Prevalence and predictors of Pap smear cervical epithelial cell abnormality among HIV-positive and negative women attending gynecological examination in cervical cancer screening center at Debre Markos referral hospital, East Gojjam, Northwest Ethiopia

Objective A screening centre in Soweto, South Africa (SA), investigated high-risk human papillomavirus (HR-HPV), HIV, cervical cancer risk amongst women. Methods This cross-sectional study (June 2018-March 2019) describes screening results (Roche Linear Array HPV test and Pap smear liquid based cytology) and history of screening (known HIV status, antiretroviral therapy [ART] use, previous Pap smears). Data were stratified by age group (18–29, 30+ years), HIV status, Pap smear results and tested for statistical significance. Results Of 280 women, 20.4% were HIV-positive, 18.2% had abnormal Pap smears, 41.8% had HR-HPV. Of older women, 48.2% (n = 78/162) had never had a Pap smear. Of younger women, 89.0% (n = 105/118) never had a Pap smear, but had significantly more low-grade squamous intraepithelial lesions (LSIL) and other HR-HPV infection than older women (12.7%[n = 15/118] vs 4.9%[n = 8/162], p = 0.0193; and 49.2%[n = 58/118] vs 29.0%[n = 47/162], p = 0.0006; respectively). HIV-positive women had more abnormal cytology results and infection with other HR-HPV types or co-infection with other HR-HPV type(s)/HPV-16 compared to HIV-negative women (35.1%[n = 20/57] vs 13.9%[n = 31/223], p = 0.0002; 56.1%[n = 32/57] vs 32.7%[n = 73/223], p = 0.001; and 12.3%[n = 7/57] vs 4.9%[n = 11/223], p = 0.044; respectively). Of 57 HIV-positive women, 45.6% (n = 26) already knew their HIV status; of which 69.2% were on ART and 34.6% never had a Pap smear. Conclusion South African women have high rates of HIV, Pap smear abnormalities and HR-HPV, with low cervical cancer screening coverage. SA cervical cancer screening policy excludes (undiagnosed) HIV-positive and HIV-negative women <30 years, both populations found to have high prevalence of HR-HPV. HPV-based primary screening from 25 years could improve outcomes.

Download Full-text

Pattern of epithelial cell abnormality in Pap smear: A clinicopathological and demographic correlation

CytoJournal ◽

10.4103/1742-6413.80527 ◽

2011 ◽

Vol 8 ◽

pp. 8 ◽

Cited By ~ 10

Author(s):

Urmila Banik ◽

Pradip Bhattacharjee ◽

Shahab Uddin Ahamad ◽

Zillur Rahman

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Epithelial Cell ◽

Developing Country ◽

Cervical Cancer Screening ◽

Pap Smear ◽

Age Group ◽

Smear Examination ◽

Group A ◽

Malignant Lesions

Background: In the low resource settings of a developing country, a conventional Papanicolaou (Pap) test is the mainstay screening system for cervical cancer. In order to counsel women and to organize a public health system for cervical cancer screening by Pap smear examination, it is imperative to know the pattern of premalignant and malignant lesions. This study was undertaken to find out the prevalence of an abnormal Pap smear, in a tertiary hospital of a developing country, and to carry out a clinicopathological and demographical analysis for establishing the pattern of epithelial cell abnormality in a Pap smear. Materials and Methods: A cross-sectional descriptive study was carried out in a total of 1699 patients who underwent Pap smear examination. The prevalence of epithelial cell abnormality in the Pap smear was calculated in proportions / percentages. Specimen adequacy and reporting was assessed according to the revised Bethesda system. Results: Among the total of 1699 patients who had their Pap smear done, 139 (8.18%) revealed epithelial cell abnormality. Altogether 26 smears revealed high-grade lesions and malignancy, most of which were found to be in women belonging to the 30 – 39 and ≥ 45 age group. A total of 75 (53.96%) women were in the 20 – 44 age group and 64 (46.04%) were in the ≥ 45 age group. A bimodal age distribution was detected in the epithelial cell abnormality, with the bulk being diagnosed in patients aged 45 or above. Overall one-third of the patients with an abnormal Pap smear result showed healthy cervix in per vaginal examination. Conclusions: A raised prevalence of epithelial cell abnormality reflects the lack of awareness about cervical cancer screening. Women aged 45 or above harbor the bulk of premalignant and malignant lesions in the Pap smear, signifying that these women are among the under users of cytological screening.

Download Full-text

Visual inspection using acetic acid and pap smear as a method of cervical cancer screening

CrossRef Listing of Deleted DOIs ◽

10.3126/joim.v28i1.437 ◽

2007 ◽

Vol 28 (1) ◽

Author(s):

K. Vadehra ◽

R. Jha

Keyword(s):

Cervical Cancer ◽

Acetic Acid ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Visual Inspection ◽

Pap Smear

Download Full-text

Cervical Cancer: Assessment of Its Knowledge, Utilization of Services and Its Determinant Among Female Undergraduate Students in a Low Resource Setting

International Quarterly of Community Health Education ◽

10.1177/0272684x211006608 ◽

2021 ◽

pp. 0272684X2110066

Author(s):

