Liquid-Based Screening Tests Results: HPV, Liquid-Based Cytology, and P16/Ki67 Dual-Staining in Private-Based Opportunistic Cervical Cancer Screening

The baseline data from the private-based opportunistic cervical cancer screening with HRHPV14, liquid-based cytology (LBC) and p16/Ki67 testing, and its quality assessment/quality control (QA/QC) tools are lacking. The age-stratified analysis of 30,066 screening tests results in a Polish population, including the investigation of HRHPV14 status, LBC, and p16/Ki67 dual-staining reporting rates, along with immediate histopathologic correlations, was conducted. For cytopathologic QA/QC, the College of American Pathologists (CAP) benchmarks and enhanced safety protocol were used. The NILM/ASC-US/LSIL/ASC-H/HSIL/AGC reporting rates were 93.9/3.4/2.0/0.22/0.24/0.11, respectively, with correlating HRHPV14-positive rates of 8.4/48.9/77.2/84.6/90.7/26.7. The reporting rates for HSIL (CIN2+) in HRHPV-positive women with NILM/ASC-US/LSIL/ASC-H/HSIL/AGC referred for a colposcopy with biopsy were 19.1/25.8/22.5/12.4/19.1/1.1% of the total HSIL (CIN2+). In total, of the 1130 p16/Ki67 tests, 30% were positive. In NILM HRHPV14-positive women with available histology result, HSIL(CIN2+) was detected in 28.3% of cases. In the first such large-scale Polish study presenting HRHPV14, informed LBC and HSIL (CIN2+) results, the reporting rates were highly consistent with data from American and other CAP-certified laboratories, confirming the possibility of using the 2019 ASCCP risk-based guidelines as one of the screening strategies outside of the US, in conditions of proper QA/QC. The private-based screening model can be effective in cervical cancer prevention, particularly in countries with low population coverage of public funds-based systems.

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Precision Prevention: The 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors

Journal of Molecular Pathology ◽

10.3390/jmp2030023 ◽

2021 ◽

Vol 2 (3) ◽

pp. 274-280

Author(s):

Ritu Nayar

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cancer Prevention ◽

Cervical Cancer Screening ◽

Hpv Vaccination ◽

Management Strategies ◽

Hpv Infection ◽

Cervical Cancer Prevention ◽

Screening Tests ◽

Consensus Guidelines

The approach to cervical cancer prevention has evolved significantly over the past two decades. HPV immunization has decreased the specificity of screening modalities and HPV-based testing has been replacing our previously successful morphology-only approach. Additionally, there is much more emphasis on providing precision prevention, rather than the previously used “one-fits-all” management strategies. A number of new biomarkers are entering clinical practice and being integrated into cervical cancer screening and management in order to enable a more personalized assessment of the risk for precancer/cancer for an individual patient. The 2019 ASCCP Risk-Based Management Consensus Guidelines expand on the concept of “equal management for equal risk”. They consider a patient’s history in addition to current test results to provide recommendations for increased surveillance/treatment in patients at higher risk for CIN3+ while minimizing interventions for lower-risk patients who have new versus persistent HPV infection. Clinical management decisions are based on immediate risk and 5-year risk estimates for CIN3+, which are determined by referencing an extensive risk table compiled by the National Cancer Institute (NCI). The course of action for a given patient is recommended by comparison of the risk in the risk database, to the predetermined clinical action thresholds. These guidelines address the need for simplification and offer some stability for the provider while being conducive to the incorporation of anticipated continued technologic advances in methods for cervical cancer prevention. Their enduring nature will allow for changes needed based on risk reduction as HPV vaccination uptake increases and vaccinated women reach screening age. Similarly, the design allows for the addition of new tests into the risk assessment calculations after their approval by applicable regulatory agencies and review/consensus approval by the ASCCP new technology and enduring guidelines workgroups. As cytopathologists, we must be familiar with the scientific advancements in primary and secondary prevention, evolving screening and management guidelines, and participate actively in the multidisciplinary approach for the prevention of cervical cancer.

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The Influence of Health Literacy on Knowledge of Cervical Cancer Prevention and Screening Practices among Female Undergraduates at a University in Southwest Nigeria

Africa Journal of Nursing and Midwifery ◽

10.25159/2520-5293/6615 ◽

2020 ◽

Vol 22 (1) ◽

Author(s):

Sunday Joseph Ayamolowo ◽

Lydia Feyisayo Akinrinde ◽

Monisola Omoyeni Oginni ◽

Love Bukola Ayamolowo

Keyword(s):

