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1.
J. Health Biol. Sci. (Online) ; 10(1): 1-9, 01/jan./2022. tab
Artículo en Portugués | LILACS | ID: biblio-1378520

RESUMEN

Objetivos: avaliar a cobertura e os fatores associados à não realização do exame citopatológico do colo do útero entre mulheres de 18 a 39 anos no Brasil. Métodos: estudo transversal, de base populacional, com dados de inquérito domiciliar com 2.002 mulheres alfabetizadas de áreas urbanas, selecionadas por amostragem aleatória por conglomerados em 2016. Foram avaliados a prática do exame nos três anos anteriores e os fatores associados à não realização, com cálculo de razão de prevalência ajustada (RPaj) e intervalos de confiança de 95% (IC95%) por regressão de Poisson. Resultados: a cobertura do exame entre mulheres de 18-39 anos foi de 66,5%, sendo mais elevada naquelas de 35-39 anos (76,8%). Mulheres com renda familiar até 1 salário-mínimo (RPaj=2,08;IC95% 1,72-2,54), que estudaram até a 4a série (RPaj=2,30;IC95% 1,22-2,67), residentes na região Nordeste (RPaj=1,79;IC95% 1,34-2,09) e em municípios com até 20.000 habitantes (RPaj=3,15;IC95% 2,33-3,96) apresentaram maior prevalência de não realização do exame. Conclusão: a cobertura do exame citopatológico esteve abaixo do recomendado, com disparidades socioeconômicas e geográficas. Os dados sugerem necessidade de oportunizar o rastreamento entre mulheres jovens de maior risco para o câncer do colo do útero.


Objectives: to evaluate the coverage and factors associated with non-performing Pap smear test among women aged 18-39 years in Brazil. Methods: cross-sectional, population-based study with household survey data with 2,002 literate women from urban areas, selected by random sampling by clusters in 2016. The practice of Pap test in the previous three years and associated factors with non-participation were evaluated, with calculation of adjusted prevalence ratio (PRad) and 95% confidence intervals (95%CI) by Poisson regression. Results: coverage of Pap tests among women 18-39 years was 66.5%, being higher in those aged 35-39 years (76.8%). Women with a family income up to 01 minimum wage (PRad=2.08; 95%CI 1.72-2.54), who studied up to 4th grade (PRad=2.30; 95%CI 1.22-2.67) and residents in the Northeast region (PRad=1.79; 95%CI 1.34-2.09) and in municipalities up to 20,000 inhabitants (PRad=3.15; 95%CI 2.33-3.96) had a higher prevalence of non-participation in screening. Conclusions: the coverage of the Pap smear test was below recommended, with socioeconomic and geographical disparities. The data suggest the need to provide screening among young women at higher risk for cervical cancer.


Asunto(s)
Prueba de Papanicolaou , Mujeres , Neoplasias del Cuello Uterino , Cuello del Útero , Tamizaje Masivo , Encuestas Epidemiológicas
2.
Cad Saude Publica ; 38(7): e00041722, 2022.
Artículo en Portugués | MEDLINE | ID: mdl-35894365

RESUMEN

This study analyzes the performance of screening and diagnosis tests for cervical cancer among women aged 25 to 64 years, as well as the delay for the initiation of treatment within Brazil and in its geographic regions, from 2013 to 2020. Information on populational procedures and estimates was obtained from the information systems of the Brazilian Unified National Health System and the Brazilian National Supplementary Health Agency. We calculated the coverage indicators of the Pap smear, the percentages of altered cytopathological and histopathological tests, and the percentage of women diagnosed with cervical cancer with over 60 days of treatment. There was great variation in the coverage of the Pap smear test among the Brazilian regions with a downward trend from 2013, which was aggravated from 2019 to 2020. The number of altered cytopathological tests was 40% lower than estimated, and the difference between the recorded number of cancer diagnoses and the estimated number of patients was below 50%. The percentage of women diagnosed with invasive cervical cancer, who started treatment after 60 days, ranged from 50% in the South to 70% in the North Region with a decrease from 2018. In 2020, there was a decrease in the number of screening and follow-up tests, reducing the proportion of women delayed in starting treatment in the North, Southeast, and South regions. The decline in screening coverage and inadequate follow-up of women with altered results indicate the need to improve early detection strategies for the disease and establish mechanisms for constant evaluation and monitoring of actions.


Este estudo teve como objetivo analisar a realização de exames de rastreamento e diagnóstico para o câncer de colo do útero entre mulheres de 25 e 64 anos, bem como o atraso para o início do tratamento no Brasil e suas regiões geográficas no período de 2013 a 2020. As informações sobre os procedimentos e as estimativas populacionais foram obtidas nos sistemas de informações do Sistema Único de Saúde (SUS) e da Agência Nacional de Saúde Suplementar (ANS). Foram calculados indicadores de cobertura do exame de Papanicolau, os percentuais de exames citopatológicos e histopatológicos alterados, e o percentual de mulheres com diagnóstico de câncer do colo do útero tratadas com mais de 60 dias. Houve grande variação na cobertura do exame de Papanicolau entre as regiões brasileiras com tendência de declínio a partir de 2013, agudizada de 2019 para 2020. O número registrado de exames citopatológicos alterados foi 40% inferior ao estimado e a diferença entre o número registrado de diagnósticos de câncer e o estimado menor que 50%. O percentual das mulheres com diagnóstico de câncer invasivo do colo do útero que iniciaram o tratamento após 60 dias variou entre 50% na Região Sul a 70% na Região Norte, com diminuição a partir de 2018. Em 2020, houve retração do número de exames de rastreamento e de seguimento com diminuição da proporção de mulheres com atraso para o início do tratamento nas regiões Norte, Sudeste e Sul. A queda na cobertura do rastreamento e o seguimento inadequado de mulheres com resultados alterados indicam a necessidade de aprimorar as estratégias de detecção precoce da doença e estabelecer mecanismos de avaliação e monitoramento constante das ações.


