scholarly journals The status of cervical cytology in Swaziland, Southern Africa: A descriptive study

CytoJournal ◽  
2009 ◽  
Vol 6 ◽  
pp. 14 ◽  
Author(s):  
Sylvain Okonda ◽  
Colleen Wright ◽  
Pam Michelow
Keyword(s):  
Cervical Cancer ◽  
Cervical Screening ◽  
Cervical Cytology ◽  
Current Status ◽  
Low Grade ◽  
Squamous Intraepithelial Lesions ◽  
Squamous Cells ◽  
Incidence And Mortality ◽  
Intraepithelial Lesions ◽  
Hiv Aids

Background: Cancer of the cervix is the most common cancer in women in Swaziland where most women never undergo cervical screening. The extremely high prevalence of HIV/AIDS in Swaziland complicates the management of preinvasive and invasive cervical cancer. The purpose of this study was to assess the current status of cervical cytology in Swaziland, its strengths and limitations. Methods: The study is a retrospective review of 12,188 conventional cervical smears received by the Central Public Health Laboratory in Swaziland from June 2004 to May 2006. Results: Review of results showed very high rates of cytologic abnormalities with 43.2% of smears screened reported as abnormal. The percentages of abnormalities were as follows: atypical squamous cells of undermined significance (ASC-US), 19.8%; atypical squamous cells, cannot exclude HSILs (ASC-H), 8.8%; low-grade squamous intraepithelial lesions (LSIL), 9.0%; high-grade squamous intraepithelial lesions (HSIL), 4.6%; squamous cell carcinomas, 0.5%; atypical endocervical cells, 0.6%; and atypical endometrial cells, 0.4%. Just over 5% of smears were inadequate. The highest rates of HSILs and invasive squamous carcinoma occurred in women aged 50–59 years. Conclusions: This study underscores the need to reduce the incidence of cervical cancer and its precursor lesions in Swaziland women. Based on studies of human papillomavirus (HPV) types in other Southern African countries, current HPV vaccines would reduce the incidence and mortality from cervical cancer in the future, but cervical screening would still be required, both for women already infected with the HPV and for HPV subtypes not covered by current vaccines. The most cost-effective combination of screening modalities such as visual inspection, HPV DNA testing, and cytology should be investigated. Cervical cancer reduction needs to be managed within the greater framework of the HIV/AIDS epidemic.

scholarly journals Colposcopy, cervical cytology and human papillomavirus detection as screening tools for cervical cancer

2001 ◽  
Vol 7 (1-2) ◽  
pp. 100-105
Author(s):  
Al Alwan Al Alwan
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Pap Test ◽  
Screening Tools ◽  
Low Grade ◽  
Squamous Intraepithelial Lesions ◽  
Sampling Device ◽  
Squamous Cells ◽  
The Bethesda System ◽  
Intraepithelial Lesions

A cohort of 77 women referred for routine screening or investigation of Pap test abnormality underwent colposcopic examination. Pap-stained liquid-based preparations were diagnosed and categorized according to the Bethesda system. Residual material on the sampling device was used to detect high-risk oncogenic human papillomavirus DNA. Although the colposcopic failure rate was higher than that of cytology, no lesion was missed when both methods were used together. High-risk types were recorded in 24% of patients with atypical squamous cells of undetermined significance, 45% with low-grade squamous intraepithelial lesions and 79% with high-grade squamous intraepithelial lesions-indicating that the efficacy of cytological screening can be improved by papillomavirus detection.

scholarly journals The effectiveness of acetic acid wash protocol and the interpretation patterns of blood contaminated cervical cytology ThinPrep® specimens

CytoJournal ◽  
2015 ◽  
Vol 12 ◽  
pp. 23 ◽  
Author(s):  
Nora K. Frisch ◽  
Yasin Ahmed ◽  
Seema Sethi ◽  
Daniel Neill ◽  
Tatyana Kalinicheva ◽  
...  
Keyword(s):  
Acetic Acid ◽  
Statistical Significance ◽  
Cervical Cytology ◽  
Low Grade ◽  
Squamous Intraepithelial Lesions ◽  
Chi Square ◽  
Chi Square Test ◽  
Acid Wash ◽  
The Difference ◽  
Intraepithelial Lesions

