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 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 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.

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.

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 Comparative study of papanicolaou smear and colposcopy in the evaluation of cervical lesions

2019 ◽  
Vol 8 (6) ◽  
pp. 2400
Author(s):  
Priyanka Mohan ◽  
Lakshmidevi M. ◽  
Shreedhar Venkatesh
Keyword(s):  
Pap Smear ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Research Centre ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Cross Sectional ◽  
Intraepithelial Lesion ◽  
Punctate Pattern

Background: Cervical cancer is the third most common type of cancer among females. Study aims to critically evaluate the sensitivity and specificity of colposcopy versus papanicolaou (Pap) smear in the early detection of dysplasias. Its secondary objective to correlate the findings in the evaluation of unhealthy cervix by cytology, colposcopy and colposcopy guided biopsy.Methods: This was a tertiary care teaching hospital based, prospective, cross sectional study done in Department of Obstetrics and Gynaecology, at Vydehi Institute of Medical Sciences and Research Centre, Bangalore, conducted on 200 women attending Gynaecology OPD.Results: PAP smear was taken for all 200 patients. 73% of smear was found to be normal, 11% showed inflammatory atypia, 9% showed low grade squamous intraepithelial lesion (LSIL), 3.5% showed atypical squamous cells of undetermined significance (ASCUS) and 3.5% showed High Grade Squamous Intraepithelial Lesion (HSIL). Among the 200 cases studied, 38% (76/200) were diagnosed as colposcopically abnormal. Among the abnormal cases, AW areas were diagnosed in 4%. Punctate pattern of vessels was seen in 5% of women. Normal findings was present in 62%, Erosion cervix in 6%, inflammatory changes were seen in 6% and polyps were diagnosed in 7.5%, leucoplakia was found in 2% and unsatisfactory colposcopy finding was seen in 4% and underwent endocervical curettage. 32 cases out of 200 women were positive on Pap smear. 66 out of 200 women were positive on Biopsy. Pap smear was positive in 22 out of 66 biopsy proven positive cases.Conclusions: The commonest presenting complaint was vaginal discharge (182/200; 91% of the patients. the PAP smear  is found to have sensitivity of 33.33%  and specificity of 92.54%. colposcopy is found to have sensitivity of 81.82%  and specificity of 82.84%.

Atypical Squamous Cells: Cytopathological Findings and Correlation with HPV Genotype and Histopathology

2018 ◽  
Vol 62 (5-6) ◽  
pp. 386-392 ◽  
Author(s):  
Geilson Gomes de Oliveira ◽  
Judite Maria da Silva Costa de Oliveira ◽  
Renata Mirian Nunes Eleutério ◽  
Rita de Cássia Carvalho Barbosa ◽  
Paulo Roberto Carvalho de Almeida ◽  
...  
Keyword(s):  
Giant Cells ◽  
Cross Sectional Study ◽  
High Grade ◽  
Sectional Study ◽  
Squamous Intraepithelial Lesion ◽  
Cross Sectional ◽  
Atypical Squamous Cell ◽  
Squamous Cells ◽  
Intraepithelial Lesion ◽  
Intraepithelial Lesions

Objective: We aimed to assess potential associations between atypical squamous cell (ASC) subgroups: ASC-US (undetermined significance) and ASC-H (cannot exclude high-grade squamous intraepithelial lesion), regarding cytomorphological features, high-risk (HR) human papillomavirus (HPV) testing, and histological outcomes in a sample of Brazilian women. Study Design: Cross-sectional study which evaluated 1,346 liquid-based cytologies between January 2010 and July 2016 with ASC results. ASC-US and ASC-H were analyzed for frequency, diagnostic criteria, and cytological findings and compared with HR-HPV tests and histological outcomes. Results: Enlarged nucleus was the most frequent ASC-US criterion, but alternative criteria were present in 20% of the total cases. No ASC-US criteria were associated with histological outcomes or HR-HPV positivity. Parakeratosis, corneal pearl, giant cells, and binucleation were strongly associated with ASC-US while hyperkeratosis was associated with high-grade squamous intraepithelial lesions (HSIL) or a superior outcome. HR-HPV was positive in 64.39% of ASC-US and 65.38% of ASC-H. HSIL or superior outcomes also occurred in 13.33% of ASC-US and 64.71% of ASC-H cases. Conclusion: Alternative criteria for ASC-US were relatively frequent. Reactive cellular changes suggestive of atypias were more abundant in ASC-US. Although ASC-H is associated with worse histological outcomes, no differences in HPV positivity were found in comparison to ASC-US.