Este estudio tuvo como objetivo analizar el desempeño de las pruebas de detección y diagnóstico de cáncer de cuello uterino entre mujeres de 25 a 64 años, así como el retraso en el inicio del tratamiento en Brasil y en sus regiones geográficas en el período entre el 2013 y el 2020. La información sobre los procedimientos y las estimaciones poblacionales se obtuvo de los sistemas de información del Sistema Único de Salud y de la Agencia Nacional de Salud Complementaria. Se calcularon indicadores de cobertura de la prueba de Papanicolaou, los porcentajes de exámenes citopatológicos e histopatológicos alterados y el porcentaje de mujeres con diagnóstico de cáncer de cuello uterino sometidas a tratamiento por más de 60 días. Hubo una gran variación en la cobertura de la prueba de Papanicolaou entre las regiones brasileñas, con tendencia a la disminución a partir del 2013, agudizada del 2019 al 2020. El número registrado de exámenes citopatológicos alterados fue un 40% inferior al estimado, y la diferencia entre el número registrado de diagnósticos de cáncer y el estimado fue menor al 50%. El porcentaje de mujeres diagnosticadas con cáncer de cuello uterino invasivo que comenzaron el tratamiento después de 60 días varió del 50% en la Región Sur al 70% en la Región Norte, con una disminución a partir del 2018. En el 2020, hubo una retracción en el número de exámenes de detección y seguimiento, con una disminución en la proporción de mujeres con retraso en el inicio del tratamiento en las regiones Norte, Sudeste y Sur. La reducción en la cobertura de la detección y el seguimiento inadecuado de las mujeres con resultados alterados indican la necesidad de mejorar las estrategias de detección temprana de la enfermedad y establecer mecanismos de evaluación y seguimiento constante de las acciones.


Asunto(s)
Neoplasias del Cuello Uterino , Brasil/epidemiología , Detección Precoz del Cáncer/métodos , Femenino , Humanos , Tamizaje Masivo/métodos , Prueba de Papanicolaou , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/prevención & control , Frotis Vaginal
3.
Rev Esp Patol ; 55(3): 173-180, 2022.
Artículo en Español | MEDLINE | ID: mdl-35779883

RESUMEN

The illustrations of Hashime Murayama were vital in enabling the Papanicolaou test to be understood, admired and observed worldwide, making Papanicolaou's Atlas of cytology so fundamental in the detection and prevention of cervical cancer. Murayama was a talented Japanese artist who initially worked for the National Geographic magazine; his figurative watercolours were ideal for portraying the wonders of nature. Later, he collaborated with George Papanicolaou in Cornell University as he was able to improve on the microphotography of the era; an era in which it was not yet understood why cervical cancer caused so many deaths. His illustrations captured the most intricate cellular details and his artistic legacy will always be enlightening in each display of cellular artistry as seen under the microscope.


Asunto(s)
Neoplasias del Cuello Uterino , Femenino , Humanos , Masculino , Prueba de Papanicolaou , Neoplasias del Cuello Uterino/diagnóstico , Frotis Vaginal
4.
Rev Med Inst Mex Seguro Soc ; 60(2): 164-170, 2022 Mar 01.
Artículo en Español | MEDLINE | ID: mdl-35759446

RESUMEN

Background: Despite the fact that the Papanicolaou technique is the most effective method of prevention and detection of cervical cancer, the precision of this tool remains controversial; Because of this, there are medical and scientific efforts to improve the quality of the procedure. Objective: Compare the quality of sampling between the conventional and modified technique. Material and methods: Descriptive and comparative observational study in 150 cervical cytology samples (75 conventional technique samples and 75 in modified technique) in women aged 25 to 64 years. Demographic variables, characteristics of the cervix and quality of the sample were analyzed. Descriptive statistics and association measures were performed. Study with risk greater than the minimum. All participants signed an informed consent. Results: The quality of the sample was satisfactory in 92.0% for the conventional technique vs 89.3% for the modified technique. The main cause of unsatisfactory samples was insufficient cellularity 6.7% in conventional technique vs 12% of the modified technique, with no significant difference between both techniques p = 0.575 (1.37; 0.45-4.1), findings that reject the working hypothesis. Conclusions: There was no significant difference when using both tests, the samples with satisfactory quality were similar between both techniques.


Introducción: a pesar de que la técnica de papanicolaou es el método más eficaz para la prevención y detección del cáncer cervicouterino, la precisión de esta herramienta sigue siendo controversial; debido a esto, existen esfuerzos médicos y científicos para mejorar la calidad del procedimiento. Objetivo: comparar la calidad en la toma de muestra entre la técnica convencional y la modificada. Material y métodos: estudio observacional descriptivo y comparativo en 150 muestras de citología cervical (75 muestras técnica convencional y 75 en técnica modificada) en mujeres de 25 a 64 años. Se analizaron variables demográficas, características del cérvix y calidad de la muestra. Se realizó estadística descriptiva y medidas de asociación. Estudio con riesgo mayor que el mínimo. Todas las participantes firmaron consentimiento informado. Resultados: la calidad de la muestra fue satisfactoria en el 92% para la técnica convencional frente al 89.3% para la técnica modificada. La causa principal de muestras insatisfactorias fue la celularidad insuficiente, la cual se presentó en el 6.7% de las muestras con técnica convencional frente al 12% de la técnica modificada, sin diferencia significativa entre ambas técnicas p = 0.575 (1.37; 0.45-4.1), hallazgos que rechazan la hipótesis de trabajo. Conclusiones: no hubo diferencia significativa al utilizar ambas pruebas, las muestras con calidad satisfactoria fueron similares entre ambas técnicas.


