scholarly journals Role of VIA and PAP Smear in the Diagnosis of Cervical Precancers: A Study of 115 C ases

2009 ◽  
Vol 22 (2) ◽  
pp. 183-189
Author(s):  
RA Jahan ◽  
F Rahman ◽  
SM Badruddoza ◽  
TA Nasir ◽  
ANNU Ahmed ◽  
...  

Carcinoma of cervix is the most frequent neoplasm of female genital tract. In Bangladesh cervical cancer is the commonest malignancy of women. This high incidence of cervical cancer is attributed to the lack of screening program, particularly in the women of low socio-economic status. Invasive cervical cancer is preceded by a tong premalignant phase known as cervical intraepithelial neoplasia (CIN). The goal of cervical cancer screening is the detection and treatment of precancer before cancer develops. The aim of this study was to evaluate the test parameters using visual inspection with acetic acid (VIA) and cervical cytology in screening and early diagnosis of the precancerous lesions of cervix. This study deals with 115 cases from Gynecology Outpatient Department of Rajshahi Medical College, Rajshahi from July 2006 to June 2008. After vaginal examination Pap smear was collected, followed by VIA and punch biopsy of cervix. All the data were evaluated by standard statistical methods. The sensitivity of VIA was 94.11% while Pap smear was 64.7%. The specificity of Pap smear was 93.94% while VIA was 57.57%. These two tests may be considered as a suitable early detection technique in the developing countries where other test like HPV-DNA detection is a costly oneTAJ 2009; 22(1): 183-189

Cervical neoplasia provides an overview of the 4th most common malignancy in women worldwide, including the premalignant phase. Specific terminology used in cytology and histology (including atypia, dyskaryosis, cervical intraepithelial neoplasia (CIN), cervical glandular intraepithelial neoplasia (CGIN) and invasive cervical cancer (ICC) are explained, and the epidemiology and risk factors (with an emphasis on human papilloma virus (HPV)) for this common malignancy are included. Clinical presentation is outlined. Cervical screening is discussed, including the role of HPV testing, and both the British Association for Cytopathology/NHS cervical screening program 2013 classification of cervical cytology and the Bethesda system (used more widely worldwide) are explained. Diagnosis includes colposcopic examination of the cervix, and the management of both CIN and cervical cancer are included. HPV vaccination, pregnancy, and women living with HIV (including ICC as AIDS-defining) are discussed.


2018 ◽  
Vol 1 (2) ◽  
pp. 9-13
Author(s):  
Renee Pradhan ◽  
U. Pant ◽  
B. Aryal

Introduction: Cancer cervix is a common genital cancer. Human papillomavirus is the main cause of cervical cancer because of the strong association of certain HPV genotypes and the development of cervical cancer and its precursor lesions, cervical intraepithelial neoplasia CIN 2 or CIN3. Methods: The study was conducted on 180 gynecological patients seen at the outpatient department of Manipal Hospital, Bangalore. A comparative study of HPV DNA test with Pap smear in the screening of cervical neoplasia was carried out over the period of 24 months from August 2011 to June 2013. Results: The incidence of cervical cancer and its associated mortality has declined in recent years, largely due to the widespread implementation of screening programs by Pap smear testing. The management and the prevention of cervical cancer should change with HPV DNA testing for high risk HPV, which is more sensitive than pap smear testing. Infection of cervix with HPV is necessary to cause cervical neoplasia and cervical cancer. Persistent infection with HPV is required for the development of cervical dysplasia and invasive cervical cancer. Conclusions: HPV testing alone for primary screening appears promising in women aged 30 years and older as this group is at greatest risk of developing CIN 3. As compared with Pap testing, HPV testing has greater sensitivity for detection of cervical intraepithelial neoplasia.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5594-5594
Author(s):  
Patrizia Serra ◽  
Dino Amadori ◽  
Oriana Nanni ◽  
Alessandra Gennari ◽  
Sara Bravaccini ◽  
...  

