scholarly journals Prevention of cervical cancer: early detection of precancerous lesions of cervix in women from a marginalized environment

Author(s):  
D. M. Christe ◽  
Anjalakshi Chandrasekar ◽  
K. Jayashree ◽  
P. Meenalochani ◽  
Shaanthy T. K. Gunasingh

Background: The objective of the present study was to find out the efficacy of low-cost methods, available for screening for cervical cancer and early detection of precancerous lesions, of cervix.Methods: The study with power above 80%, was conducted over a period of almost three years. Women aged below fifty years were included in the study. A total of 100 women were diagnosed with cervical intraepithelial neoplasia (CIN) and 244 women with chronic cervicitis by histopathological examination reports. Ten women were HIV positive.   Results: Low cost screening tests of visual inspection of cervix after application of 5% acetic acid (VIA) and visual inspection of cervix after application of Lugol’s iodine (VILI) were positive in 75% of women with CIN and in combination with colposcopy, positive in 93%. The diagnostic accuracy of colposcopy was highest at 86%. (Odds ratio-.48.79).Conclusions: Initial screening for younger women with fewer years of exposure, the low cost tests, VIA / VILI  could be used under low magnification. Colposcopy should be done for all women with positive tests. The costlier human papilloma virus (HPV) tests should be done at cost effective purpose for high risk groups and when indicated, for early detection of precancerous lesions of cervix and prevention of cervical cancer.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Leite ◽  
S Pereira ◽  
D Vaz ◽  
T Smet ◽  
C Portilheiro ◽  
...  

Abstract Background Population-based cervical cancer screening (CCS) are deemed to be more cost-effective than opportunistic screening and to reduce inequalities. Implementation in Portugal has been heterogeneous, at the regional level. In Amadora healthcare cluster (Lisbon area), implementation started in April 2018 in a pilot unit and was scaled-up. We aimed to assess population-based CCS implementation in Amadora. Methods Population-based CCS targets women aged 30-65, and utilises liquid-based cytology with partial HPV genotyping (HPV16/18 and other high-risk HPV - hrHPV). Samples positive for other hrHPV undergo a cytology. HPV16/18+ and other hrHPV+ with ≥ASCUS (atypical squamous cells of undetermined significance) are referred to colposcopy. We assessed implementation according to key indicators extracted from our information system: geographic coverage, number of tests, positive results, positive predictive value of referral (number of cervical intraepithelial neoplasia-CIN/number colposcopies). Results As of 30 August 2019, CCS were in place in 4 of the 9 units, potentially covering 20904 women (48.4% of the target population). 1797 womem performed screening within the programme. Invitation for screening is currently implemented in 1 of the 4 units. Screening results were available for 1702 women, 11,1% were HPV+. From these, 26,5% were HPV 16/18+ and 86.2% positive for other hrHPV. Among the latter, 63.2% were negative for intraepithelial lesion and 36.8% were ≥ASCUS. Overall, of these 189 women, 51.3% (n = 97) were referred for colposcopy. Colposcopy results were available for 37 women, of which 13 had a CIN. PPV of referral was 35.1% (95%confidence interval: 20.7;52.6). Conclusions Despite being a population-based screening most tests are still opportunistic. There is still a limited number of colposcopies results but the current PPV of referral is low and requires further investigation. Implementation towards a full population-based screening in Amadora should continue. Key messages Implementation of a population-based cervical cancer screening in Amadora, Portugal is underway but most screening tests are still applied in an opportunistic manner. A limited number of results is avaliable to estimate positive predictive value of referral to colposcopy. Results available indicate a value of 35.1%, which requires further investigation.


2018 ◽  
Vol 26 (2) ◽  
pp. 149-152 ◽  
Author(s):  
Ashley Langell ◽  
Timothy Pickett ◽  
Catherine Mangum ◽  
Jennwood Chen ◽  
John Langell

Background. Cervical cancer remains a leading cause of cancer-related deaths worldwide despite being a highly preventable disease. Nine out of every 10 deaths due to cervical cancer occur in developing regions with limited access to medical care and unique resource constraints. To address cervical cancer prevention within the confines of these unique limitations, our team of students and faculty advisors at the University of Utah’s Center for Medical Innovation developed a low-cost, portable technology that utilizes thermal coagulation, a form of heat ablation, to treat cervical intraepithelial neoplasia. Methods. A multidisciplinary team of students worked with clinical and industry advisors to develop a globally applicable treatment for cervical intraepithelial neoplasia through a systematic process of problem validation, stakeholder analysis, user-centered design, business plan development, and regulatory clearance. Results. Our efforts resulted in the development of a functional, self-contained, battery-operated prototype within 72 days, followed by Food and Drug Administration clearance of a finalized device within 18 months. Conclusion. Interdisciplinary university programs that leverage the capabilities of academic-industry partnerships can accelerate the development and commercialization of affordable medical technologies to solve critical global health issues.


2018 ◽  
Author(s):  
Mercy Nyamewaa Asiedu ◽  
Anish Simhal ◽  
Usamah Chaudhary ◽  
Jenna L. Mueller ◽  
Christopher T. Lam ◽  
...  