Asunto(s)
Neoplasia Intraepitelial Cervical , Neoplasias del Cuello Uterino , Neoplasia Intraepitelial Cervical/diagnóstico , Cuello del Útero , Femenino , Humanos , Prueba de Papanicolaou/métodos , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/prevención & control , Frotis Vaginal/métodos
5.
Math Biosci Eng ; 19(7): 6415-6434, 2022 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-35730264

RESUMEN

Cervical cancer is the second most commonly seen cancer in women. It affects the cervix portion of the vagina. The most preferred diagnostic test required for screening cervical cancer is the pap smear test. Pap smear is a time-consuming test as it requires detailed analysis by expert cytologists. Cytologists can screen around 100 to 1000 slides depending upon the availability of advanced equipment. Due to this reason Artificial intelligence (AI) based computer-aided diagnosis system for the classification of pap smear images is needed. There are some AI-based solutions proposed in the literature, still an effective and accurate system is under research. In this paper, the deep learning-based hybrid methodology namely DeepCyto is proposed for the classification of pap smear cytology images. The DeepCyto extracts the feature fusion vectors from pre-trained models and passes these to two workflows. Workflow-1 applies principal component analysis and machine learning ensemble to classify the pap smear images. Workflow-2 takes feature fusion vectors as an input and applies an artificial neural network for classification. The experiments are performed on three benchmark datasets namely Herlev, SipakMed, and LBCs. The performance measures of accuracy, precision, recall and F1-score are used to evaluate the effectiveness of the DeepCyto. The experimental results depict that Workflow-2 has given the best performance on all three datasets even with a smaller number of epochs. Also, the performance of the DeepCyto Workflow 2 on multi-cell images of LBCs is better compared to single cell images of other datasets. Thus, DeepCyto is an efficient method for accurate feature extraction as well as pap smear image classification.


Asunto(s)
Neoplasias del Cuello Uterino , Inteligencia Artificial , Cuello del Útero/diagnóstico por imagen , Femenino , Humanos , Prueba de Papanicolaou/métodos , Neoplasias del Cuello Uterino/diagnóstico por imagen , Frotis Vaginal/métodos
6.
BMC Womens Health ; 22(1): 228, 2022 06 13.
Artículo en Inglés | MEDLINE | ID: mdl-35698067

RESUMEN

BACKGROUND: Despite the early diagnosis and treatment of cervical cancer, it is still a significant public health problem in Somalia. This study was conducted to evaluate the knowledge and attitudes of healthcare professionals towards the early diagnosis of cervical cancer. METHODS: This study was conducted in Mogadishu, the capital of Somalia, between December 2020 and February 2021. The cross-sectional study consisted of a total of 280 healthcare professionals. The study data was collected using a questionnaire consisting of 38 questions evaluating the knowledge and attitudes of all healthcare professionals towards the early diagnosis of cervical cancer, an additional 15 questions for women only, and a total of 43 questions. RESULTS: 22.1% of the participants received cervical cancer training during vocational education and training. Cervical cancer education after graduation is 16.8%, and the rate of providing education to patients is only 29.6%. The rate of female healthcare professionals having a Pap smear test is 2%. The participants' cervical cancer total knowledge score was 16.5 ± 6.69, and the success rate was 63.46. The highest success rate in knowledge subgroup questions was HPV questions with 69.6. A statistically significant difference was found between the participants' profession, training on the subject during their vocational education, and total knowledge scores (p < 0.001). When the knowledge question subscales were compared, a significant difference was found between participants' gender and HPV questions subscale score (p = 0.028). A statistically significant difference was found between the participants' professions, receiving training on the subject during vocational training, and all subscales (p < 0.05). A statistically significant difference was found between the participants' income status and risk factors questions scores (p = 0.026). CONCLUSION: This study shows that the knowledge and training of healthcare professionals working in a training and research hospital in Somalia for early cervical cancer diagnosis are not sufficient. In addition, it reveals that female healthcare professionals have almost no Pap smears. Therefore, studies and training should be planned to train all healthcare professionals, especially female healthcare professionals, and overcome all possible obstacles to the acceptance of the screening tests by women.


