scholarly journals The impact of a community intervention to improve cervical cancer screening uptake in the Amazon region of Brazil

2007 ◽  
Vol 125 (1) ◽  
pp. 42-45 ◽  
Author(s):  
Marcus Vinicius Von Zuben ◽  
Sophie Françoise Derchain ◽  
Luis Otávio Sarian ◽  
Maria Cristina Westin ◽  
Luiz Claudio Santos Thuler ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Amazon Region ◽  
Routine Screening ◽  
Pap Smears ◽  
Cervical Lesions ◽  
Screening Programs ◽  
Brazilian Amazon Region ◽  
The Impact

CONTEXT AND OBJECTIVE: In the northern region of Brazil, cervical cancer is the most important cause of cancer-related deaths among women. There is considerable likelihood, however, that official incidence and mortality figures are greatly underestimated. The aim of this study was to estimate the repercussions from improvement in cervical cancer screening programs on the incidence of pre-invasive and invasive cervical lesions in a municipality in this region. DESIGN AND SETTING: This was a quasi-experimental study that assessed process dimensions relevant to the program objectives. The study comprised a sample of 2,226 women seen at primary healthcare units in Cruzeiro do Sul, a small city in the Brazilian Amazon region, from April 2003 to July 2004. METHODS: Women were recruited through local radio advertisements and by oral communication from the investigators. The women answered a structured questionnaire and underwent pelvic examination, which included Papanicolaou (Pap) smears and naked-eye inspection of the cervix after applying diluted acetic acid. Women with positive Pap smears or abnormal gynecological examination were referred for colposcopy and possible biopsy, diathermic large loop excision of the transformation zone or conization. RESULTS: The results obtained were compared with historical official data retrieved from the Brazilian Ministry of Health’s database. Intervention resulted in a 40% increase in positive Pap smears and detection of cancer was nine times higher than had been observed in routine screening. CONCLUSIONS: Detection of pre-invasive and invasive cervical lesions in the intervention group was remarkably higher than among women seen during routine screening.

scholarly journals Cervical intraepithelial lesions in females attending Women's Health Clinics in Alexandria, Egypt

CytoJournal ◽  
2015 ◽  
Vol 12 ◽  
pp. 13 ◽  
Author(s):  
Mona Abdel-Hadi ◽  
Adel Khalaf ◽  
Hanaa Aboulkassem ◽  
Noha Naeem ◽  
Mohamed Abdel Baqy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Screening Program ◽  
Intraepithelial Neoplasia ◽  
Pap Smears ◽  
Cervical Lesions ◽  
Screening Programs ◽  
Life Saving ◽  
Egyptian Women

Background: Data from Egyptian studies provide widely varying estimates on the prevalence of preinvasive cervical lesions. The aim of this study was to estimate the rate of cervical intraepithelial neoplasia (CIN) in Egyptian women living in Alexandria to clarify the need for implementing a national organized screening program and a vaccination program in our community. Materials and Methods: The study was conducted over a 6 years period and covered the different socioeconomic levels to have a representative sample for women living in Alexandria. All women included did not have any cervical disorder related complaints. Conventional Pap smears were obtained and diagnosed using the Bethesda system. Women with abnormal Pap smears were managed according to the 2006 consensus guidelines within the available facilities. Persistent abnormal cytological results were referred for colposcopic biopsy. Histological results were grouped into: Reactive changes, CIN 1, CIN 2/CIN 3 and adenocarcinoma in-situ (AIS). Results: Out of the 6173 smears included in the study 6072 (98.36%) were normal and only 101 (1.63%) were abnormal. After colposcopic biopsies, 0.08% had CIN 1, 0.03% had CIN 2, 3 and 0.01% had AIS. Conclusion: We concluded that cervical cancer screening programs, although life-saving for a number of women, are not a sufficiently high priority in our community. Money for national health screening programs should preferably be directed more towards recruiting women for breast cancer screening, since breast cancer accounts for about 33% of all female cancers in Egypt ranking number one, while cervical cancer ranks number 13.

scholarly journals Performance of an affordable urine self-sampling method for human papillomavirus detection in Mexican women

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254946
Author(s):  
Rubí Hernández-López ◽  
Luis Hermosillo ◽  
Leith León-Maldonado ◽  
Rafael Velázquez-Cruz ◽  
Leticia Torres-Ibarra ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Healthcare Workers ◽  
Sampling Method ◽  
Urine Collection ◽  
Hpv Testing ◽  
Screening Programs ◽  
The Impact

