scholarly journals Screening for Cervical Cancer Using Automated Analysis of PAP-Smears

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Ewert Bengtsson ◽  
Patrik Malm
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Cost Effective ◽  
Automated Analysis ◽  
Lessons Learned ◽  
Pap Smears ◽  
Turn Of The Millennium ◽  
Prevention Measure ◽  
Key Issues ◽  
Analysis System

Cervical cancer is one of the most deadly and common forms of cancer among women if no action is taken to prevent it, yet it is preventable through a simple screening test, the so-called PAP-smear. This is the most effective cancer prevention measure developed so far. But the visual examination of the smears is time consuming and expensive and there have been numerous attempts at automating the analysis ever since the test was introduced more than 60 years ago. The first commercial systems for automated analysis of the cell samples appeared around the turn of the millennium but they have had limited impact on the screening costs. In this paper we examine the key issues that need to be addressed when an automated analysis system is developed and discuss how these challenges have been met over the years. The lessons learned may be useful in the efforts to create a cost-effective screening system that could make affordable screening for cervical cancer available for all women globally, thus preventing most of the quarter million annual unnecessary deaths still caused by this disease.

scholarly journals Cervical pap smear- A prospective study in a tertiary hospital

2015 ◽  
Vol 5 (10) ◽  
pp. 820-823 ◽  
Author(s):  
S Pudasaini ◽  
KBR Prasad ◽  
SK Rauniyar ◽  
R Pathak ◽  
K Pande ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Cost Effective ◽  
Tertiary Hospital ◽  
Pap Smears ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Effective Screening ◽  
Intraepithelial Lesion ◽  
A Prospective Study

Background: Cervical cancer is a leading cause of mortality and morbidity among women worldwide and most common gynaecological cancer in developing countries. Papanicolaou smear is a simple and cost effective screening test for cervical cancer. The aim of this study is to evaluate and interpret the cervical pap smear cytology in a tertiary hospital. The interpretation and reporting of the pap smear is based on 2001Bethesda system.Materials and methods: This is a prospective study conducted in a tertiary hospital, Nepal Medical College over a period of two and a half years (January 2013 to June 2015). All cervical pap smears received in the department of Pathology in the study period were included.Results: A total of 4160 cervical pap smears were reported in the study period. Majority of the cases were Negative for Intraepithelial lesion or malignancy (87.9%). Bacterial vaginosis, atrophy and reactive cellular changes associated with inflammation were seen in 5.3%, 2.4% and 1.5% cases respectively.   Epithelial cell abnormalities (0.5%) include Atypical squamous cells of undetermined significance, Low grade squamous intraepithelial lesion and High grade intraepithelial lesion. 88% of Low grade squamous intraepithelial lesion was seen in reproductive age group (20-45 years).Conclusion: Cervical cancer is the most common gynaecological cancer in the developing countries. Pap smear is the simple and cost effective screening tool to detect pre invasive cervical epithelial lesions.

CLINICAL EVALUATION OF CYTOLOGICAL FINDINGS OF CERVICAL PAP SMEARS IN ANMCH OF GAYA, BIHAR, INDIA

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Vivek Kumar ◽  
Jaideo Prasad
Keyword(s):  
Cervical Cancer ◽  
Clinical Evaluation ◽  
Pap Smear ◽  
Early Stage ◽  
Cancer Control ◽  
Cost Effective ◽  
Screening Tests ◽  
Pap Smears ◽  
Mortality And Morbidity ◽  
Pap Smear Screening

Introduction: Some of the cancer control programmes and screening tests have checked the cervical cancer incidence and its related mortality. The incidence and death rate due to cervical cancer is reduced upto 80% in some of the developing countries. Pap smear cytology is useful to detect and evaluate the degree of cellular alterations seen among cervical abnormalities. As Pap smear screening test is simple, rapid and cost effective, it is an ideal tool for mass screening programmes and better reliable results are obtained compared to other tests. Hence based on above findings the present study was planned for Clinical Evaluation of Cytological Findings of Cervical PAP Smears in ANMCH Gaya, Bihar, India. The present study was planned in Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India. In the present study 25 cases of the females cervical smears of patients undergone Papanicolaou (Pap) smear testing were enrolled in the present study. Pap smears were obtained from squamocolumnar junction with the help of Ayre’s spatula. The material obtained was quickly smeared on a clean glass slide and the smear was immediately fixed in 95% ethyl alcohol. In the central laboratory, the slides were stained with Papanicolaou stain and examined under light microscope. The cytological interpretation of the smears was made according to The Bethesda System 2014 (TBS). The data generated from the present study concludes that Pap smear tests are inexpensive and affordable by the patients. This Procedure doesn’t need experts and specialists for collection of smear. Early detection of possibility of malignancy helps in prompt treatment at early stage and prolongation of life expectancy of many women and reduce the mortality and morbidity of cancer cervix. Till today Pap smear test is the most useful screening procedure for cervical cancer. Keywords: cytology, pap smear, screening, squamous intraepithelial lesion, etc.

