scholarly journals HPV sampling options for cervical cancer screening: preferences of urban-dwelling Canadians in a changing paradigm

2019 ◽  
Vol 27 (2) ◽  
Author(s):  
G.D. Datta ◽  
M.H. Mayrand ◽  
S. Qureshi ◽  
N. Ferre ◽  
L. Gauvin
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Online Survey ◽  
Invasive Cervical Cancer ◽  
Pap Test ◽  
The United States ◽  
Sample Collection ◽  
Policy Makers ◽  
Screening Behaviors

Fifty percent of women in Canada diagnosed with invasive cervical cancer have not been screened according to guidelines. Interventions involving HPV self-collected sampling could be a promising avenue to increase screening uptake. In order to guide the development of cervical cancer screening interventions, we assessed: 1) women’s preference for cervical cancer screening sample collection options, 2) sampling preferences according to previous screening behaviors, and 3) women’s preference for self-sampling according to their reasons for not being screened according to guidelines. Data were collected via an online survey (Montreal, QC 2016) and included information from female participants between the ages of 21 and 65 who had not had a hysterectomy and who had provided answers to survey questions on screening history, screening interval, and screening preferences (N=526). We observed that 68% of all women surveyed preferred screening via a self-sampled test. Among women born outside of Canada, the United States, or Europe, preference ranged from 47% to 60%. Nearly all women (95% - 100%), who reported fear or embarrassment, not liking undergoing a pap test, and both time- and geographic-related availability of screening as one of their reasons for not being screened stated a preference for undergoing screening via a self-sampled test. Policy-makers and researchers should consider if self-sample ought to be offered primarily to never or infrequently screened women, or be rolled out to all eligible women, and how best to integrate self-sampled screening into both organized and opportunistic screening contexts.

scholarly journals Reducing the Excess Burden of Cervical Cancer among Latinas

2013 ◽  
Vol 11 (1) ◽  
pp. 45-57 ◽  
Author(s):  
Lourdes Baezconde-Garbanati ◽  
Sheila T. Murphy ◽  
Meghan Bridgid Moran ◽  
Victoria K. Cortessis
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Los Angeles ◽  
Cervical Cancer Screening ◽  
Invasive Cervical Cancer ◽  
Pap Test ◽  
Barriers To Screening ◽  
Tailored Interventions ◽  
Health Promotion Interventions ◽  
Culturally Tailored Interventions

Purpose: Although deaths from cervical cancer are declining, Latinas are not benefiting equally in this decline. Incidence of invasive cervical cancer among Los Angeles’, California Latinas is much higher than among non-Latina Whites (14.7 versus 8.02 per 100,000). This paper examines cervical cancer screening among Latinas. Methods: Ninety-seven women of Mexican origin participated in 12 focus groups exploring barriers to screening. Saturation was reached. Results: All participants knew what a Pap test was and most knew its purpose. More acculturated participants understood the link between HPV and cervical cancer. More recent immigrants did not. There was confusion whether women who were not sexually active need to be screened. Most frequently mentioned barriers were lack of time and concern over missing work. Lower income and less acculturated women were less likely to be aware of free/lowcost clinics. Older and less acculturated participants held more fatalistic beliefs, were more embarrassed about getting a Pap test, were more fearful of being perceived as sexually promiscuous, and were more fearful of receiving disapproval from their husbands. Conclusions: Latinas are informed regarding cervical cancer screening; rather they encounter barriers such as a lack of time, money and support. Health promotion interventions can be enhanced via peer-to-peer education, by addressing barriers to cervical cancer screening with in-language, culturally tailored interventions, and working with clinics on systemic changes, such as extended clinic hours.

scholarly journals Point-Counterpoint: Cervical Cancer Screening Should Be Done by Primary Human Papillomavirus Testing with Genotyping and Reflex Cytology for Women over the Age of 25 Years

2015 ◽  
Vol 53 (9) ◽  
pp. 2798-2804 ◽  
Author(s):  
Mark H. Stoler ◽  
R. Marshall Austin ◽  
Chengquan Zhao
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Positive Likelihood Ratio ◽  
Pap Test ◽  
The United States ◽  
Primary Screening ◽  
Screening Algorithm ◽  
Hpv Test