Introduction Urine self-sampling for human papillomavirus (HPV)-based cervical cancer screening is a non-invasive method that offers several logistical advantages and high acceptability, reducing barriers related to low screening coverage. This study developed and evaluated the performance of a low-cost urine self-sampling method for HPV-testing and explored the acceptability and feasibility of potential implementation of this alternative in routine screening. Methods A series of sequential laboratory assays examined the impact of several pre-analytical conditions for obtaining DNA from urine and subsequent HPV detection. Initially, we assessed the effect of ethylaminediaminetetraacetic acid (EDTA) as a DNA preservative examining several variables including EDTA concentration, specimen storage temperature, time between urine collection and DNA extraction, and first-morning micturition versus convenience sample collection. We further evaluated the agreement of HPV-testing between urine and clinician-collected cervical samples among 95 women. Finally, we explored the costs of self-sampling supplies as well as the acceptability and feasibility of urine self-sampling among women and healthcare workers. Results Our results revealed higher DNA concentrations were obtained when using a 40mM EDTA solution, storing specimens at 25°C and extracting DNA within 72 hrs. of urine collection, regardless of using first-morning micturition or a convenience sampling. We observed good agreement (Kappa = 0.72) between urine and clinician-collected cervical samples for HPV detection. Furthermore, urine self-sampling was an affordable method (USD 1.10), well accepted among cervical cancer screening users, healthcare workers, and decision-makers. Conclusion These results suggest urine self-sampling is feasible and appropriate alternative for HPV-testing in HPV-based screening programs in lower-resource contexts.

scholarly journals Barriers to and Facilitators of Cervical Cancer Screening among Women in Southeast Asia: A Systematic Review

2021 ◽  
Vol 18 (9) ◽  
pp. 4586
Author(s):  
Brandon Chua ◽  
Viva Ma ◽  
Caitlin Asjes ◽  
Ashley Lim ◽  
Mahsa Mohseni ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Southeast Asia ◽  
Cervical Cancer Screening ◽  
The Philippines ◽  
Barriers And Facilitators ◽  
Pap Smears ◽  
Screening Programs ◽  
Education Status ◽  
Low Coverage

In Southeast Asia, cervical cancer is the second most common cancer in women. Low coverage for cervical cancer screening (CCS) becomes a roadblock to disease detection and treatment. Existing reviews on CCS have limited insights into the barriers and facilitators for SEA. Hence, this study aims to identify key barriers and facilitators among women living in SEA. A systematic literature review was conducted on Pubmed, Embase, PsycINFO, CINAHL, and SCOPUS. Primary qualitative and quantitative studies published in English that reported barriers and facilitators to CCS were included. The Mix Methods Appraisal Tool was used for the quality assessment of the included studies. Among the 93 included studies, pap smears (73.1%) were the most common screening modality. A majority of the studies were from Malaysia (35.5%). No studies were from Timor-Leste and the Philippines. The most common barriers were embarrassment (number of articles, n = 33), time constraints (n = 27), and poor knowledge of screening (n = 27). The most common facilitators were related to age (n = 21), receiving advice from healthcare workers (n = 17), and education status (n = 11). Findings from this review may inform health policy makers in developing effective cervical cancer screening programs in SEA countries.

scholarly journals National data analysis and systematic review for human resources for cervical cancer screening in Japan: Who should take Pap smears for cervical cancer screening?

2020 ◽  
Author(s):  
Chisato Hamashima ◽  
Seiju Sasaki ◽  
Keika Hoshi ◽  
Satoyo Hosono ◽  
Takafumi Katayama ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Human Resources ◽  
Cervical Cancer Screening ◽  
Pap Smears ◽  
Primary Role ◽  
Screening Programs ◽  
Ovid Medline ◽  
General Physicians

Abstract Background: Although cervical cancer screening has been performed as a national program since 1983 in Japan, taking Pap smears from the cervix has usually been performed by gynecologists and obstetricians in their offices. Conventionally, general physicians and midwives cannot take Pap smears of cervical cancer screening in Japan. Accessibility is one of the important factors to consider when planning to increase the participation rate in cancer screening programs. Gynecologists also play a primary role in the diagnosis and treatment of cervical cancers. Discussions regarding the needed human resources for cancer screening programs have remained scared in Japan. Methods: We examined the number of gynecologists and obstetricians based on a national survey. Candidate literature was searched using Ovid-MEDLINE and Ichushi-Web until the end of January 2019. Then, a systematic review regarding accessibility to cervical cancer screening was performed. The results of the selected articles were summarized in the tables.Results: Although the total number of all physicians in Japan increased from 1996 to 2016, the proportion of gynecologists and obstetricians has remained at approximately 5% over the last 2 decades. However, 43.6% of municipalities have no gynecologists and obstetricians in 2016. Five articles identified from Ovid-MEDLINE and Ichushi-Web were eligible and assessed. Two Japanese studies showed consistent results regarding the association of resources as gynecologists and obstetricians with participation rates in cervical cancer screening. Another article reported on the national distribution of gynecological oncologists and compared the treatment outcomes between hospitals with and without certified gynecologists. The number of certified gynecological oncologists has remained insufficient with a biased distribution. Thus, the survival rate of cervical cancer patients was different between hospitals with and without accreditation by academic society. Although the perspectives of selected articles were different, the results suggested the burden to access to cervical cancer screening and consequent diagnosis and treatment.Conclusions: The human resources for taking Pap smears for cervical cancer screening has remained insufficient with a huge disparity among municipalities in Japan. Enabling general physicians to take Pap smears or the introduction of self-sampling HPV testing may be considered to augment the limited access to cervical cancer screening.