AbstractGoalIn this work, we propose methods for (1) automatic feature extraction and classification for acetic acid and Lugol’s iodine cervigrams and (2) methods for combining features/diagnosis of different contrasts in cervigrams for improved performance.MethodsWe developed algorithms to pre-process pathology-labeled cervigrams and to extract simple but powerful color and textural-based features. The features were used to train a support vector machine model to classify cervigrams based on corresponding pathology for visual inspection with acetic acid, visual inspection with Lugol’s iodine, and a combination of the two contrasts.ResultsThe proposed framework achieved a sensitivity, specificity, and accuracy of 81.3%, 78.6%, and 80.0%, respectively when used to distinguish cervical intraepithelial neoplasia (CIN+) relative to normal and benign tissues. This is superior to the average values achieved by three expert physicians on the same data set for discriminating normal/benign cases from CIN+ (77% sensitivity, 51% specificity, 63% accuracy).ConclusionThe results suggest that utilizing simple color- and textural-based features from visual inspection with acetic acid and visual inspection with Lugol’s iodine images may provide unbiased automation of cervigrams.SignificanceThis would enable automated, expert-level diagnosis of cervical pre-cancer at the point-of-care.


2003 ◽  
Vol 45 ◽  
pp. 399-407 ◽  
Author(s):  
R Sankaranarayanan ◽  
BM Nene ◽  
K Dinshaw ◽  
R Rajkumar ◽  
S Shastri ◽  
...  

2008 ◽  
Vol 47 (170) ◽  
Author(s):  
Pragya Dhaubhadel ◽  
A Vaidya ◽  
P Choudhary

A hospital-based, prospective study was done in 350 women of 20-50 years to compare VIA withPap smear for early detection of cervical dysplasia at Maternity Hospital, Thapathali, from May2004 to December 2004. Pap smear was taken from each woman followed by VIA. Women withpositive VIA and/or positive Pap smear were referred for colposcopy-directed cervical biopsy. Thevariables studied were age group, presenting complaint, age of marriage, parity, smoking habit andappearance of cervix.The incidence of positive VIA and Pap smear was 2.86 and 0.57 respectively. Pelvic pain was themost common presenting complaint. The majority of the women were married before 20 years ofage. All women with either positive VIA and/or Pap smear were of parity two or above. Therewas no significant association between smoking and positive VIA (P=0.699) or Pap smear (P=0.397).Approximately 36.57% of the women screened had abnormal looking cervix. There were two womenwith high grade intraepithelial lesion (HSIL) and both were VIA positive and this was statisticallysignificant (Fischer exact P=0.0007). Of the ten VIA positive women, on histopathological examinationsix showed chronic cervicitis, one acute cervicitis, one showed cervical intraepithelial neoplasia (CIN)II, one had normal finding and one was lost to follow up.VIA as a screening test for cervical neoplasia did not miss any lesion detected by Pap smear andconfirmed by cervical biopsy.Key words: cervical neoplasia, pap smear, visual inspection


2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 26s-26s
Author(s):  
Carlos Munoz-Zuluaga ◽  
Armando Sardi ◽  
Mavalynne Orozco-Urdaneta ◽  
Luis Gabriel Parra-Lara ◽  
Andres Perez ◽  
...  

Purpose For Colombian women, breast and cervical cancer are the leading causes of mortality, despite being potentially curable through early detection and timely treatment. Tedious administrative processes and a lack of cancer screening education and awareness hinders early detection. Mobile applications (mApps) have permeated all levels of society and are potential tools by which to deliver personalized information and identify high-risk patients in need of screening tests thereby improving early cancer detection. The aim of this work is to create a free mApp that educates and guides patients to the national screening programs for breast and cervical cancer. Methods An mApp Amate was advertised to women (age ≥ 14 years) in the waiting rooms of a health care facility of a community hospital during a period of 9 months. Amate used educational, evaluative, and risk factor questions to measure the population’s knowledge of breast and cervical cancer. Each question was followed by an explanation. Correct answers yielded points that were redeemable for cellular data. Risk assessment questions identified women who required screening who were subsequently contacted by a health care provider and enrolled in the national cancer care program. Results A total of 4,553 women were contacted from August 2017 to May 2018. Of this group, 830 downloaded Amate and answered all of the questions. On the basis of the risk factor questions, 16% of patients (n = 131) were identified as being at risk for breast and/or cervical cancer and needed to be enrolled in the national screening program. Thus far, 24% of patients (n = 32) have successfully completed their recommended screening tests—mammogram, Papanicolau smear, or both. We also identified specific barriers to enrolling patients in these programs, including an unwillingness to be enrolled, limited available appointments at health care centers, and denied access as a result of health care coverage. Conclusion Amate is a low-cost, accessible tool that identifies women who are at risk for breast and cervical cancer and detects access barriers to early cancer detection. Administrative obstacles still exist and must be addressed to improve early cancer detection and screening. Amate has the potential to reach people from rural areas of Colombia and other underserved countries. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Armando Sardi Stock or Other Ownership: Celgene, Johnson & Johnson Mavalynne Orozco-Urdaneta Employment: Partners For Cancer Care And Prevention Foundation, Stamina-in-Action Stock or Other Ownership: Celgene, Johnson & Johnson Luis Gabriel Parra-Lara Research Funding: Merk & Co


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Gaia Peluso ◽  
Paola Incollingo ◽  
Armando Calogero ◽  
Vincenzo Tammaro ◽  
Niccolò Rupealta ◽  
...  

Background. Colorectal cancer (CRC) is one of the most spread neoplasia types all around the world, especially in western areas. It evolves from precancerous lesions and adenomatous polyps, through successive genetic and epigenetic mutations. Numerous risk factors intervene in its development and they are either environmental or genetic.Aim of the Review. Alongside common screening techniques, such as fecal screening tests, endoscopic evaluation, and CT-colonography, we have identified the most important and useful biomarkers and we have analyzed their role in the diagnosis, prevention, and prognosis of CRC.Conclusion. Biomarkers can become an important tool in the diagnostic and therapeutic process for CRC. But further studies are needed to identify a noninvasive, cost-effective, and highly sensible and specific screening test for their detection and to standardize their use in clinical practice.


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