Screening for cervical cancer with cytology testing has been very effective in reducing cervical cancer in the United States. For decades, the approach was an annual Pap test. In 2000, the Hybrid Capture 2 human papillomavirus (HPV) test was approved by the U.S. Food and Drug Administration (FDA) for screening women who have atypical squamous cells of underdetermined significance (ASCUS) detected by Pap test to determine the need for colposcopy. In 2003, the FDA approved expanding the use of the test to include screening performed in conjunction with a Pap test for women over the age of 30 years, referred to as “cotesting.” Cotesting allows women to extend the testing interval to 3 years if both tests have negative results. In April of 2014, the FDA approved the use of an HPV test (the cobas HPV test) for primary cervical cancer screening for women over the age of 25 years, without the need for a concomitant Pap test. The approval recommended either colposcopy or a Pap test for patients with specific high-risk HPV types detected by the HPV test. This was based on the results of the ATHENA trial, which included more than 40,000 women. Reaction to this decision has been mixed. Supporters point to the fact that the primary-screening algorithm found more disease (cervical intraepithelial neoplasia 3 or worse [CIN3+]) and also found it earlier than did cytology or cotesting. Moreover, the positive predictive value and positive-likelihood ratio of the primary-screening algorithm were higher than those of cytology. Opponents of the decision prefer cotesting, as this approach detects more disease than the HPV test alone. In addition, the performance of this new algorithm has not been assessed in routine clinical use. Professional organizations will need to develop guidelines that incorporate this testing algorithm. In this Point-Counterpoint, Dr. Stoler explains why he favors the primary-screening algorithm, while Drs. Austin and Zhao explain why they prefer the cotesting approach to screening for cervical cancer.

scholarly journals Persistent Disparities in Cervical Cancer Screening Uptake: Knowledge and Sociodemographic Determinants of Papanicolaou and Human Papillomavirus Testing Among Women in the United States

2020 ◽  
Vol 135 (4) ◽  
pp. 483-491
Author(s):  
Nicole L. Johnson ◽  
Katharine J. Head ◽  
Susanna Foxworthy Scott ◽  
Gregory D. Zimet
Keyword(s):  
United States ◽  
Cervical Cancer ◽  
Health Insurance ◽  
Human Papillomavirus ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Test ◽  
The United States ◽  
Populations At Risk ◽  
Hpv Test

Objectives Cervical cancer is the second-most common type of cancer among women aged 15-44, and racial, ethnic, and economic disparities exist in survival rates despite widely available screening tests and early treatment options. The objective of this study was to describe the association among knowledge, sociodemographic characteristics, and cervical cancer screening, with the goal of developing interventions to prevent cervical cancer in populations at risk of the disease. Methods In 2017, we conducted a nationwide survey of women in the United States aged ≥18 who had ever received a Papanicolaou (Pap) test (N = 630). We conducted t tests and one-way analysis of variance to determine sociodemographic differences (age, education, race, ethnicity, income, type of health insurance) in knowledge about cervical cancer screening (Pap test and human papillomavirus [HPV] test). We used logistic regressions to define significant determinants of cervical cancer screening behaviors in the previous 5 years. Results Of 629 respondents, 407 (64.7%) had an annual household income <$30 000, and 322 of 536 (60.1%) respondents had government-provided health insurance. Of 630 women who had ever had a Pap test, 425 (67.5%) had an HPV test. Hispanic and non-Hispanic white women were more likely than Hispanic and non-Hispanic black women (odds ratio [OR] = 2.49; 95% CI, 1.12-4.54; P = .02) and women with government-provided health insurance (OR = 1.91; 95% CI, 1.08-3.37; P = .03) were more likely than women with private health insurance to have received a Pap test in the previous 5 years. Knowledge of HPV was a significant predictor of having received an HPV test in the previous 5 years (OR = 1.37; 95% CI, 1.22-1.54; P < .001). Conclusion Disparities in cervical cancer screening among sociodemographic groups of women suggest the need for targeted interventions to improve knowledge about Pap and HPV tests.

Glandular Lesions of the Cervix in Clinical Practice: A Cytology, Histology, and Human Papillomavirus Correlation Study From 2 Institutions

2015 ◽  
Vol 139 (11) ◽  
pp. 1431-1436 ◽  
Author(s):  
Ross A. Miller ◽  
Dina R. Mody ◽  
Kimberlee C. Tams ◽  
Michael J. Thrall
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Test ◽  
The United States ◽  
Adenocarcinoma In Situ ◽  
Screening Techniques ◽  
Detection Failure

ContextThe Papanicolaou (Pap) test has indisputably decreased cervical cancer mortality, as rates have declined by up to 80% in the United States since its implementation. However, the Pap test is considered less sensitive for detecting glandular lesions than for detecting those of squamous origin. Some studies have even suggested an increasing incidence of cervical adenocarcinoma, which may be a consequence of a relatively reduced ability to detect glandular lesions with cervical cancer screening techniques.ObjectiveTo evaluate the detection rate of glandular lesions with screening techniques currently used for cervical cancer screening and to provide insight as to which techniques are most efficacious in our study population.DesignWe retrospectively reviewed any available cytology, human papillomavirus (HPV), and histologic malignancy data in patients diagnosed with adenocarcinoma in situ and adenocarcinoma from 2 geographically and socioeconomically disparate hospital systems. Identified patients having had a negative/unsatisfactory Pap test within 5 years of adenocarcinoma in situ or adenocarcinoma tissue diagnosis were considered Pap test screening failures. Patients with negative HPV tests on cytology samples were considered HPV screening failures.ResultsOne hundred thirty cases were identified (age range, 22–93 years); 39 (30%) had no Pap history in our files. Eight of 91 remaining cases (8.8%) were screening failures. The detected sensitivity for identifying adenocarcinoma in situ/adenocarcinoma in this study was 91.2% by cytology alone and 92.3% when incorporating HPV testing. The most common cytologic diagnosis was atypical glandular cells (25 cases), and those diagnosed with adenocarcinoma were 7.4 years older than those diagnosed with adenocarcinoma in situ (50.3 versus 42.9 years). Nine of 24 HPV-tested cases (37.5%) were called atypical squamous cell of undetermined significance on cytology.ConclusionsOur results highlight the importance of combined Pap and HPV cotesting. Although the number of cases identified is relatively small, our data suggest screening for squamous lesions facilitates the recognition of glandular lesions in the cervix. Additionally, increased use of combined Pap and HPV cotesting may decrease detection failure rates with regard to glandular lesions.