scholarly journals Prevalence of Human Papilloma virus in women with Abnormal Cervical Smears from Sarawak, Malaysia

2021 ◽  
pp. 2729-2734
Author(s):  
Myat San Yi ◽  
Tan Cheng Siang ◽  
Soe Lwin ◽  
Kay Thi Myint ◽  
Khin Than Yee ◽  
...  
Keyword(s):  
High Risk ◽  
Hpv Vaccination ◽  
Hpv Infection ◽  
Cross Sectional Study ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Cross Sectional ◽  
Incidence And Mortality ◽  
Intraepithelial Lesion

Introduction: Cervical cancer is common cancer and ranked in fourth place in both incidence and mortality worldwide. It is 3rd most common female cancer in Malaysia with a lifetime risk of 1 in 116. Infection with high-risk oncogenic human papillomavirus (HPV) is recognized as one of the substantial risk factors for the development of cervical cancers. Methods: It was a cross-sectional study conducted to determine the prevalence of HPV infection and its subtypes among women with various degrees of abnormal smears, who were seen in the colposcopy clinic of Sarawak General Hospital within six months’ period from January to June 2018. We recruited 56 participants. There were 23 each for an atypical squamous cell of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL) and 10 high- grade squamous intraepithelial lesion (HSIL). DNA was extracted, and HPV genotypes were determined via polymerase chain reaction (PCR) using two primer pairs MY09/MY11 and GP5+/GP6+. Results: The age ranged from 23 to 56 years, with a mean age of 42.96 years. HPV was detected in 20 out of 56 (35.7%). There were 6 high-risk oncogenic HPVs (18, 51, 52, 56, 58, 68) detected in participants and the most prevalent subtypes were 18, 52, and 58 (20% each). Four low-risk HPVs detected were 6, 53, 70, and 84. There was a significant association between the severity of cervical lesions and HPV positivity (P < 0.004). HSIL had the highest positive predictive value to have HPV infection as 70% compared to 43.4% of LSIL and 9.3% of ASC-US. Conclusion: Distribution of HPV subtypes from women with abnormal smears from Sarawak indicated a high prevalence of HPV 18, 52, and 58. We also identified HPV 70, which has never been reported in West Malaysia. These findings could contribute valuable information for HPV vaccination strategies, particularly for Sarawakian women.

scholarly journals Time trends of socioeconomic inequalities in adolescent smoking in Okinawa, Japan, 2008–2016: a repeated cross-sectional study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Minoru Takakura ◽  
Masaya Miyagi ◽  
Akira Kyan
Keyword(s):  
Time Trends ◽  
Parental Education ◽  
Cross Sectional Study ◽  
Socioeconomic Inequalities ◽  
School Type ◽  
Sectional Study ◽  
Cross Sectional ◽  
Japanese Adolescents ◽  
Index Of Inequality ◽  
Over Time

Abstract Background Smoking among Japanese adolescents has decreased noticeably. However, little is known whether the decreasing trend in adolescent smoking can be seen across all socioeconomic status (SES) groups. This study aimed to examine trends in socioeconomic inequalities in smoking among Japanese adolescents between 2008 and 2016. Methods We conducted a repeated cross-sectional study using data from three surveys of high school students in Okinawa, Japan, in 2008, 2012, and 2016. The study participants consisted of 7902 students in grades 10 through 12 (15–18 years). Smoking was assessed as current cigarette use. SES indicators included familial SES (parental education and family structure) and student’s own SES (school type). To evaluate absolute and relative inequalities, prevalence differences (PDs) and ratios (PRs) between low and high SES groups were estimated. The slope index of inequality (SII) and relative index of inequality (RII) were also calculated. Results Smoking prevalence among boys and girls significantly declined from 11.5% and 6.2% in 2008 to 4.7% and 1.9% in 2016, respectively. Similar decreasing trends in smoking were found among most of the SES groups. The PDs and SII for parental education in boys and family structure in girls decreased over time while those for school type persisted among boys and girls. The PRs and RII for school type in boys increased while those for other SES indicators among both sexes remained stable over time. Conclusions Smoking among Japanese adolescents has been declining and time trends of socioeconomic inequalities in smoking varied by absolute and relative measures. Further policies and/or interventions to reduce smoking inequalities should focus on the context of schools, especially in vocational high schools.

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