The cervical cancer screening programme in Norway, 1992–2000: changes in Pap smear coverage and incidence of cervical cancer

2002 ◽  
Vol 9 (2) ◽  
pp. 86-91 ◽  
Author(s):  
J.F. Nygård ◽  
G.B. Skare ◽  
S.Ø. Thoresen
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Smear ◽  
Screening Programme ◽  
Invasive Cervical Cancer ◽  
Pap Smears ◽  
Cancer Screening Programme ◽  
Cervical Cancer Screening Programme ◽  
The Impact

OBJECTIVES: Changes in the incidence of cervical cancer were studied to assess the impact of the Norwegian coordinated cervical cancer screening programme introduced in 1995. Attention was given as to whether recommendation letters sent to women without a screen in the previous 3 years could be an alternative to a conventional screening programme that invites women irrespectively of their spontaneous screening. SETTING: A population based, nationwide, screening programme in which women of 25 to 69 are recommended to have a conventional Pap smear every 3 years. METHODS: The impact of the screening programme was assessed indirectly by comparing trends in invasive cervical cancer, changes in coverage, and changes in interval between Pap smears in the 3 year period (1992–4) before screening with the two first screening rounds (1995–7 and 1998–2000). All Pap smears taken from women of all ages were included, a total of 4 744 967 Pap smears from more than 1.4 million women. Further, the impact was assessed directly by logistic regression by comparing the screening results of women recruited for the programme with women who had regularly had Pap smears. RESULTS: In the last 2 years studied, the incidence of invasive cancer was 22% lower than in the period before the programme. The proportion of women who had a Pap smear was higher after the implementation of the coordinated screening programme. The number of smears taken was less as the interval after a normal smear was greater. The newly recruited women had a threefold risk of having a high grade precursor and a 20-fold higher risk of cancer than the women who had had regular smears. CONCLUSIONS: The coordinated screening programme provides a low cost way of increasing the coverage of the female population, and consequently has reduced the rate of invasive cervical cancer.

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.

scholarly journals Recovery strategies following COVID-19 disruption to cervical cancer screening and their impact on excess diagnoses

2021 ◽  
Author(s):  
Alejandra Castanon ◽  
Matejka Rebolj ◽  
Francesca Pesola ◽  
Peter Sasieni
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Intraepithelial Neoplasia ◽  
Cervical Cancers ◽  
Screening Interval ◽  
Recovery Strategies ◽  
Screening Services ◽  
The Impact ◽  
Published Research

Abstract Background The COVID-19 pandemic has disrupted cervical cancer screening services. Assuming increases to screening capacity are unrealistic, we propose two recovery strategies: one extends the screening interval by 6 months for all and the other extends the interval by 36/60 months, but only for women who have already missed being screened. Methods Using routine statistics from England we estimate the number of women affected by delays to screening. We used published research to estimate the proportion of screening age women with high-grade cervical intraepithelial neoplasia and progression rates to cancer. Under two recovery scenarios, we estimate the impact of COVID-19 on cervical cancer over one screening cycle (3 years at ages 25–49 and 5 years at ages 50–64 years). The duration of disruption in both scenarios is 6 months. In the first scenario, 10.7 million women have their screening interval extended by 6 months. In the second, 1.5 million women (those due to be screened during the disruption) miss one screening cycle, but most women have no delay. Results Both scenarios result in similar numbers of excess cervical cancers: 630 vs. 632 (both 4.3 per 100,000 women in the population). However, the scenario in which some women miss one screening cycle creates inequalities—they would have much higher rates of excess cancer: 41.5 per 100,000 delayed for screened women compared to those with a 6-month delay (5.9 per 100,000). Conclusion To ensure equity for those affected by COVID-19 related screening delays additional screening capacity will need to be paired with prioritising the screening of overdue women.

scholarly journals Automated Quantitative Cytology Imaging Analysis System in Cervical Cancer Screening in Shanxi Province, China

2017 ◽  
Vol 6 (2) ◽  
pp. 51 ◽  
Author(s):  
Yan Dong ◽  
Jigeng Bai ◽  
Yuping Zhang ◽  
Guangjie Shang ◽  
Yan Zhao ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Population Based ◽  
Shanxi Province ◽  
Detection Rates ◽  
Screening Programs ◽  
Quantitative Cytology ◽  
Automated Platform

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.

scholarly journals Role of Protein Biomarkers in the Detection of High-Grade Disease in Cervical Cancer Screening Programs

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Charlotte A. Brown ◽  
Johnannes Bogers ◽  
Shaira Sahebali ◽  
Christophe E. Depuydt ◽  
Frans De Prins ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
False Negative ◽  
Pap Test ◽  
Developed Countries ◽  
Protein Biomarkers ◽  
Ki 67 ◽  
Screening Programs

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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