Asunto(s)
Infecciones por Papillomavirus , Neoplasias del Cuello Uterino , Estudios Transversales , Detección Precoz del Cáncer , Femenino , Conocimientos, Actitudes y Práctica en Salud , Hospitales , Humanos , Prueba de Papanicolaou , Infecciones por Papillomavirus/prevención & control , Somalia , Encuestas y Cuestionarios , Neoplasias del Cuello Uterino/prevención & control , Frotis Vaginal
7.
JMIR Mhealth Uhealth ; 10(6): e32089, 2022 06 27.
Artículo en Inglés | MEDLINE | ID: mdl-35759319

RESUMEN

BACKGROUND: Despite the availability and accessibility of free Papanicolaou (Pap) smear as a screening tool for cervical cancer, the uptake of Pap smear in Malaysia has not changed in the last 15 years. Previous studies have shown that the high uptake of Pap smear reduces the mortality rate of patients with cervical cancer. The low uptake of Pap smear is multifactorial, and the problem could be minimized through the use of mobile technologies. Nevertheless, most intervention studies focused on individual factors, while other important aspects such as mobile technologies, especially WhatsApp, have not been investigated yet. OBJECTIVE: This study aims to determine the effects of a theory-based educational intervention and WhatsApp follow-up (Pap smear uptake [PSU] intervention) in improving PSU among postnatal women in Seremban, Negeri Sembilan, Malaysia. METHODS: A 2-arm, parallel single-blind cluster randomized controlled trial was conducted among postpartum women from the Seremban district. Twelve health clinics were randomly assigned to the intervention and control groups. At baseline, both groups received a self-administered questionnaire. The intervention group received standard care and PSU intervention delivered by a researcher. This 2-stage intervention module was developed based on Social Cognitive Theory, where the first stage was conducted face-to-face and the second stage included a WhatsApp follow-up. The control group received standard care. Participants were observed immediately and at 4, 8, and 12 weeks after the intervention. The primary endpoint was PSU, whereas the secondary endpoints were knowledge, attitude, and self-efficacy scores for Pap smear screening self-assessed using a Google Forms questionnaire. A generalized mixed model was used to determine the effectiveness of the intervention. All data were analyzed using IBM SPSS (version 25), and P value of .05 was considered statistically significant. RESULTS: We analyzed 401 women, of whom 76 (response rate: 325/401, 81%) had withdrawn because of the COVID-19 pandemic, with a total of 162 respondents in the intervention group and 163 respondents in the control group. The proportion of Pap smears at the 12-week follow-up was 67.9% (110/162) in the intervention group versus 39.8% (65/163) in the control group (P<.001). Significant differences between the intervention and control groups were found for Pap smear use (F4,1178; P<.001), knowledge scores (F4,1172=14.946; P<.001), attitude scores (F4,1172=24.417; P<.001), and self-efficacy scores (F1,1172=10.432; P<.001). CONCLUSIONS: This study demonstrated that the PSU intervention is effective in increasing the uptake of Pap smear among postnatal women in Seremban district, Malaysia. This intervention module can be tested in other populations of women. TRIAL REGISTRATION: Thai Clinical Trials Registry TCTR20200205001; https://www.thaiclinicaltrials.org/show/TCTR20200205001.


Asunto(s)
COVID-19 , Conocimientos, Actitudes y Práctica en Salud , Medios de Comunicación Sociales , Neoplasias del Cuello Uterino , Femenino , Estudios de Seguimiento , Humanos , Malasia , Pandemias , Prueba de Papanicolaou , Teoría Psicológica , Autoeficacia , Método Simple Ciego , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/prevención & control
8.
Artículo en Inglés | MEDLINE | ID: mdl-35682440

RESUMEN

Pap smear screening can detect cervical cancer early, but is underutilized. Motivational factors play a role in ensuring that women undergo Pap smear screening. This study was conducted to validate the adapted instrument, which was based on the protection motivation theory (PMT), into the Malay language to evaluate the motivational factors for Pap smear screening among women. The original 26-item PMT scale was developed based on seven constructs of the PMT framework. The adaptation involved translation by bilingual experts (n = 4), followed by synthesis (n = 6). Subsequently, we performed content validation (content validation index, CVI) among the health experts (n = 5) and face validation (face validation index, FVI) among women (n = 11). Reliability testing for internal consistency was determined via the confirmatory factor analysis (CFA) of women aged between 21 and 65 years (n = 150). One item was deleted based on the expert consensus, leaving a total of 25 items after the adaptation. The validation yielded a good CVI and FVI. Prior to CFA reliability testing, one item was deleted due to very low factor loading. The CFA indicated a good fit for 24 items. The factor loading (range: 0.45-0.98), average variance extracted (range: 0.44-0.90), and composite reliability (range: 0.69-0.97) indicated that the convergent validity for each construct was acceptable, except for the perceived vulnerability. However, the perceived vulnerability construct was accepted based on expert verification. We confirmed that the translation, cross-cultural, adaptation, and validation of the Malay-version PMT scale were valid and reliable. The scale contains 24 items that represent the seven constructs of the PMT framework.


Asunto(s)
Lenguaje , Motivación , Adulto , Anciano , Comparación Transcultural , Femenino , Humanos , Malasia , Persona de Mediana Edad , Prueba de Papanicolaou , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Adulto Joven
9.
J Popul Ther Clin Pharmacol ; 29(1): e1-e8, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35686892