“A Pap smear saved my life”: Personal experiences of cervical abnormalities shape attitudes to cervical screening renewal

2019 ◽  
Vol 27 (4) ◽  
pp. 223-226 ◽  
Author(s):  
Helena M Obermair ◽  
Kirsten J McCaffery ◽  
Rachael H Dodd
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Screening Program ◽  
Cervical Screening ◽  
Personal History ◽  
Pap Smears ◽  
Increased Risk ◽  
Women's Lives ◽  
History Of ◽  
Screening Intervals

Objective In 2017, the Australian National Cervical Screening Program changed from two-yearly Pap smears between ages 18 and 69, to five-yearly human papillomavirus screening between ages 25 and 74 (the “Renewal”). This study investigated attitudes towards the changes, among individuals previously affected by cervical abnormalities/cervical cancer, personally or through a friend/relative. Methods We conducted a thematic analysis of comments expressing personal history or a family/friend history of cervical abnormalities/cervical cancer as a reason for opposing changes to the cervical screening program. The comments were taken from a 20% random sample of 19,633 comments posted on the “Change.org” petition “Stop May 1st Changes to Pap Smears – Save Women's Lives” in February–March 2017. Results There were 831 (20.8%) commenters who reported that they were concerned about a change in screening due to: feelings of increased personal vulnerability to cervical cancer due to their own personal history of cervical abnormalities; comparison of extended screening intervals and later age of first screening to their own experiences; and a perception of increased personal risk due to family history. Conclusion Women previously affected by cervical abnormalities or cervical cancer, personally or through a friend/relative, expressed concern about changes to cervical screening due to perceived increased risk and feeling vulnerable due to personal history.

scholarly journals Cytohistological correlation of conventional Papanicolaou smears in cervical neoplasia at a tertiary care hospital of Nepal

2019 ◽  
Vol 9 (1) ◽  
pp. 1475-1479
Author(s):  
Anuj Poudel ◽  
Prahar Dahal
Keyword(s):  
Uterine Cervix ◽  
Pap Smear ◽  
Cervical Screening ◽  
Tertiary Care ◽  
Cost Effective ◽  
Cervical Cytology ◽  
Pap Smears ◽  
Care Hospital ◽  
Cervical Lesions ◽  
Cervical Biopsy

Background: Conventional Cervical Cytology is the most widely used cervical cancer screening test. The incidence of cervical carcinoma is incredibly high in developing countries due to lack of proper knowledge. The extensive use of cervical screening with Papanicolau smears had considerably increased the detection of precancerous and cancerous lesion of uterine cervix. Study was conducted to evaluate cytohistological correlation and to calculate concordance and discordance of Pap smear in detection of precancerous and cancerous lesions of uterine cervix. Materials and Methods: A total of 54 samples reported in Pap smear as cervical intraepithelial lesions and suspicious for invasive malignancies were selected and correlated with corresponding histopathological findings. It was an observational study done for a period of 18 months from November 2016 to May 2018 at UCMS-TH. All the statistical evaluation was done by using SPSS version 20. Results: During the study period 54 cases were evaluated. Atypical Squamous Cell of Undetermined Significance was the common abnormal findings in the Pap smear with frequency of 26 (48.1%). Out of total 54 cases of Pap smears, 30 (55.55%) were concordant while discrepancies occurred in 24(44.44%) cases with cervical biopsy. Conclusions: The study revealed a good correlation between cervical cytology and cervical biopsy. We also concluded that conventional Pap smear is a cost effective test for the early detection of precancerous and cancerous cervical lesions.

scholarly journals Spectrum of cytological patterns in cervical PAP smears in a tertiary care center of Western region of Nepal

2019 ◽  
Vol 4 (1) ◽  
pp. 2-8
Author(s):  
Pragya Gautam Ghimire ◽  
Durga BC Rawat ◽  
Kavita Sinha ◽  
Kamar Jahan ◽  
Richa Shrestha
Keyword(s):  
Cervical Cancer ◽  
Epithelial Cell ◽  
Pap Smear ◽  
Statistical Significance ◽  
Care Center ◽  
Tertiary Care ◽  
Pap Smears ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion

