Cervical Cytology–Histology Correlation Based on the American Society of Cytopathology Guideline (2017) at the Russian National Medical Research Center for Obstetrics, Gynecology, and Perinatology

Recent evidence suggests that a cytology–histology correlation (CHC) with discrepancy detection can both evaluate errors and improve the sensitivity and specificity of the cytologic method. We aimed to analyze the errors in cytologic–histologic discrepancies according to the CHC protocol guideline of the American Society of Cytopathology (2017). This retrospective study included 273 patients seen at the National Medical Research Center of Obstetrics, Gynecology and Perinatology (Moscow, Russia) between January 2019 and September 2021. The patients’ mean age was 34 ± 8.1 years. The cytology–histology agreement was noted in 158 cases (57.9%). Major discrepancies were found in 21 cases (7.6%), while minor discrepancies were noted in 93 cases (34.1%). The reason for 13 (4.8%) discrepancies was a colposcopy sampling error and, in 46 (16.8%) cases, the reason was a Papanicolaou (PAP) test sampling error. The discrepancy between primary and reviewed cytology was due interpretive errors in 13 (4.8%) cases and screening errors in 42 (15.4%) cases. We demonstrated that the ASC guidelines facilitate cervical CHC. A uniform application of these guidelines would standardize cervical CHCs internationally, provide a scope for the inter-laboratory comparison of data, and enhance self-learning and peer learning.

Reduction in Standard Cancer Screening in 2020 throughout the U.S.

Cancer screening is an important way to reduce the burden of cancer. The COVID-19 pandemic created delays in screening with the potential to increase cancer disparities in the United States (U.S.). Data from the 2014–2020 Behavioral Risk Factor Surveillance System (BRFSS) survey were analyzed to estimate the percentages of adults who reported cancer screening in the last 12 months consistent with the U.S. Preventive Services Task Force (USPSTF) recommendation for cervical (ages 21–65), breast (ages 50–74), and colorectal cancer (ages 50–75) prior to the pandemic. Cancer screening percentages for 2020 (April–December excluding January–March) were compared to screening percentages for 2014–2019 to begin to look at the impact of the COVID-19 pandemic. Screening percentages for 2020 were decreased from those for 2014–2019 including several underserved racial groups. Decreases in mammography and colonoscopy or sigmoidoscopy were higher among American Indian/Alaskan Natives, Hispanics, and multiracial participants, but decreases in pap test were also highest among Hispanics, Whites, Asians, and African-Americans/Blacks. Decreases in mammograms among women ages 40–49 were also seen. As the 2020 comparison is conservative, the 2021 decreases in cancer screening are expected to be much greater and are likely to increase cancer disparities substantially.

Family-Centered Sexual Health Intervention to Promote Cervical Cancer Screening Uptake Among Low-income Rural Women in India: A Community-Based Protocol study (Preprint)