Chidebe Christian Anikwe ◽

Philip Chidubem Osuagwu ◽

Cyril Chijioke Ikeoha ◽

Okechukwu B Ikechukwu Dimejesi ◽

Bartholomew Chukwunonye Okorochukwu

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Pap Smear ◽

Health Workers ◽

P Value ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Resource Setting ◽

Study Population

Background Cervical cancer is a preventable disease that contributes significantly to the death of women. This study is aimed at determining the level of knowledge and utilization of cervical cancer screening and its determinants among female undergraduates of Ebonyi State University. Methods A structured questionnaire was used for a cross-sectional survey of the study population between January 1 and March 3, 2018. The data were analyzed using IBM SPSS Statistics version 20. Data were represented with frequency table, simple percentage, mode, range, Chi square and pie chart. The level of significance is at P-value < 0.05. Results Majority (74.8%) of the respondents were aware of cervical cancer and it could be prevented (70.8%). More than three-fifths (68.30%) were informed via health workers, and 86.8% were aware that post-coital vaginal bleeding is a symptom. Less than half (49.8%) knew that HPV is the primary cause, and only 32.9% were aware of the HPV vaccine. One-quarter of the respondent were aware that early coitarche is a risk factor for cervical cancer. Only 41.8% of the women were aware of Pap smear, 9.2% had undergone screening, and 97.6% were willing to be screened. Marital status was the significant determinant of being screened while class level did not significantly influence uptake of cervical cancer screening. The most common reason (20.6%) for not being screened was lack of awareness of the test. Conclusion Our study population had a good knowledge of cervical cancer, but utilization of cervical cancer screening was poor. Awareness creation through the mass media and provision of affordable screening services can promote the use of cervical cancer screening in the study area.

Download Full-text

Study on cervical cancer screening amongst nurses

10.1055/s-0039-1685284 ◽

2016 ◽

Author(s):

Astha Srivastava ◽

Bindiya Gupta ◽

Vikas Lakha ◽

Shilpa Singh

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Pap Smear ◽

Tertiary Care ◽

Tertiary Care Centre ◽

Attitude And Practice ◽

Validated Questionnaire ◽

Incidence And Mortality ◽

Knowledge Attitude And Practice

Objective: To study the knowledge, attitude and practice of nurses at tertiary centre regarding cervical cancer screening. Material and Methods: Validated questionnaire was circulated amongst staff nurses at tertiary care centre after taking informed consent. Results and Discussion: Cancer of cervix is the most common genital tract malignancy in female and it is ranked second to breast cancer. It has a positive association with HPV infection. Cervical cancer incidence and mortality have declined substantially following introduction of screening programmes. This present study investigated the knowledge, attitude and practice of nurses at GTB Hospital towards cervical cancer risk factors, sign & symptoms and screening as they are important health professionals. In our study, the results showed that 99% of respondents were aware of Pap smear as screening programme and about 60-70% were aware of HPV as positive organism, but most of them never had a Pap smear done before. Majority of them did not know VIA, VILI and colposcopy as screening techniques. Conclusion: It may thus be recommended that institutions should periodically organize seminars and training for health personnel especially the nurses which form a group of professionals that should give health education to women about cervical cancer.

Download Full-text

Cervical cancer screening service utilization and associated factors among HIV positive women attending adult ART clinic in public health facilities, Hawassa town, Ethiopia: a cross-sectional study

BMC Health Services Research ◽

10.1186/s12913-019-4718-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 6

Author(s):

Abiyu Ayalew Assefa ◽

Feleke Hailemichael Astawesegn ◽

Bethlehem Eshetu

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Cross Sectional Study ◽

Partner Support ◽

Hiv Positive ◽

Screening Service ◽

Hiv Diagnosis ◽

Cross Sectional ◽

Hiv Positive Women

Abstract Background In Ethiopia, cervical cancer is a public health concern, as it is the second most cause of cancer deaths among reproductive age women and it affects the country’s most vulnerable groups like; rural, poor, and HIV-positive women. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, its utilization remains low. Methods An institution-based cross-sectional study was conducted from March 2 to April 1/2019 to assess the level and factors affecting utilization of cervical cancer screening among HIV positive women in Hawassa town. Quantitative data collection methods were used. Data were gathered using a structured and pretested questionnaire. Epi-Info version 7 and SPSS version 23 were used for data entry and analysis respectively. Statistically significant association of variables was determined based on Adjusted Odds ratio with its 95% confidence interval and p-value of ≤0.05. Results Of the 342 women interviewed, 40.1% (95% CI: 35.00, 45.33%) of them were screened. Having a post primary education (AOR = 5.1, 95% CI: 1.8, 14.5), less than 500 cell/mm3 CD4 count (AOR = 2.7, 95% CI: 1.2, 5.9); duration since HIV diagnosis (AOR = 4.2, 95% CI: 2.1, 8.5), partner support (AOR = 4.7, 95% CI: 2.3, 9.4), having knowledge about risk factors (AOR = 2.9 (95% CI: 1.2, 6.9) and having favorable attitude towards cervical cancer and its screening (AOR = 3.7 (95% CI: 1.8, 7.5) were associated with cervical cancer screening utilization. Conclusions The study revealed utilization of cervical cancer screening service was low among HIV positive women. Educational status, duration of HIV diagnosis, partner support, knowledge status about risk factor, CD4 count and attitude towards cervical cancer and its screening were associated with cervical cancer screening utilization. Health care workers need to provide intensive counseling services for all ART care attendants to increase utilization.

Download Full-text