Background: ThinPrep® (TP) cervical cytology, as a liquid-based method, has many benefits but also a relatively high unsatisfactory rate due to debris/lubricant contamination and the presence of blood. These contaminants clog the TP filter and prevent the deposition of adequate diagnostic cells on the slide. An acetic acid wash (AAW) protocol is often used to lyse red blood cells, before preparing the TP slides. Design: From 23,291 TP cervical cytology specimens over a 4-month period, 2739 underwent AAW protocol due to initial unsatisfactory smear (UNS) with scant cellularity due to blood or being grossly bloody. Randomly selected 2739 cervical cytology specimens which did not undergo AAW from the same time period formed the control (non-AAW) group. Cytopathologic interpretations of AAW and non-AAW groups were compared using the Chi-square test. Results: About 94.2% of the 2739 cases which underwent AAW were subsequently satisfactory for evaluation with interpretations of atypical squamous cells of undetermined significance (ASCUS) 4.9% (135), low-grade squamous intraepithelial lesions (LSIL) 3.7% (102), and high-grade squamous intraepithelial lesions (HSIL) 1% (28). From the 2739 control cases, 96.3% were satisfactory with ASCUS 5.5% (151), LSIL 5.1% (139), and HSIL 0.7% (19). The prevalence of ASCUS interpretations was similar (P = 0.33). Although there were 32% more HSIL interpretations in the AAW group (28 in AAW vs. 19 in non-AAW), the difference was statistically insignificant (P = 0.18). AAW category; however, had significantly fewer LSIL interpretations (P = 0.02). The percentage of UNS cases remained higher in the AAW group with statistical significance (P < 0.01). Conclusions: While AAW had a significantly higher percent of UNS interpretations, the protocol was effective in rescuing 94.2% of specimens which otherwise may have been reported unsatisfactory. This improved patient care by avoiding a repeat test. The prevalence of ASCUS and HSIL interpretations between AAW and non-AAW groups were comparable. Though not statistically significant, HSIL interpretations were relatively higher in the AAW group. LSIL interpretations showed lower prevalence in AAW group.

scholarly journals Regulation of cell cycles is of key importance in human papillomavirus (HPV)-associated cervical carcinogenesis

2003 ◽  
Vol 121 (3) ◽  
pp. 128-132 ◽  
Author(s):  
Sylvia Michelina Fernandes Brenna ◽  
Kari Juhani Syrjänen
Keyword(s):  
Cell Cycle ◽  
Cervical Cancer ◽  
Human Papillomavirus ◽  
High Risk ◽  
Cell Cycle Checkpoints ◽  
Low Grade ◽  
Clinical Progression ◽  
Squamous Intraepithelial Lesions ◽  
High Risk Hpv ◽  
Intraepithelial Lesions

The rapid progress in molecular biology has allowed the identification of the genes involved in different functions of normal cells and has also improved our understanding of the mechanisms of human carcinogenesis. The human papillomavirus (HPV) is a small double-stranded DNA tumor virus and its genes can manipulate cell cycle control to promote viral persistence and replication. The E6 and E7 proteins of high-risk HPV bind to cell cycle regulatory proteins and interfere with both G1/S and G2/M cell cycle checkpoints much more effectively than the low-risk HPV. The difference between the ability of low and high-risk HPV types to induce immortalization and transformation may well lie in their abilities to interact with the various cell cycle components, resulting in the loss of multiple cell cycle checkpoints, which are important in host genome fidelity, thus potentially resulting in accumulation of genetic abnormalities. Cervical cancer is one of the leading malignancies in women worldwide, with substantial morbidity and mortality. According to current concepts, HPV is recognized as the single most important causal agent in the pathogenesis of this cancer. HPV infection clearly precedes the development of malignancy, while being regularly associated with cervical cancer precursor lesions (all grades of squamous intraepithelial lesions). HPV-infected low-grade squamous intraepithelial lesion (SIL) has three possible outcomes: a) it may regress; b) it can persist; or c) it can make a clinical progression to in situ or invasive carcinoma. It has been well established by prospective cohort studies that the spontaneous regression rate increases in parallel with follow-up duration. In contrast, the clinical progression of lesions usually takes place quite rapidly, i.e. during the first two years from diagnosis. The mechanisms responsible for this divergent clinical behavior of HPV-associated squamous intraepithelial lesions are largely unknown, but currently under intense study in different laboratories worldwide.