BACKGROUND Human papillomavirus (HPV) is the primary cause of cervical cancer, which is preventable through screening and early treatment. The Papanicolaou (Pap) test and visual inspection with acetic acid (VIA), traditionally performed at the clinical setting, have been used effectively to screen for cervical cancer and pre-cancerous changes, and reduce cervical cancer mortality in high-income countries for many decades. However, these screening methods are not easily accessible to women living in low- and middle- income countries (LMIC), especially women living in rural areas. OBJECTIVE Preventing Cervical Cancer in India through Self-Sampling (PCCIS) is a community-based family-centered research project that aims to reduce avoidable cervical cancer disparities in rural area in India. The project will use HPV self-sampling, supported by a sexual health literacy intervention to increase rural women’s participation in cervical cancer screening. The objectives are to determine the effectiveness of this program in: (a) increasing sexual health literacy; (b) reducing gendered stigma of HPV and cervical cancer; (c) promoting cervical cancer screening using HPV self-sampling. METHODS We will recruit 120 women aged 30-69, who are under or never screened (UNS) for cervical cancer along with 120 supportive male relatives or friends from 3 impoverished rural / tribal villages in Palghar district in the state of Maharashtra, India. Participants will attend gender-specific sexual health education (SHE) followed by a Movie Matinee. Data will be collected though an interviewer-administered questionnaire before and after SHE. The questionnaire will include items on social demographics, medical history, attitudes, sexual health stigma, cervical cancer knowledge, and screening practices. Women will self-select whether to use HPV self-sampling. Those who do not may or may not undergo Pap test/VIA. Participants’ views regarding barriers and facilitators and suggestions to improve access and uptake will also be elicited. RESULTS PCCIS was funded in January 2020 for 15 months. Due to the COVID19 pandemic, the project was extended by one year. The protocol was approved by the research ethics boards of Ryerson University (REB 2020-104) and Tata Memorial Center (OIEC/3786/2021 /00003). Study outcome measures will include changes in knowledge/attitudes about cervical cancer screening, proportion of participants who self-select into each cohort, proportion of positive test result in each cohort- and proportion of participants with confirmed cervical cancer. Women’s experiences related to barriers and facilitators associated with the screening uptake will be captured. CONCLUSIONS This multi-faceted work could lead to reduced cervical cancer mortality and morbidity, and increased community capacity in sexual health promotion and cervical cancer prevention. Insights and lessons learned from this project can be used to inform the adaptation and scale-up of HPV self-sampling among women across India and in other countries, promote collective commitment to family-centred wellness, and support women to make healthful, personalized cervical screening decisions. CLINICALTRIAL Not Applicable

STUDY AND ANALYSIS OF CERVICAL PAP SMEARS IN A MEDICAL COLLEGE HOSPITAL

Introduction: Cervical cancer is the second most common gynaecological cancer worldwide and the third leading cause of cancer-related mortality in the less developed countries. Cervical cancer may be prevented or diagnosed at early stages due to the easy accessibility and clinical evaluation of the cervix. A pap test is a simple, easy, painless procedure which can be carried out as an outpatient procedure to detect specic, nonspecic inammations, precancerous and cancerous lesions In our study we have analysed the results of PAP smears of women in all age groups and have tried to evaluate the prevalence of cervical lesions and the importance of cervical cancer screening. Material And Methods: Our study was conducted between October 2020 to JULY 2021 and patients who have visited the Gynaec OP during this period were included for this study. We received Pap smears from the Department of Obstetrics and Gynecology, stained the slides with Pap stain and studied the smears according to the new Bethesda System for Reporting Cervical Cytology 2014. Results: In our study, majority of the patients were in the age group of 41-50 years. Smears showing ASCUS were 14 , LSIL reports were 5, HSIL reports were 4. No Smears showed squamous cell carcinoma in our study. Reports in our study like many other studies has shown the importance of Pap smear test in screening cervical cancer. By conducting health camps, increasing health awareness and performing Pap smear screening programmes the incidence of cervical carcinoma can be decreased.

Knowledge, attitudes, and practices toward cervical cancer prevention among women in Khartoum state, Sudan

Background Cervical cancer is considered as the third most leading cause of death among female worldwide with most of the deaths were found to occur in the developing countries. Several etiological agents were studied however Human papilloma virus (HPV) is identified as the most common etiological agent that involved in the induction of cervical cancer. The aim of our current study was to assess the Knowledge, attitudes, and practices toward cervical cancer prevention among women in Khartoum state, Sudan. Methods this is a descriptive cross-sectional community-based study. An electronic questionnaire was used for data collection. Descriptive statistics like frequency, mean and percentage were computed using SPSS version 20.0 software program. Results About 716 females in age between 18 and 74 years old with a mean age 27.58 years (STD 8.74 years) have enrolled in this study. 93.7 of them are educated at university level or higher. Although that 580 (81.0%) of our study participants have heard about cervical cancer only 29 (4.1%) were vaccinated against HPV as a preventive measure against the disease. Conclusion We highly recommended conducting health education sessions for both the Obstetrician and females in reproductive age regarding the benefit of the Pap test in the early detection of the cervical intraepithelial lesions and malignancy as well as HPV vaccination should be introduced in the local healthcare facilities

A Look into Women’s Preventative Care, Contraception Practices and Cesarean Delivery Rates in Rural Guanajuato, Mexico in Comparison to the United States