5594 Background: In Sub-Saharan Africa cervical cancer represents 24% of all cancers and accounts for 23% of all cancer deaths in women. An early diagnosis program for breast and cervical cancer (Vanda Project) is ongoing in Mwanza and the surrounding lake area (12 districts with a population of 14,000,000). The aim of this project was to screen women aged 15-64 years living in the 12 districts. Methods: Women were invited to participate through local media and a mobile unit operating within the districts. A multidisciplinary team including medical oncologists was involved. Interventions consisted in Pap smear, clinical breast examination, breast self-examination training and training of district physicians to perform Pap smear and breast examination. Results: From May to December 2012, 2155 women from the districts of Shinyanga, Bukumbi, Kibara, Serengema and Musoma took part in the program: of these 91 (4%) had clinically evident cervical cancer. Age distribution classes were: < 18 years, 12% ; 18-35, 38%; 36-50, 41%; > 50, 9%. As expected a high stage distribution at diagnosis was observed: 30% stage III and 20% stage IV. Among the women with no clinical evidence of cancer, 408 samples were analyzed by cytology and 4% consisted of inadequate material. Of the remaining 392 samples, 85 (22%) were normal, 216 (55%) were infections (chiefly mycotic), 72 (18%) were precancerous lesions (50% H-SIL according to Bethesda classification) and 19 (5%) were positive for cancer (mainly stages III-IV). Precancerous lesions turned out to be cancer at histology in 44% of cases. 22% of precancerous lesions and 8% of clinically evident cancer were HIV-positive. Conclusions: This experience shows the high feasibility, good compliance and usefulness of a screening program for the early detection of cervical cancer in this high-risk population. [Table: see text]


2007 ◽  
Vol 23 (4) ◽  
pp. 213-227 ◽  
Author(s):  
F. Xavier Bosch ◽  
Silvia de Sanjosé

Cervical cancer has been recognized as a rare outcome of a common Sexually Transmitted Infection (STI). The etiologic association is restricted to a limited number of viral types of the family of the Human Papillomaviruses (HPVs). The association is causal in nature and under optimal testing systems, HPV DNA can be identified in all specimens of invasive cervical cancer. As a consequence, it has been claimed that HPV infection is a necessary cause of cervical cancer. The evidence is consistent worldwide and implies both the Squamous Cell Carcinomas (SCC), the adenocarcinomas and the vast majority (i.e. > 95%) of the immediate precursors, namely High Grade Squamous Intraepithelial Lesions (HSIL)/Cervical Intraepithelial Neoplasia 3 (CIN3)/Carcinomain situ. Co-factors that modify the risk among HPV DNA positive women include the use of oral contraceptives (OC) for five or more years, smoking, high parity (five or more full term pregnancies) and previous exposure to other sexually transmitted diseases such as Chlamydia Trachomatis (CT) and Herpes Simplex Virus type 2 (HSV-2). Women exposed to the Human Immunodeficiency Virus (HIV) are at high risk for HPV infection, HPV DNA persistency and progression of HPV lesions to cervical cancer.


2008 ◽  
Vol 122 (12) ◽  
pp. 2835-2841 ◽  
Author(s):  
Angel Chao ◽  
Kuang-Hung Hsu ◽  
Chyong-Huey Lai ◽  
Huei-Jean Huang ◽  
Swei Hsueh ◽  
...  

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Maria Lina Tornesello ◽  
Luigi Buonaguro ◽  
Paolo Giorgi-Rossi ◽  
Franco M. Buonaguro

Cervical cancer arises from cells localized in the ectoendocervical squamocolumnar junction of the cervix persistently infected with one of about 13 human papillomavirus (HPV) genotypes. The majority of HPV infections induces low grade squamous epithelial lesions that in more than 90% of cases spontaneously regress and in about 10% eventually progress to high grade lesions and even less frequently evolve to invasive cancer. Tumor progression is characterized by (1) increased expression of E6 and E7 genes of high risk HPVs, known to bind to and inactivate p53 and pRb oncosuppressors, respectively; (2) integration of viral DNA into host genome, with disruption of E2 viral genes and host chromosomal loci; and (3) molecular alterations of key regulators of cell cycle. Molecular markers with high sensitivity and specificity in differentiating viral infections associated with cellular abnormalities with high risk of progression are strongly needed for cervical cancer screening and triage. This review will focus on the analysis of clinical validated or candidate biomarkers, such as HPV DNA, HPV E6/E7 mRNA, HPV proteins, p16(INK4a) and Ki67, TOP2A and MCM2 cellular factors, and DNA methylation profiles, which will likely improve the identification of premalignant lesions that have a high risk to evolve into invasive cervical cancer.


