scholarly journals Ordinal losses for classification of cervical cancer risk

2021 ◽  
Vol 7 ◽  
pp. e457
Author(s):  
Tomé Albuquerque ◽  
Ricardo Cruz ◽  
Jaime S. Cardoso

Cervical cancer is the fourth leading cause of cancer-related deaths in women, especially in low to middle-income countries. Despite the outburst of recent scientific advances, there is no totally effective treatment, especially when diagnosed in an advanced stage. Screening tests, such as cytology or colposcopy, have been responsible for a substantial decrease in cervical cancer deaths. Cervical cancer automatic screening via Pap smear is a highly valuable cell imaging-based detection tool, where cells must be classified as being within one of a multitude of ordinal classes, ranging from abnormal to normal. Current approaches to ordinal inference for neural networks are found to not sufficiently take advantage of the ordinal problem or to be too uncompromising. A non-parametric ordinal loss for neuronal networks is proposed that promotes the output probabilities to follow a unimodal distribution. This is done by imposing a set of different constraints over all pairs of consecutive labels which allows for a more flexible decision boundary relative to approaches from the literature. Our proposed loss is contrasted against other methods from the literature by using a plethora of deep architectures. A first conclusion is the benefit of using non-parametric ordinal losses against parametric losses in cervical cancer risk prediction. Additionally, the proposed loss is found to be the top-performer in several cases. The best performing model scores an accuracy of 75.6% for seven classes and 81.3% for four classes.

2005 ◽  
Vol 16 (3) ◽  
pp. 233-236 ◽  
Author(s):  
L C Chingang ◽  
U Bischof ◽  
G Andall-Brereton ◽  
O Razum

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


2002 ◽  
Vol 18 (1) ◽  
pp. 67-76 ◽  
Author(s):  
Mfon S. Cyrus-David ◽  
Robert Michielutte ◽  
Electra D. Paskett ◽  
Ralph D'Agostino ◽  
David Goff

2013 ◽  
Vol 2013 ◽  
pp. 1-7
Author(s):  
Fauziah Abdullah ◽  
Michael O’Rorke ◽  
Liam Murray ◽  
Tin Tin Su

Background. Despite the significant burden of cervical cancer, Malaysia like many middle-income countries relies on opportunistic cervical screening as opposed to a more organized population-based program. The aim of this study was to ascertain the effectiveness of a worksite screening initiative upon Papanicolaou smear test (Pap test) uptake among educated working women in Malaysia.Methods. 403 female teachers who never or infrequently attended for a Pap test from 40 public secondary schools in Kuala Lumpur were recruited into a cluster randomized trial conducted between January and November 2010. The intervention group participated in a worksite cervical screening initiative whilst the control group received usual care from the existing cervical screening program. Multivariate logistic regression was performed to determine the impact of the intervention program on Pap smear uptake after 24 weeks of followup.Results. The proportion of women attending for a Pap test was significantly higher in the intervention than in the control group (18.1% versus 10.1%,Pvalue < 0.05) with the worksite screening initiative doubling the Pap smear uptake, adjusted odds ratio 2.44 (95% CI: 1.29–4.62).Conclusion. Worksite health promotion interventions can effectively increase cervical smear uptake rates among eligible workers in middle-income countries. Policy makers and health care providers in these countries should include such interventions in strategies for reducing cervical cancer burden. This trial is registered withIRCT201103186088N1.


2021 ◽  
Vol 22 (4) ◽  
pp. 2201
Author(s):  
Sinead Carse ◽  
Martina Bergant ◽  
Georgia Schäfer

Infection by oncogenic human papillomavirus (HPV) is the primary cause of cervical cancer and other anogenital cancers. The majority of cervical cancer cases occur in low- and middle- income countries (LMIC). Concurrent infection with Human Immunodeficiency Virus (HIV) further increases the risk of HPV infection and exacerbates disease onset and progression. Highly effective prophylactic vaccines do exist to combat HPV infection with the most common oncogenic types, but the accessibility to these in LMIC is severely limited due to cost, difficulties in accessing the target population, cultural issues, and maintenance of a cold chain. Alternative preventive measures against HPV infection that are more accessible and affordable are therefore also needed to control cervical cancer risk. There are several efforts in identifying such alternative prophylactics which target key molecules involved in early HPV infection events. This review summarizes the current knowledge of the initial steps in HPV infection, from host cell-surface engagement to cellular trafficking of the viral genome before arrival in the nucleus. The key molecules that can be potentially targeted are highlighted, and a discussion on their applicability as alternative preventive means against HPV infection, with a focus on LMIC, is presented.


2021 ◽  
pp. 1418-1425
Author(s):  
Kehinde S. Okunade ◽  
Adaiah Soibi-Harry ◽  
Sarah John-Olabode ◽  
Adebola A. Adejimi ◽  
Matthew J. Allsop ◽  
...  

PURPOSE We assessed the impact of mHealth on Pap test screening uptake and also determined the factors that affect screening uptake among women in Lagos, Nigeria. MATERIALS AND METHODS A randomized controlled trial was carried out among women in two tertiary health institutions in Lagos, Nigeria, between July 2020 and March 2021. Participants were randomly assigned to either a text message (mHealth) intervention or usual care arm. The main study outcome was the uptake of Pap smear testing within 6 months of enrollment in the study. We tested the associations between two groups of continuous variables using the unpooled independent-sample t-test (normal distribution) and that of two groups of categorical variables with the chi-square (χ2) test. Using a multinomial logistic regression model, we adjusted for relevant sociodemographic and clinical predictors of uptake of Pap smear screening. Statistical significance was defined as P < .05. RESULTS There was a significantly higher rate of uptake of Pap smear screening among women in the mHealth arm compared with those in the usual care arm (51.0% v 35.7%, P = .031). Following adjustment in the final multivariate model, level of income (odds ratio [OR] = 5.13, 95% CI, 1.55 to 16.95), awareness of Pap smear (OR = 16.26; 95% CI, 2.49 to 76.64), General Outpatient clinic attendance, and introduction of mHealth intervention during follow-up (OR = 4.36; 95% CI, 1.44 to 13.22) were the independent predictors of Pap smear uptake. CONCLUSION The use of mHealth technologies intervention via short-text message services is a feasible solution for cervical cancer prevention in low- and middle-income countries, and thus, the widespread use of mHealth services by health care providers and policymakers could contribute to the implementation of cervical cancer prevention services in Nigeria and in the settings of other low- and middle-income countries.


Heliyon ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e05919
Author(s):  
Shiba Das ◽  
Lutfur Naher ◽  
Tutun Das Aka ◽  
Md. Abdul Aziz ◽  
Samia Shabnaz ◽  
...  

2010 ◽  
Vol 197 (2) ◽  
pp. 174-178 ◽  
Author(s):  
Pei Jiang ◽  
Jianxin Liu ◽  
Xiaoxi Zeng ◽  
Wen Li ◽  
Jianxin Tang

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