Statement of Significance: According to the World Health Organization (WHO), a third of health issues for women aged 15 and 44 years are sexual and reproductive health problems with unsafe sex practices being a major risk factor.1 Additionally, “every day in 2017, approximately 810 women died from preventable causes related to pregnancy and childbirth.”2 Although there have been improvements in prenatal and postpartum care, these benefits do not extend worldwide. Cervical and breast cancer represent additional issues in women’s health wherein adequate preventative medicine can dramatically improve patient outcomes. Our findings provide insight into the use of accessible contraception, preventive screenings, and cesarean deliveries based on the self-reported experience of a rural population near Guanajuato, Mexico. The results stand to inform future research and public health efforts in the region aiming to improve knowledge and use of contraception, investigate increasing cesarean delivery rates, and improve screening rates for cervical and breast cancer. Background: The objective of this study was to evaluate preventative screening for breast and cervical cancer, contraceptive practices, and cesarean section rates for women in rural Guanajuato Mexico. Understanding this data is important because such accessibility and healthcare practices can influence the safety of this population’s lives as well as provide insight to the impact of public healthcare programs. Methods: A twenty-one question oral survey was administered to both male and female participants of health fairs and screenings in seven rural communities around the cities of Juventino Rosas and San Miguel de Allende. The survey covered diet and exercise habits as well as women’s health topics for participants who self-identified as female. Women’s health topics included questions about mammography & Papanicolaou test (Pap test) history as well as contraception use and cesarean section history. Results: A total of 155 participants. Mean respondent age was 46 years and a majority of respondents were female (81%, n = 155). Of female respondents, almost half reported a previous cesarean section. More women in the younger cohort (aged <50 years) reported a history of cesarean section compared to the older cohort (aged >50 years), but not at a level of statistical significance. Almost half of the women of childbearing age denied contraception utilization. Most women (72%, n = 110) reported a Pap test within the past five years and about a third had one within the past year. Of the women aged >40 years, almost half had not received mammography. Conclusions: Younger women appeared more likely to have had at least one cesarean delivery than older women, but the sample size provided inadequate power for statistical significance. Access to contraception did not appear to be a barrier to contraception utilization in this region, an important finding for future investigations of associated topics, such as rates of unplanned pregnancies or the spread of communicable sexual diseases. Though the Pap test rates were comparable to that of the United States, mammogram rates lagged. Further studies should investigate increasing cesarean delivery rates in rural Guanajuato, Mexico, strategies to increase education regarding contraceptive modalities, and approaches to improve screening and treatment of cervical and breast cancer.

The Cervical pap smear cytological changes with clinicopathological correlation in a sample of Iraqi patients

Objectives: This study aimed to evaluate the role of Pap test in detecting pre-cancerous lesions in Iraqi women aged 45 years to 85 years, correlate the pap result with patient’s age, parity, number of births, number of abortions, chief complaint, and clinical cervical exam, and to evaluate the diagnostic accuracy of the pap test in correlation to histopathological examination. Methods: Women who attended the outpatient gynaecological clinic of the Department of Obstetrics and Gynaecology at Baghdad medical city, Baghdad, Iraq, from January 2019 to January 2020 who had different chief complaints were selected for the study. Women who are 45 years to 85 years old were included in the study. A Pap smear was used for all women to screen for cervical cancer and the results were reported according to the 2014 Bethesda system. The data analysis was done utilizing statistical package for social sciences version 24 (SPSS v24). Results: Total number of pap smears analyzed were 510, NILM (negative for intraepithelial lesions or malignancy) constituted major group 464/510 (91%) and epithelial cell abnormality were 46/510 (9%), age is significantly correlated with increasing rate of pre-neoplastic and neoplastic lesions in women and the significance of vaginal discharge & postmenopausal bleeding and its association with premalignant changes in the cervix. The sensitivity of Pap test is 94%, the Specificity was 60% and accuracy rate 74%. Conclusion: There is significant correlation between Pap smear abnormality and increasing age, vaginal discharge and postmenopausal bleeding, were evident in this study.