2019 ◽  
Vol 31 (1) ◽  
pp. 15-20
Author(s):  
Nargis Zahan ◽  
Mosammat Nargis Shamima ◽  
Sharmin Sultana ◽  
Mohd Alamgir Hossain

Background: Cervical cancer is the second most common cancer in women throughout the world, and it is the leading cause of cancer death among women in underdeveloped countries like Bangladesh is preventable and curable if detected at and early stage using proper screening tools. This study was done to see the effectiveness of VIA and find out the CIN and introduce as a complementary to cytology for diagnosing precancerous form of cervix. Materials & Methods: A total 175 subjects were studied & relevant data of cervix related patients have been collected. The data regarding Pap smear, VIA and biopsy have been taken and collected data was analysis by SPSS. Results: Out of 175 Patients VIA positive 53 (30.3%), Pap smear reports, 84 (48.0%) had inflammatory findings and 38 (21.7%) had dysplasia and biopsy result 41(23.4%) CIN positive. Sensitivity of VlA was 90.2%, specificity 88.1%, PPV 69.8%, NPV 96.7% and accuracy 88.6%. Sensitivity of Pap smear reports was 80.5%, specificity 96.3%, PPV 86.8%, NPV 94.2% and accuracy 92.6%. Conclusion: Visual inspection of cervix after application of acetic acid (VIA) is valid as cytology test for the identification of pre-invasive cervical cancer (CIN). Thus VIA is a useful screening method of Cervical Intraepithelial Neoplasia lesion as Pap smear. TAJ 2018; 31(1): 15-20


Author(s):  
Devikala Kumaresan

Pap smear is the most widely used test for screening of cervical cancer and precancerous lesions. Liquid-based cytology is a cervical cancer screening technology that inspects cells by dissolving them in liquid and is used as a main screening tool for invasive cervical cancer. The purpose of this article is to demonstrate how fluid-based cytology has surpassed conventional cytology in the interpretation of cervical smear biopsy results in order to identify early cervical lesions in a more efficient and convenient manner, allowing for early diagnosis and treatment of cervical cancer patients and thus improving patient wellbeing.


Author(s):  
Mehak Reyaz ◽  
Nupur Nandi ◽  
Ritika Aggarwal

Background: Cervical cancer is the fourth most common cancer in women. In India and other developing countries cervical cancer is the leading cause of morbidity and mortality. Cancer cervix continues to be most common genital carcinoma in India accounting for 80% of all female genital malignancies. Pre-invase lesions can spontaneously regress to normal or remain stable for long period or progress to a higher degree of dysplasia. Cancer of cervix is preventable if diagnosed at the pre-invasive stage with regular intervals of cytological screening by Papanicolaou (Pap) smears. The aim of the study is to analyse the pap reports in terms of normal findings, infections, premalignant lesions and invasive cancers.Methods: All women attending the outpatient department gynaecology at TMMC and RC Moradabad, Uttar Pradesh over a period of 1 year from august 2017-18 presented of obstetrics and with white discharge per vagina were screened for cervical cancer using pap smear. All the smears were reported as per the 2014 Bethesda system.Results: Out of 1392 Pap smear reports ASCUS was reported in 27 cases (2%), LSIL in 27 cases (2%), HSIL in 15 cases (1%), malignant cells in 15 cases (1%) and normal including the infection is reported in 1308 cases (94%).Conclusions: Early cervical epithelial changes can be identified by a Pap smear test, which is the primary screening test for detection of precancerous cervical intraepithelial neoplasia and the early stage of invasive cervical cancer.


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