RESUMEN

BACKGROUND AND OBJECTIVES: Cervical cancer (CC) has a long preinvasive stage, which allows for preventive detection and possible cure. In this study, this stage was a target stage to investigate women with precancerous lesions by applying the Papanicolaou (Pap) smear test and comduct performing a correlation study.s. PATIENTS AND METHODS: A 2-year cross-sectional study was conducted, in which 200 married women (21-60 years old) participated in the investigation, which included women with Pap test abnormal results (atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesions (LSILs), and high-grade squamous intraepithelial lesions (HSILs)). These results were used to perform a polymerase chain reaction (PCR) test to detect the presence of human papillomavirus (HPV) of (6 and 11), a low-risk type, and (16 and 18), a high-risk type with colposcopy examination and colposcopy-guided biopsy, if needed for women with abnormal colposcopy outcomes. The treatment, per severity and disease stage, was applied. RESULTS: The clinical presentation and Pap smear results of women enrolled in the study were as follows: 82.5% women were asymptomatic, postcoital bleeding (PCB) was seen in 17.0%, and intermenstrual bleeding was seen in a single case (0.5%). The history of sexually transmitted diseases was seen in 2.5% of the subjects. Pap smear results were as follows: no remarkable pathology was seen in 36.0%, inflammatory evidence was seen in 32.0%, ASCUS was seen in 19.0%, LSIL was seen in 7.5%, and HSIL was seen in 5.5% of the subjects. Regarding the HPV, the infection was negative in 95.0%, low-risk virus strains were seen in 1.5%, and high-risk viruses were seen in 3.5%. Low-risk HPV included 6, 11, and 42, whereas the high-risk group included five cases of HPV16 and two cases of HPV 18. CONCLUSIONS: The present work presents the Pap smear test as a highly useful, easy, technically safe, and cost-effective tool for detecting cervical epithelial precancerous lesions, which can be used as a routine screening technique for better treatment outcomes and reducing mortality rates. The power of detection of these lesions can be potentiated when using the Pap test and HPV-PCR test together.


Asunto(s)
Células Escamosas Atípicas del Cuello del Útero , Neoplasia Intraepitelial Cervical , Infecciones por Papillomavirus , Neoplasias del Cuello Uterino , Adulto , Neoplasia Intraepitelial Cervical/diagnóstico , Neoplasia Intraepitelial Cervical/patología , Estudios Transversales , ADN Viral/análisis , Detección Precoz del Cáncer , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prueba de Papanicolaou , Papillomaviridae/genética , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/patología , Sensibilidad y Especificidad , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/patología , Adulto Joven
10.
Asian Pac J Cancer Prev ; 23(6): 1959-1965, 2022 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-35763637

RESUMEN

OBJECTIVE: This survey examined the barriers to cervical cancer screening uptake by adult women in Nnewi, a town located in southeast Nigeria. METHODS: In this descriptive survey, data were collected data from 379women aged between 21 and 65 years using the adapted version of the Health Belief Model Scale for Cervical Cancer and Pap smear test questionnaire. RESULTS: The major perceived barriers to the practice of cervical cancer screening were fear of the result (2.32±1.05), lack of knowledge of what pap smear is (2.32±0.90), and lack of information about when and where pap smear could be done (2.25±1.07). The logistic regression model showed that the following perceived barriers predicted uptake of cervical cancer screening (P< 0.05): time constraint (P = 0.001, OR= 3.368, CI=  1.455, 4.11); attitude of healthcare workers (P = 0.008, OR= 6.642; CI= 2.764, 18.196); knowledge of test frequency (P = 0.005, OR= 1.443; CI 0.946, 3.811); fear of result(P = 0.001, OR= 3.660, CI=0.679, 4.061); lack of information on when and where pap smear could be obtained (P = 0.010; OR= 6.732; CI= 2.286, 10.490); distance from test centre (P = 0.003; OR= 1.387; CI=0.126, 2.193); not knowing what it is for (P = 0.024, OR10.895, CI = 2.938, 14.401).


Asunto(s)
Neoplasias del Cuello Uterino , Adulto , Anciano , Detección Precoz del Cáncer , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Persona de Mediana Edad , Nigeria , Prueba de Papanicolaou , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/prevención & control , Adulto Joven
11.
J Pak Med Assoc ; 72(6): 1025-1030, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35751302

RESUMEN

Objectives: To assess knowledge, attitude and practice of medical and paramedical staff about cervical cancer as well as its screening and prevention. METHODS: The descriptive cross-sectional study was conducted at the Jinnah Post-graduate Medical Centre, Karachi, from March 1 to August 30, 2019, and comprised women medical and paramedical staff randomly selected from different specialties. Data was collected using a structured questionnaire. Data was analysed using SPSS 20. RESULTS: Of the 347 participants 144(41.5%) were nurses and 203(58.5%) were doctors. The overall mean age was 26.22±6.38 years. Of the total, 108(30%) respondents were married and 239(68%) were single. Overall, 239(68.8%) were well aware of Pap smear being the screening test; 85(24.5%) were aware of the true guidelines to repeat the test; 152(43.8%) had an idea of the exact use of visual Inspection with acetic acid; 61(17.6%) had got a Pap smear done; and 156(45%) thought they were at risk of developing carcinoma cervix. The common risk factors identified were multiple sexual partners 254(73.2%), age at first sexual intercourse 160(46%), smoking 131(37.8%), foul-smelling discharge 221(63.7%), and post-coital bleeding 231(66.6%). CONCLUSIONS: Cervical cancer prevalence is rising due to inadequate knowledge and awareness among healthcare personals. Improvement can be brought by regular use of Pap smear.


