common cancer in women of Nepal. This disease undergoes a state of prolong premalignant state during which it can be detected and treated effectively. Papanicolaou (pap) smear is an effective method of identifying premalignant disease and with this there has been more than 90 percent decrease in the incidence of cervical cancer. The objective of this study was to analyse the pattern of Pap smear screening at Patan hospital. Methods: This is a population based retrospective cross-sectional study conducted at Patan hospital, Lagankhel. The study population includes women with gynaecological symptoms who required Pap smear screening over a period of two years. The pap smear data were collected and statistical analysis was done. Results: Among 1993 smear studied, only 89 reports had some form of intraepithelial lesion. The most prevalent lesion was low grade intraepithelial lesion (49.43%) whereas the least common was Atypical glandular cells (1.12%). The highest number of respondent were in the age of 30 – 40 years whereas the lowest was in the group of age less than 20 years. The patient who had abnormal epi­thelial lesions had multiple symptoms like vaginal discharge, vulval itching and lower abdominal pain. Conclusions: Pap smear screening should be started by the age of 21 and should be done in all women with any gynaecological symptoms.

scholarly journals Thyroid cancer overdiagnosis and overtreatment: a cross- sectional study at a thyroid cancer referral center in Ecuador

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paola Solis-Pazmino ◽  
Jorge Salazar-Vega ◽  
Eddy Lincango-Naranjo ◽  
Cristhian Garcia ◽  
Gabriela Jaramillo Koupermann ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Mortality ◽  
Incidental Finding ◽  
Cross Sectional Study ◽  
Anaplastic Carcinoma ◽  
Treatment Modalities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Referral Center ◽  
Clinical Records

Abstract Background In contrast to the rapid increase in thyroid cancer incidence, the mortality has remained low and stable over the last decades. In Ecuador, however, thyroid cancer mortality has increased. The objective of this study is to determine possible drivers of high rates of thyroid cancer mortality, through a cross-sectional analysis of all patients attending a thyroid cancer referral center in Ecuador. Methods From June 2014 to December 2017, a cross-sectional study was conducted at the Hospital de Especialidades Eugenio Espejo, a regional reference public hospital for endocrine neoplasia in adults in Quito, Ecuador. We identified the mechanism of detection, histopathology and treatment modalities from a patient interview and review of clinical records. Results Among 452 patients, 74.8% were young adults and 94.2% (426) were female. 13.7% had a family history of thyroid cancer, and patients’ median tumor size was 2 cm. The incidental finding was 54.2% whereas 45.8% was non-incidental. Thyroid cancer histology reported that 93.3% had papillary thyroid cancer (PTC), 2.7% follicular, 1.5% Hurtle cells, 1.6% medullary, 0.7% poor differentiated, and 0.2% anaplastic carcinoma. The mean MACIS (metastasis, age, completeness, invasion, and size) score was 4.95 (CI 4.15–5.95) with 76.2% of the thyroid cancer patients having MACIS score less than or equal to 6. The very low and low risk of recurrence was 18.1% (79) and 62% (271) respectively. An analysis of 319 patients with non-metastatic thyroid cancer showed that 10.7% (34) of patients had surgical complications. Moreover, around 62.5% (80 from 128 patients with thyroglobulin laboratory results) of TC patients had a stimulated-thyroglobulin value equal or higher than 2 ng/ml. Overall, a poor surgical outcome was present in 35.1% (112) patients. Out of 436 patients with differentiated thyroid carcinoma, 86% (375) received radioactive iodine. Conclusion Thyroid cancer histological characteristics and method of diagnosis are like those described in other reports without any evidence of the high frequency of aggressive thyroid cancer histology. However, we observed evidence of overtreatment and poor surgical outcomes that demand additional studies to understand their association with thyroid cancer mortality in Ecuador.

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