Introduction: Cervical cancer is a common health problem in Nepal. There is paucity of data regarding the spectrum of findings in cervical Pap in western Nepal. This study was aimed to study the cytological patterns in cervical Pap smears in patients in a tertiary hospital of Nepal. Methods: This is a prospective, cross sectional, hospital based study. Clinical features of patients who had presented with Pap smear was noted in a structured proforma. Pap smears were studied by a senior pathologist and reported based on revised Bethesda system (2014). Results: Most of the cases belonged to 31-40 years 399 (42.8%). Unsatisfactory/ inadequate sample was present in 133(14.05%) with obscuration due to inflammatory exudate being most common cause. Negative for intraepithelial lesion or malignancy rate was noted in 798 (85.54%) with 477(51.2%) being normal findings. Epithelial cell abnormalities were noted in 116 (14.5 %) smears. Low-grade squamous intraepithelial lesion constituted 321(34.5%), High grade squamous intraepithelial lesion 273(29.3 %) and Atypical squamous cells of undetermined significance 153(16.4%) of epithelial cell abnormalities. Squamous cell carcinoma was present in 9(1%) of all reviewed smears. There was no statistical significance between the age and abnormalities of Pap smear (p=0.9). Conclusions: Pap smear is pivotal in cervical cancer screening in developing countries. It also identifies various inflammatory, infective, benign and malignant pathologies at the earliest thereby decreasing the morbidity and mortality.

Knowledge, Attitude, Practice and Barriers regarding cervical cancer and its screening using Pap smear, in rural women of Ba, Lautoka and Nadi, Fiji.

2015 ◽  
Vol 1 (2) ◽  
pp. 50 ◽  
Author(s):  
Swaran Naidu ◽  
Gillian Heller ◽  
George Qalomaiwasa ◽  
Sheetal Naidu ◽  
Rajat Gyaneshwar
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Rural Women ◽  
Pap Smear ◽  
Age Groups ◽  
Pap Test ◽  
High Rate ◽  
Pap Smears ◽  
Screening Programs ◽  
Lack Of Knowledge

<p><strong>Background</strong>: Fiji has a high rate of cervical cancer, which is the second most common cause of cancer deaths in women in the country. Less than 10% of women are screened for cervical cancer in Fiji.In this paper we report the result of a study on Knowledge, Attitude, Practice and Barriers (KAPB) to cervical cancer and its screening with Pap smears, conducted on 1505 rural women in Fiji.</p><p><strong>Objectives:</strong> To assess the knowledge, attitudes, practice and barriers to cervical cancer and it’s screening with Pap smears in rural women of Ba, Lautoka and Nadi, in Fiji.</p><p><strong>Methods</strong>: Structured questionnaires were administered to women presenting to a rural outreach Reproductive Health education and clinics, by trained health educators to ascertain their Knowledge, Attitudes, Practice and Barriers to cervical cancer and its screening with Pap smears.</p><p><strong>Results</strong>: Seventy two percent of rural women had no knowledge of cervical cancer and 80% had no knowledge of the risk factors of cervical cancer. Lack of knowledge was significantly different for age groups (p=0.006), education levels and employment status(p&lt;0.001) and ethnicity  (p=0.022). Those groups with lowest knowledge were teenagers (18 to 19 years); those with less education; and iTaukei respondents. Of the respondents who had at least some knowledge of the Pap smear, 75% had had a Pap test. Of those who had no knowledge of the Pap smear, only 45% had had the test (p&lt;0.001). Of those who did not have a Pap smear the commonest barrier was lack of knowledge at 46.3% and fear of procedure was 29.4%.</p><p><strong>Conclusion</strong>: More education is required to acquaint women in rural Fiji about cervical cancer, its associated risk factors as well as the benefits of cervical cancer screening programs and other prevention strategies. </p>

Pap Hub: A system to improve compliance with pap smear screening guidelines in a large health care system.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 193-193
Author(s):  
Deanna Gek Koon Teoh ◽  
Lisa A. Fall ◽  
Erin A. Beitelspacher ◽  
Charles W. Lais
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Tracking System ◽  
Invasive Cervical Cancer ◽  
The United States ◽  
Pap Smears ◽  
Health Maintenance ◽  
Screening Guidelines ◽  
Pap Smear Screening