Asunto(s)
Personal de Enfermería , Neoplasias del Cuello Uterino , Adulto , Estudios Transversales , Detección Precoz del Cáncer , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Tamizaje Masivo , Prueba de Papanicolaou , Encuestas y Cuestionarios , Centros de Atención Terciaria , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/prevención & control , Frotis Vaginal , Adulto Joven
12.
Cancer ; 128(14): 2753-2759, 2022 07 15.
Artículo en Inglés | MEDLINE | ID: mdl-35570647

RESUMEN

BACKGROUND: Cervical cancer screening is recommended for those with a cervix who are 21 to 65 years old, with specific timelines being dependent on individual risk. This study compared rates of ever undergoing Papanicolaou (Pap) testing at the intersection of self-reported sexual minority (SM) status and race/ethnicity. METHODS: Data from the National Health Interview Survey (2015 and 2018) were used to examine cervical cancer screening disparities. Natal females without a history of hysterectomy who were 21 to 65 years old and had reported their sexual orientation and Pap testing history were included. Demographic and health characteristics were summarized with descriptive statistics. To adjust for differences in confounding variables between groups, propensity score-based inverse probability of treatment weighting (IPTW) was performed. IPTW-adjusted multivariable logistic regression models estimated odds of ever undergoing a Pap test by sexual orientation alone and with race/ethnicity (non-Hispanic White, non-Hispanic Black, and Hispanic). RESULTS: SM persons (n = 877) had significantly reduced odds of ever undergoing Pap testing (odds ratio, 0.54; 95% confidence interval, 0.42-0.70) in comparison with heterosexual persons (n = 17,760). When the intersection of sexual orientation and race/ethnicity was considered, non-Hispanic White SM participants and Hispanic SM participants had reduced odds of ever undergoing Pap testing in comparison with non-Hispanic White heterosexual participants. No significant differences were observed between non-Hispanic White heterosexual participants and participants of non-Hispanic Black SM or Hispanic heterosexual identities. CONCLUSIONS: SM participants were significantly less likely to have ever undergone a Pap test in comparison with heterosexual participants, with Hispanic SM participants having the lowest uptake. Future studies should further examine the roles of systemic discrimination and other key drivers of these disparities.


Asunto(s)
Neoplasias del Cuello Uterino , Adulto , Anciano , Detección Precoz del Cáncer , Etnicidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prueba de Papanicolaou , Conducta Sexual , Neoplasias del Cuello Uterino/prevención & control , Adulto Joven
13.
Infect Dis Obstet Gynecol ; 2022: 3932110, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35634175

RESUMEN

Background: The epidemiology of human papilloma virus (HPV) infection and the pattern of HPV genotype distribution are much-needed parameters to assess the risk of cervical cancer among females. However, due to less availability of data on HPV burden and its genotypes from various geographical regions in India makes cervical cancer screening modalities and vaccination strategies difficult to implement. Objective: The present study was conducted to identify the various genotypes particularly high-risk HPV types in premalignant or malignant cervical lesions. Methods: The study was a hospital-based cross-sectional study wherein 295 symptomatic women were screened by Pap smear and multiplex real-time PCR was performed for HPV genotypes identification in women with abnormal cervical cytology. Results: Out of 295 women, 237 (80.3%), 45 (15.3%), and 13 (4.4%) women had normal Pap smear, squamous cell carcinoma and precancerous cytology, respectively. Among these 58 women having abnormal cervical cytology, HPV was detected in 48 (81.0%) participants. Most common HPV genotypes in our study were HPV 16 (n = 29; 60.4%) followed by mixed infections; i.e., more than one type of HPV was detected (n = 10, 20.8%). HPV 18 was detected only in 6.25%, whereas other high-risk HPV genotypes were found to be 12.5%. Conclusion: HPV positivity was >80% in women having abnormal Pap smear. The prevalence of HPV 18 was found to be much less in Central India, compared to other parts of country. HPV 16 was the most common genotype followed by mixed HPV genotype infections. It is evident from our study that symptomatic women even if having normal Pap smear should be screened for HPV and followed up with periodic Pap smears for detecting any change in cervical cytology, thus preventing cervical cancer in women.


Asunto(s)
Coinfección , Infecciones por Papillomavirus , Neoplasias del Cuello Uterino , Estudios Transversales , Detección Precoz del Cáncer , Femenino , Genotipo , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Humanos , India/epidemiología , Masculino , Prueba de Papanicolaou , Papillomaviridae/genética , Neoplasias del Cuello Uterino/epidemiología
14.
Rev Epidemiol Sante Publique ; 70(3): 117-122, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35491336

RESUMEN

OBJECTIVE: To explore the factors associated with the uptake of mammography screening in Reunionese women aged 50-65 years. METHODS: This study included all women aged 50 to 65 years participating in a population-based cross-sectional study "FOSFORE". Participants were recruited between March and June 2017 using two sampling frames. The first frame consisted of households with a landline telephone, with or without a mobile line, by first randomly generating a telephone number and then randomly selecting an individual from among all eligible women in the household. The second sampling frame was constituted of women with an exclusive mobile line, who were selected directly if they met the eligibility criteria. Data were weighted for age and socio-professional status to ensure representativeness at the Reunion Island level. Weighted logistic regression was used to calculate odds ratios while adjusting for confounders. RESULTS: 417 women were included in the study; 63.8% were up to date with guidelines on mammography screening and 36.2% were not up to date. Four factors were significantly associated with mammography screening, with an adjusted odds ratio of 2.92 (95% CI 1.51-5.61) for not having an Active Solidarity Income, 1.98 (95% CI 1.22-3.23) for having a regular gynecological follow-up by a physician, 6.53 (95% CI 3.23-13.21) for performing a Pap smear test in the past two years, and 2.07 (95% CI 1.21-3.52) for having an adequate literacy level (HLQ3). CONCLUSION: The findings of this study suggest that higher socio-economic status is an indicator of participation in mammography screening in La Réunion, and future educational and intervention programs should target women in deprived areas.