scholarly journals Primary High-Risk Human Papillomavirus Testing for Cervical Cancer Screening in the United States: Is It Time?

2018 ◽  
Vol 142 (6) ◽  
pp. 688-692 ◽  
Author(s):  
Melina B. Flanagan
Keyword(s):  
United States ◽  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Test ◽  
The United States ◽  
Screening Methods ◽  
Hpv Testing ◽  
Screening Guidelines

Context.— The most recent update to cervical cancer screening guidelines offers interim guidance on the use of primary human papillomavirus (HPV) screening, with algorithms for management of results. After decades of screening with pure cytology and a shorter time with adjunctive HPV or cotesting with Papanicolaou (Pap) test and HPV, this is a significant change to our screening methods. Objective.— To briefly review the history of cervical cancer screening, the evidence upon which these interim guidelines were based, the arguments for and against primary HPV testing, and the current state of the field. Data Sources.— Primary studies, review articles, and commentaries were reviewed. Conclusions.— While there is evidence both for and against primary HPV testing, there are a growing number of countries adopting the practice. It would be worthwhile to be informed and prepared for such a change in the United States as well.

scholarly journals Sociodemographic Factors Associated With HPV Awareness/Knowledge and Cervical Cancer Screening Behaviors Among Caregivers in the US

2021 ◽  
Author(s):  
Jiyeong Kim ◽  
Melanie Dove ◽  
Julie HT Dang
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Family Caregivers ◽  
Cervical Cancer Screening ◽  
The United States ◽  
Sociodemographic Factors ◽  
Screening Guidelines ◽  
Factors Associated ◽  
Screening Behaviors ◽  
Hpv Awareness

Abstract Background. Family caregivers may be at a higher risk for several chronic diseases including cancer. Cervical cancer is one of the most prevalent cancers among U.S. women. Despite family caregivers’ vulnerability, the status of their HPV awareness, knowledge, and preventive health behaviors, including cervical cancer screening, have been understudied. Thus, this study aimed to examine the sociodemographic factors associated with HPV awareness and knowledge, and adherence to the cervical cancer screening guidelines among caregivers in the U.S. Methods. Nationally representative cross-sectional survey data were obtained from the Health Information National Trends Survey (HINTS 5, 2017-2020). Only female caregivers, aged 21-65, were included (N= 834). Weighted multivariate logistic regression was performed to identify factors associated with HPV awareness, knowledge, and adherence to the United States Preventive Service Task Force cervical cancer screening guidelines (by age, race/ethnicity, education, household income, marital status, employment status, and health insurance type). Results. Caregivers who were older (aged 51-65 vs. 21-50), were less educated (high school graduate or less vs. some college or more) showed lower adherence to the cervical cancer screening guidelines (every 3 years) than their counterparts. Caregivers who were older and less educated showed lower HPV awareness (Heard of HPV).Conclusions. There are caregiving populations whose HPV awareness, knowledge and cervical cancer screening adherence are low. To improve their awareness and knowledge of HPV and support their cervical cancer screening behaviors, we need to consider interventions that target those specific populations.

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.

'Have a Pap smear!' – doctors, their clients, and opportunistic cervical cancer screening

2005 ◽  
Vol 16 (3) ◽  
pp. 233-236 ◽  
Author(s):  
L C Chingang ◽  
U Bischof ◽  
G Andall-Brereton ◽  
O Razum
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Smear ◽  
Cervical Screening ◽  
Pap Test ◽  
Community Members ◽  
Middle Income ◽  
Middle Income Countries ◽  
High Incidence

In many middle-income countries with a high incidence of cervical cancer, organized screening programmes with the Pap test are being planned. We assessed the knowledge of, and attitudes towards, cervical screening among 63 doctors and 102 randomly selected community members in Trinidad where screening is still opportunistic. Doctors were well informed about cervical cancer, but not all knew the approximate specificity of the Pap test. Many did not routinely discuss the benefits and disadvantages of screening with their clients. Most women had heard of the Pap test, but only 56% knew its purpose; 25% would not participate in screening, stating reasons such as being in menopause or not having symptoms. More information about the aim of screening and the purpose of the Pap test must be communicated. Doctors need to keep their knowledge on screening up-to-date, and offer counselling that helps women to make an informed decision whether or not to participate in screening.

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