193 Background: Cervical cancer is the most prevalent gynecologic cancer worldwide, but is third in the U.S. due to pap smear screening. However, American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines are complex and frequently changed, resulting in guideline adherence as low as 33-44%. We describe a centralized pap smear tracking system (“pap hub”) and report preliminary results. Methods: On 1/1/13 we implemented the pap hub, routing all screening pap smear results to a dedicated OB/Gyn nursing staff with a new Epic workbench. Epic Health Maintenance Modifier updated to recommend pap smears for women age 21-65 years (not younger or older per guidelines). Screening Pap/HPV results auto routed to Pap Pool Epic inbasket (not to individual providers). Centralized nurse reviews results alongside past pap results on Pathology flowsheet in Epic If normal Normal history -> appropriate follow-up interval per screening guidelines If abnormal history -> repeat pap as determined by previous history and treatment If abnormal -> manage per ASCCP guidelines Document plan in Epic Result Note Update Epic problems list If Normal: document “Pap Hub Normal History” If Abnormal: document “Pap Hub Abnormal History” with specifics in Overview History Communicate results/plan to the patient. Update Health Maintenance Modifier with next step. Review abnormal results to ensure proper follow-up, with reminders as indicated. Results: Guideline recommendations against pap smears for patients <21 years and >65 years have not changed since 2009. Comparison of first-quarter data for 2010 (pre-Pap Hub) to 2013 (post-Pap Hub) have shown a 63.86% reduction in pap smears in women <21 years. Pap smears in women >65 years has always been low, but has decreased slightly from 2.4% of all pap smears in 2010 to 1.5% of all pap smears in 2013. The 2012 ASCCP guidelines have changed recommended pap smear frequency and abnormal pap smear follow-up, and compliance with these new recommendations is being collected. Conclusions: Pap smear screening has decreased the incidence of invasive cervical cancer in the United States. The Pap Hub, a centralized pap smear tracking system, improves compliance with pap smear screening guidelines.

scholarly journals Features of Pap smears in women of reproductive life with papillomavirus 16, 18

2021 ◽  
pp. 96-97
Author(s):  
Shafag Eldar Aliyeva ◽  
Keyword(s):  
Cervical Cancer ◽  
Epithelial Cells ◽  
Pap Smear ◽  
Reproductive Age ◽  
Pap Smears ◽  
Pathological Changes ◽  
Women Of Reproductive Age ◽  
Hpv 16 ◽  
Sexually Transmitted ◽  
Cervical Disease

Introduction. According to modern data, cervical diseases do not occur by chance. Precancerous lesions vary from person to person and become invasive over time. The need for specific diagnostic methods for early detection of cervical cancer in women of reproductive age always remains relevant. Over the years, numerous diagnostic, cytological and histological studies have been carried out to identify malignant lesions of the cervix. Human papillomavirus (HPV) is a widespread sexually transmitted infection that affects both women and men around the world and plays an important role in the development of cervical disease. It is the most common sexually transmitted virus in the United States of America. For the first time in 1942, Papanicolaou emphasized the possibility of using smears (PAP smears) from the cervix and from the vagina to diagnose cervical disease. PAP preparations of smears are mainly multilayered flat epithelial cells of the ectocervix and vagina, endocervical cylindrical cells, including mononuclear and polynuclear inflammatory cells that enter the vagina through diapedesis from the surface of the epithelial layer, mixing with the mucoid fluid produced by the endocervical epithelial fluid. Purpose — using objective criteria for cytological examination to identify neoplastic changes in the cervix. Materials and methods. The study included 100 women of reproductive age (18–45 years old) during 2015–2020. Of these, 20 were in the control group (group I — control) and 80 — in the high-risk group for cervical cancer (group II — the main group). Group II women were also divided into 2 subgroups: II A — with pathology of the cervix (n=41), II B — without pathology of the cervix (n=39). The study included patients with a positive result on HPV 16/18 including patients whose PAP smears revealed intracellular damage. Pap smears were included in the study according to the following criteria. The smears contained a sufficient number of squamous epithelial cells and their integrity was preserved. Endocervical cells were monitored in all PAP smears. The examination was carried out with at least 5 cells in each, not completely, and with 2 clusters of endocervical glandular or squamous metaplastic cells. Squamous epithelial cells covered at least 10% of the preparation. Bloody, technically artifactic preparations without clinical data have not been studied. The deficit rate did not exceed 3%, and high interest rates on artifacts were not included in the study. Despite the small number of cells in the presence of abnormal cells, this was unequivocally considered sufficient. Results. Interpretation of PAP smear results identified n=35 ASCUS patients, n=24 LSIL, n=21 HSIL patients in the PAP smear positive reproductive age group. HPV serotypes 16.18 were found in 24 of these patients. In women of the II B subgroup, no pathological changes in the cervix were observed. Conclusions. In women of reproductive age with positive HPV 16, 18, for the diagnosis of precancerous diseases of the cervix, taking pap smears is an integral part of the study. As a result of the study, it was revealed that, despite the absence of a clinical picture, pathological changes at the cell level are detected. Key words: HPV16, 18, ASCUS, LSIL, HSIL, PAP.