Asunto(s)
Neoplasias de la Mama , Mamografía , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/epidemiología , Estudios Transversales , Detección Precoz del Cáncer , Femenino , Humanos , Tamizaje Masivo , Prueba de Papanicolaou , Factores Socioeconómicos , Frotis Vaginal
15.
BMC Womens Health ; 22(1): 126, 2022 04 21.
Artículo en Inglés | MEDLINE | ID: mdl-35449007

RESUMEN

BACKGROUND: Cervical cancer is one of the leading malignancies globally and has taken third place in Namibia amongst women aged 15-44 years. Infection with the Human Immunodeficiency Virus (HIV) has been proven to increase women's susceptibility to developing cervical carcinoma. Sadly, Namibia carries a twin burden of HIV and cervical cancer. Namibians are aware of HIV/AIDS, but remain poorly informed about cervical cancer. Furthermore, among those who are aware of the disease, low utilisation of screening tests have been reported. OBJECTIVE: The purpose was to explore perceptions and attitudes held by women about cervical cancer, reasons for low uptake of Pap smear testing amongst those who are aware of the malignancy as well as unearth motivation factors that has fuelled women to go for screening. METHODOLOGY: A descriptive, cross-sectional study was conducted using convenience sampling as a sampling technique. The survey instrument used was a self-administered questionnaire. It consisted of both closed and open ended questions. A total of 136 women were surveyed. RESULTS AND CONCLUSION: The level of awareness for cervical cancer (92.6%) and Pap smear (93.4%) were high. Most were able to identify that Pap smear test is used for screening for pre-cancerous lesions. However, knowledge about the impact of a HIV positive status along with co infection with HPV as the leading causes for progression of invasive cervical carcinoma was not well known. Knowledge about the other risk factors such as multiple sexual partners (39.7%), early sex debut (34.9%) and smoking was poorly demonstrated. This suggests that a high awareness level does not necessarily translate into having a good perception or understanding of a disease. A good attitude towards screening was observed although less than half of the study population reported ever having a test done.


Asunto(s)
Infecciones por VIH , Neoplasias del Cuello Uterino , Estudios Transversales , Detección Precoz del Cáncer , Femenino , Infecciones por VIH/diagnóstico , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Tamizaje Masivo/métodos , Namibia , Prueba de Papanicolaou , Encuestas y Cuestionarios , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/prevención & control , Frotis Vaginal
16.
Artículo en Inglés | MEDLINE | ID: mdl-35409875

RESUMEN

Cervical cancer is a major public health problem, especially in the north region of Brazil. The aim of the study was to identify the factors associated with not undergoing the cervical cancer screening test in rural riverside populations in the Amazon. A cross-sectional home-based survey was carried out in 38 locations covered by a fluvial primary healthcare team, and the administrative records of the screening tests from January 2016 to May 2019 were analyzed. After the descriptive analysis, logistic regression was performed considering the outcome of having undergone cervical cancer screening within the past three years. Of the 221 women assessed, 8.1% had never undergone the test, and 7.7% had undergone it more than three years ago. Multiparity (OR = 0.76 (95%CI = 0.64-0.90)), occupation in domestic activities (OR = 0.31 (95%CI = 0.11-0.89)), and lack of knowledge of the healthcare unit responsible for the service (OR = 0.18 (95%CI = 0.04-0.97)) were associated with not undergoing the cervical cancer screening test. The administrative records revealed that the screening test was performed outside the recommended age range (24%), performed needlessly (9.6%) with undue repetitions (3.2%), and a high percentage of the samples collected were unsatisfactory (23.5%). The findings revealed the existence of barriers for riverside women to access cervical cancer screening tests.


Asunto(s)
Prueba de Papanicolaou , Neoplasias del Cuello Uterino , Estudios Transversales , Detección Precoz del Cáncer , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Tamizaje Masivo , Atención Primaria de Salud , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/prevención & control , Frotis Vaginal
17.
Cancer Causes Control ; 33(6): 823-830, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35426540

RESUMEN

BACKGROUND: Low rates of Papanicolaou (Pap) screening among sub-Saharan African immigrant (SAI) women in the US contribute to cancer diagnoses at late stages and high mortality rates. This study was conducted to examine if social support, positively associated with preventive health practices, was predictive of Pap screening in a sample of SAI women. METHODS: We conducted a cross-sectional study with SAI women who recently immigrated to the US. Participants completed a survey to assess ever having had Pap screening and social support using the Medical Outcomes Study Social Support Survey. RESULTS: Among the 108 SAI women in our study, Pap screening uptake was 65.7%. Affectionate and positive social support were each associated with Pap screening [adjusted odds ratio (AOR) = 1.73 (1.05, 2.87) and 1.68 (1.01, 2.78), respectively]. DISCUSSION: These findings suggest that consideration should be given to strengthening certain aspects of social support to increase uptake of Pap screening among SAI women.