scholarly journals Human papillomaviruses: The cervical cancer saga in developing countries

2017 ◽  
Vol 11 (11) ◽  
pp. 819-825 ◽  
Author(s):  
Fatimah Saeed Alhamlan ◽  
Mohammed N A AlAhdal ◽  
Ali S Al-Zahrani ◽  
Shaihana A Almatrrouk
Keyword(s):  
Cervical Cancer ◽  
Developing Countries ◽  
Cervical Screening ◽  
Hpv Vaccination ◽  
National Level ◽  
Human Papillomaviruses ◽  
World Health ◽  
Current Status ◽  
Vaccination Programs ◽  
Incidence And Mortality

Cervical cancer is the fourth most common cancer affecting women, with worldwide annual incidence and mortality rates of 528,000 and 266,000, respectively, according to the World Health Organization. It is well established that cervical cancer is predominantly caused by a persistent human papillomavirus (HPV) infection of cervical cells. Increasing numbers of studies have investigated HPV and cervical cancer, contributing greatly to the global knowledge and unraveling some of the critical questions regarding HPV transmission, infection, and prevention. However, despite these studies, our knowledge is far from complete and much remains to be discovered. Although molecular detection and HPV prophylactic approaches have greatly advanced in recent years, approximately 85% of the global burden of mortality from cervical cancer still occurs in developing countries. Clinical and molecular epidemiological studies have demonstrated a need for developing countries in general to adopt cervical screening and vaccination programs. However, studies examining cervical cancer screening modalities and HPV prevalence as well as whether HPV vaccination programs should be implemented are lacking at the national level in some developing countries. Therefore, this review describes the current status of HPV in developing countries, presenting some of the existing challenges in implementing cervical screening and HPV vaccination programs.

scholarly journals Critical Analyses of the Introduction of Liquid-Based Cytology in a Public Health Service of the State of São Paulo, Brazil

2015 ◽  
Vol 59 (3) ◽  
pp. 273-277 ◽  
Author(s):  
Adhemar Longatto-Filho ◽  
José Eduardo Levi ◽  
Toni Ricardo Martins ◽  
Diane Cohen ◽  
Lise Cury ◽  
...  
Keyword(s):  
Public Health ◽  
Sao Paulo ◽  
The State ◽  
Low Grade ◽  
High Grade ◽  
São Paulo ◽  
Squamous Intraepithelial Lesions ◽  
Squamous Cells ◽  
Liquid Based Cytology ◽  
Intraepithelial Lesions

Objective: The aim of this study was to compare the performance of the current conventional Pap smear with liquid-based cytology (LBC) preparations. Study Design: Women routinely undergoing their cytopathological and histopathological examinations at Fundação Oncocentro de São Paulo (FOSP) were recruited for LBC. Conventional smears were analyzed from women from other areas of the State of São Paulo with similar sociodemographic characteristics. Results: A total of 218,594 cases were analyzed, consisting of 206,999 conventional smears and 11,595 LBC. Among the conventional smears, 3.0% were of unsatisfactory preparation; conversely, unsatisfactory LBC preparations accounted for 0.3%. The ASC-H (atypical squamous cells - cannot exclude high-grade squamous intraepithelial lesion) frequency did not demonstrate any differences between the two methods. In contrast, the incidence of ASC-US (atypical squamous cells of undetermined significance) was almost twice as frequent between LBC and conventional smears, at 2.9 versus 1.6%, respectively. An equal percentage of high-grade squamous intraepithelial lesions were observed for the two methods, but not for low-grade squamous intraepithelial lesions, which were more significantly observed in LBC preparations than in conventional smears (2.2 vs. 0.7%). The index of positivity was importantly enhanced from 3.0% (conventional smears) to 5.7% (LBC). Conclusions: LBC performed better than conventional smears, and we are truly confident that LBC can improve public health strategies aimed at reducing cervical lesions through prevention programs.

Sign in / Sign up

Export Citation Format

Share Document