scholarly journals Cervical cancer knowledge and screening uptake by marginalized population of women in inner-city Durban, South Africa: Insights into the need for increased health literacy

2021 ◽  
Vol 17 ◽  
pp. 174550652110471
Author(s):  
Jennifer F Ducray ◽  
Colette M Kell ◽  
Jyotika Basdav ◽  
Firoza Haffejee
Keyword(s):  
South Africa ◽  
Cervical Cancer ◽  
Inner City ◽  
Support Groups ◽  
Pap Smear ◽  
Cancer Education ◽  
Pap Smears ◽  
Cancer Knowledge ◽  
Screening Uptake ◽  
Universal Healthcare

Background: Cervical cancer in South Africa accounts for 15.85% of all female cancers and 30.29% of African female cancers, resulting in over 5000 deaths annually. South Africa’s proposed move towards universal healthcare places emphasis on health promotion through education and screening, but there is little data on the baseline levels of knowledge and screening uptake regarding cervical cancer. This study explored the levels of knowledge and screening rates of cervical cancer among vulnerable women living in the inner-city of Durban, South Africa. Methods: A mixed-method study was conducted within the context of a Women’s Health outreach initiative. Data were collected from women attending the outreach ( n = 109), many of whom were from marginalized communities. A pre-intervention survey was used to collect the data. This was followed by cervical cancer education sessions and the opportunity for a free Pap smear. Results: Knowledge of cervical cancer was low (<25%) and only a third of the women had previously been screened. After the educational sessions, 64% of women ( n = 70) took advantage of the opportunity for Pap smears, with many expressing the need for wider cervical cancer education, screening centres and support groups. Only 20% of the Pap smears were normal ( n = 14). Half of the women tested positive for infections ( n = 36; 51.4%), and a small proportion ( n = 8; 11.4%) tested positive for human papilloma virus. Abnormal cervical intra-epithelial neoplasia (CIN1 and CIN 2) were also detected in this population ( n = 12; 17.1%). Conclusion: Cervical cancer knowledge and screening among vulnerable women in Durban, South Africa, is inadequate, especially considering the high levels of abnormality found in the Pap smears. Education drives, accompanied with the provision of free testing, are required. Community health outreach initiatives in collaboration with non-government organizations set in accessible locations could be a possible course of action.

scholarly journals Postpartum Pap Smear Results in Women with Abnormal Pap Smears Detected at First Antenatal Care: A Retrospective Study in a Songklanagarind Hospital

2021 ◽  
Vol 1 (2) ◽  
pp. 55-62
Author(s):  
Nungrutai Saeaib
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Cervical Cancer Screening ◽  
Pap Smear ◽  
Remission Rate ◽  
Pap Smears ◽  
Care Providers ◽  
Pregnancy And Postpartum

Objective: To assess the remission rate at postpartum periods of abnormal Pap smears during pregnancy, and to identify the demographic and clinical characteristics of pregnant women with abnormal Pap smears.Material and Methods: Pregnant women, who had antenatal care (ANC) in Songklanagarind Hospital in period of January 2011 to December 2019, were identified retrospectively. Exclusion criteria included inaccessible results of Pap smears during pregnancy and postpartum periods. Medical records of all pregnant women with abnormal Pap smears were reviewed. The association between Pap smear results during pregnancy and postpartum were analyzed by Cramer’s V statistic ranging from 0 to 1, with a 1 indicating perfect association.Results: Of these 8,238 pregnant women had available Pap smear results, 109 (1.3%) women were shown with abnormal results. The most common of abnormality from Pap smears were atypical squamous cells of undetermined significance. In postpartum period, 50 women who had abnormal Pap smear during pregnancy, underwent postpartum follow-up examination at six weeks postpartum, respectively. The majority of results (84.0%) were normal whilst rate of remission occurred in 45 women (90.0%). The association of Pap smears between during pregnancy and postpartum was shown to have a small association (Cramer’s V = 0.2).Conclusion: There was low prevalence of abnormal Pap smear during pregnancy and high remission rate at postpartum. However, health care providers should be aware of cervical cancer screening in all pregnant women, because many women had not undergone cervical cancer screening before pregnancy.

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