Asunto(s)
Emigrantes e Inmigrantes , Neoplasias del Cuello Uterino , África del Sur del Sahara/epidemiología , Estudios Transversales , Detección Precoz del Cáncer , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Tamizaje Masivo , Prueba de Papanicolaou , Apoyo Social , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/prevención & control , Frotis Vaginal
18.
Asian Pac J Cancer Prev ; 23(4): 1285-1290, 2022 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-35485687

RESUMEN

AIM: Human Papillomavirus is one of the most crucial infectious disease in gynecology disease. To assess the efficacy of supplemental zinc treatment in clearance of HPV infection. METHODS: Eighty zinc-sufficient women between 21-55 years, with positive HPV DNA testing, and abnormal cervical cytology in Pap test (ASCUS or LISL) were randomly divided to case (n=40) and control group (n=40). Case group received oral tablets of zinc sulfate twice a day for 3 months while control group received no placebo. During follow-up patients underwent repeat HPV DNA test and PAP test and were evaluated for clearance/persistence of HPV infection and regression/progression in the lesion grading. RESULTS: As far as demographics, serum zinc levels and the relevant risk factors for persistence of HPV were concerned, there was no significant difference between two groups, except for the frequency distribution of HR-HPV which was significantly higher in case  group. Zinc treatment for 3 months reduced the risk of persistence of HPV infection and progression from baseline cytology (OR = 0.130) (CI 95% 0.04-0.381; p <0.001) and 0.301 (95% CI 0.777-0.116; p = 0.012), respectively. Age, initial cytology, HPV type, and contraceptive method were not related to persistence of HPV. Serum zinc levels increased in the casr group as a result of oral zinc consumption for 3-month period, though without any statistical significance (p = 0.407). CONCLUSION: The results of the following study suggested that oral intake of zinc sulfate supplement for 3 months increases the rates of HPV clearance and resolution of pre-existing cervical lesion.


Asunto(s)
Alphapapillomavirus , Infecciones por Papillomavirus , Neoplasias del Cuello Uterino , Suplementos Dietéticos , Femenino , Humanos , Prueba de Papanicolaou , Papillomaviridae/genética , Neoplasias del Cuello Uterino/patología , Zinc , Sulfato de Zinc/uso terapéutico
19.
Comput Methods Programs Biomed ; 219: 106776, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35398621

RESUMEN

BACKGROUND AND OBJECTIVE: Cervical cancer is one of the leading causes of women's death. Like any other disease, cervical cancer's early detection and treatment with the best possible medical advice are the paramount steps that should be taken to ensure the minimization of after-effects of contracting this disease. PaP smear images are one the most effective ways to detect the presence of such type of cancer. This article proposes a fuzzy distance-based ensemble approach composed of deep learning models for cervical cancer detection in PaP smear images. METHODS: We employ three transfer learning models for this task: Inception V3, MobileNet V2, and Inception ResNet V2, with additional layers to learn data-specific features. To aggregate the outcomes of these models, we propose a novel ensemble method based on the minimization of error values between the observed and the ground-truth. For samples with multiple predictions, we first take three distance measures, i.e., Euclidean, Manhattan (City-Block), and Cosine, for each class from their corresponding best possible solution. We then defuzzify these distance measures using the product rule to calculate the final predictions. RESULTS: In the current experiments, we have achieved 95.30%, 93.92%, and 96.44% respectively when Inception V3, MobileNet V2, and Inception ResNet V2 run individually. After applying the proposed ensemble technique, the performance reaches 96.96% which is higher than the individual models. CONCLUSION: Experimental outcomes on three publicly available datasets ensure that the proposed model presents competitive results compared to state-of-the-art methods. The proposed approach provides an end-to-end classification technique to detect cervical cancer from PaP smear images. This may help the medical professionals for better treatment of the cervical cancer. Thus increasing the overall efficiency in the whole testing process. The source code of the proposed work can be found in github.com/rishavpramanik/CervicalFuzzyDistanceEnsemble.


Asunto(s)
Neoplasias del Cuello Uterino , Detección Precoz del Cáncer , Femenino , Humanos , Prueba de Papanicolaou , Neoplasias del Cuello Uterino/diagnóstico por imagen , Frotis Vaginal
20.
Artículo en Inglés | MEDLINE | ID: mdl-35409892

RESUMEN

BACKGROUND: Cervical cancer is mainly caused by human papillomavirus (HPV). Worldwide, knowledge of HPV and cervical cancer among women is reported to be inadequate. The study aimed to assess the knowledge and awareness of HPV and cervical cancer among women attending gynecology clinics at a tertiary hospital in Pretoria, South Africa. The study also intended to identify socio-demographic factors influencing women's knowledge about HPV and cervical cancer risk factors. METHODS: This was a clinic-based analytic cross-sectional study conducted among women aged 18 years and older. Participants were enrolled in the clinic waiting rooms while waiting to be attended to by the clinician. A self-administered questionnaire to assess knowledge of HPV, cervical cancer, and risk factors for developing cervical cancer was distributed to the participants. RESULTS: A total of 527 women aged ≥18 years and older were randomly enrolled with a 99.8% response rate. Less than half (47.1%) of the participants had been previously screened for cervical cancer using a Papanicolaou (Pap) test. Few (18.8%) women correctly mentioned cervical cancer risk factors. Unemployed women were less likely to have correct knowledge of cervical cancer causes/risk factors (OR: 0.63; 95% CI 0.40-0.97) compared to employed women. Divorced/separated/widowed women were more likely to have good HPV knowledge compared to single participants (OR: 2.74; 95% CI 1.46-5.15). CONCLUSION: From this study, it is evident that cervical cancer screening is very low, and women lack knowledge of HPV and cervical cancer disease symptoms and its risk factors. There is a need for policies to prioritize providing accurate information to the public to reduce cervical cancer morbidity and mortality.


Asunto(s)
Alphapapillomavirus , Infecciones por Papillomavirus , Neoplasias del Cuello Uterino , Adolescente , Adulto , Estudios Transversales , Detección Precoz del Cáncer , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Prueba de Papanicolaou , Papillomaviridae , Infecciones por Papillomavirus/prevención & control , Sudáfrica/epidemiología , Neoplasias del Cuello Uterino/diagnóstico , Frotis Vaginal
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