Cervical Cancer ◽

Health Literacy ◽

Cancer Screening ◽

Cancer Prevention ◽

Cervical Cancer Screening ◽

Low Income ◽

Cervical Cancer Prevention ◽

Screening Practices ◽

Cancer Prevention And Screening ◽

Southwest Nigeria

The global incidence of cancer is rising, and low-income and lower-middle-income countries have the worst figures. However, knowledge of cervical cancer prevention and cervical cancer screening practices remains poor in these regions. This study assessed the concept of health literacy as a potential determinant of knowledge of cervical cancer prevention and screening practices among female undergraduates. A descriptive cross-sectional study was conducted among 385 female undergraduates at a university in southwest Nigeria. A validated questionnaire composed of subscales on nine components of health literacy, knowledge of cervical cancer prevention, and cervical cancer screening practices was used for data collection. The majority of the respondents obtained a high score on most of the components of health literacy and 66% had good knowledge of cervical cancer prevention. Only 11% demonstrated good practices of Pap smear testing. Of all the components of health literacy, “feeling understood and supported by healthcare providers” (OR = 0.075; 95% CI [0.036–0.115]; p = 0.015) and “understanding health information well enough to know what to do” (OR = 0.055; 95% CI [0.006–0.104]; p = 0.029) were significantly associated with knowledge of cervical cancer prevention. Out of the major challenges related to cervical cancer screening among undergraduates, the feeling of being at risk (OR = 4.71; p < 0.05) and uncomfortable experiences from past screening (OR = 0.12; p < 0.05) were significantly associated with going for cervical cancer screening. The study concluded that levels of health literacy influenced knowledge of cervical cancer prevention among female undergraduates, but it did not affect their engagement in cervical cancer screening practices.

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A new method to address verification bias in studies of clinical screening tests: cervical cancer screening assays as an example

Journal of Clinical Epidemiology ◽

10.1016/j.jclinepi.2013.09.013 ◽

2014 ◽

Vol 67 (3) ◽

pp. 343-353 ◽

Cited By ~ 9

Author(s):

Xiaonan Xue ◽

Mimi Y. Kim ◽

Philip E. Castle ◽

Howard D. Strickler

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

New Method ◽

Screening Tests ◽

Clinical Screening ◽

Verification Bias ◽

Screening Assays

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A Comparison of Liquid-Based Cytology with Conventional Cytology in Cervical Cancer Screening

Acta Cytologica ◽

10.1159/000337641 ◽

2012 ◽

Vol 56 (4) ◽

pp. 370-374 ◽

Cited By ~ 25

Author(s):

Setsu Akamatsu ◽

Shoji Kodama ◽

Yukari Himeji ◽

Naomi Ikuta ◽

Nikako Shimagaki

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Conventional Cytology ◽

Liquid Based Cytology

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Accuracy of Visual Tests for Primary Cervical Cancer Screening in Rural Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.3857 ◽

2018 ◽

Vol 56 (214) ◽

pp. 917-923

Author(s):

Niresh Thapa ◽

Muna Maharjan ◽

Girishma Shrestha ◽

Narayani Maharjan ◽

Deborah Lindell ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Negative Predictive Value ◽

Cervical Cancer Screening ◽

Predictive Value ◽

Odds Ratio ◽

Screening Program ◽

Diagnostic Odds Ratio ◽

Screening Tests ◽

Resource Setting

Introduction: In Nepal, cervical cancer is the most common female cancer. Unfortunately, there is no uniform effective screening system available all around the country. The objective of this study is to evaluate the cytology, Visual Inspection with Acetic Acid and with Lugol’s Iodine alone or in combination to detect a pre-cancerous lesion in rural Nepal.Methods: It is an analytical cross-sectional study. Convenience sampling technique was used to select participants who were apparently healthy, married, non- pregnant women of aged 20-65 years for cervical cancer screening program. Screening tests were performed on all eligible women (n=2143) after socio-demographic and reproductive health data collection. A biopsy was applied as a gold standard test. Cross-tabulations were used to describe the test sensitivity, specificity, positive predictive value, and negative predictive value at a 95% confidence interval. Diagnostic odds ratio was also calculated. Results: A majority, 2143 (94%), of women accepted and participated in this study. The sensitivity vs specificity of cytology, VIA, and VILI was 57.1% vs 98.3%, 71.4% vs 88.8% and 78.6% vs 85.1%, and of the co-testing of ‘Both positive VIA and VILI’ and ‘Either positive VIA or VILI’ was 64.3% vs 85.7% and 90.1% vs 83.7% respectively. Negative predictive value of all tests exceeded 99.7%. Cytology had the highest Diagnostic odds ratio (64.9), followed by the co-test ‘Either positive VIA or VILI’ (27.7).Conclusions: Cervical cancer screening by co-testing ‘Either positive VIA or VILI’ is more useful than cytology; VIA and or VILI are easy, safe, feasible and well-accepted tests in a low resource setting, Nepal.

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