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Giovannetti O, Tomalty D, Velikonja L, Gray G, Boev N, Gilmore S, Oladipo J, Sjaarda C, Sheth PM, Adams MA. Pre- and post-LEEP: analysis of the female urogenital tract microenvironment and its association with sexual dysfunction. Sex Med 2023; 11:qfad039. [PMID: 37588087 PMCID: PMC10425579 DOI: 10.1093/sexmed/qfad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 08/18/2023] Open
Abstract
Background The loop electrosurgical excision procedure (LEEP) to treat cervical dysplasia (CD) is known to alter the cervical microbiota, the community of bacteria that play a central role in female genital health. Perturbations to the microbiota of the female urogenital tract (FUT), including the urethra, vagina, and cervix, have been linked with symptoms of sexual dysfunction (SD), though correlations among LEEP, the microenvironment, and SD have not yet been described. Aims To characterize the FUT microbiota before and after LEEP and investigate possible associations with SD. Methods Females undergoing LEEP for CD were recruited to participate in the study. Urinary samples and vaginal and cervical swabs were collected immediately before and 3 months after treatment. Bacterial communities were characterized by 16S rRNA next-generation sequencing. Self-report surveys assessing demographics, medical history, and sexual function were completed at the same intervals. Outcomes Microbiota taxonomy and Female Sexual Function Index (FSFI) scores. Results Alpha diversity revealed a significant decrease in species richness in the FUT microbiota post-LEEP. Beta diversity demonstrated significant differences among the cervical, urinary, and vaginal microenvironments pre- and post-LEEP. Lactobacillus spp were the dominant microbial genus in the cervical microenvironment pre- and post-LEEP. Although the vaginal and urinary microenvironments were characterized by Prevotella pre-LEEP, they were colonized by Lactobacillus post-LEEP. Following LEEP, some participants experienced a significant increase in proinflammatory bacteria, including the genera Gardnerella, Megasphaera, Sneathia, Parvimonas, and Peptostreptococcus. Others experienced significant decreases in inflammatory and protective bacteria post-LEEP, including Butyricicoccus, Terriporobacter, Intestinimonas, and Negativibacillus. Overall there were no significant changes in pre- and post-LEEP FSFI scores. However, post-LEEP FSFI scores were seemingly associated with changes in inflammatory bacteria in some participants. Clinical Implications There is an overall reduction in FUT microbiota dysbiosis post-LEEP. However, we show variability as some participants experienced persistent dysbiosis of FUT microbiota and elevated FSFI scores, suggesting that therapies to treat dysbiosis of FUT microbiota may reduce FSFI scores, thereby improving SD symptoms. Strengths and Limitations We demonstrate novel associations among urogenital sites, microbiota changes, LEEP, and SD. The small sample size and inability of species classification are limitations. Conclusion Diverse inflammatory microbiota characterizes CD in the FUT, and LEEP mostly returns microenvironments to a healthy state. However, some participants have persistent inflammatory bacteria post-LEEP, suggesting a non-uniform healing response. This study provides an impetus for future longitudinal studies to monitor and restore FUT microenvironments post-LEEP, aimed at mitigating postoperative SD symptoms.
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Affiliation(s)
- Olivia Giovannetti
- Department of Biomedical and Molecular Science, Queen’s University, Kingston K7L3N6, Canada
| | - Diane Tomalty
- Department of Biomedical and Molecular Science, Queen’s University, Kingston K7L3N6, Canada
| | - Leah Velikonja
- Department of Biomedical and Molecular Science, Queen’s University, Kingston K7L3N6, Canada
| | - George Gray
- Department of Obstetrics and Gynaecology, Kingston General Hospital, Kingston K7L3N6, Canada
| | - Nadejda Boev
- Department of Pathology and Molecular Medicine, Queen’s University, Kingston K7L3N6, Canada
| | - Shelby Gilmore
- Department of Biomedical and Molecular Science, Queen’s University, Kingston K7L3N6, Canada
| | - Jummy Oladipo
- Department of Biomedical and Molecular Science, Queen’s University, Kingston K7L3N6, Canada
| | - Calvin Sjaarda
- Department of Pathology and Molecular Medicine, Queen’s University, Kingston K7L3N6, Canada
| | - Prameet M Sheth
- Department of Biomedical and Molecular Science, Queen’s University, Kingston K7L3N6, Canada
- Department of Pathology and Molecular Medicine, Queen’s University, Kingston K7L3N6, Canada
| | - Michael A Adams
- Department of Biomedical and Molecular Science, Queen’s University, Kingston K7L3N6, Canada
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Chigozie N, Hilfinger Messiaa DK, Adebola A, Ojiegbe T. Men's willingness to support HPV vaccination and cervical cancer screening in Nigeria. Health Promot Int 2021; 37:6276503. [PMID: 33993249 DOI: 10.1093/heapro/daab056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cervical cancer is the second most common female cancer in Nigeria, even though it can be prevented by vaccination and screening. The uptake of these preventive services is extremely low due to lack of spousal support and cost. Human papilloma virus (HPV) vaccines and cervical screening require finance as health services are mostly paid out of pocket. This study explored Nigerian men's willingness to encourage and pay for family member to obtain HPV vaccine and cervical screening. This is a cross-sectional study of 352 men aged 18-65 years living in 12 communities in the 6-geopolitical region. We found poor perception of HPV risk, and believed their family was not susceptible to cervical cancer. However, the majority (>80%) believed HPV vaccine and cervical screenings are important. Additionally, a good number (>58%) would encourage and pay for their family member to receive HPV vaccine and cervical screening. Residency, educational level and monthly income were significantly associated with willingness to encourage their family to receive HPV vaccine and cervical screening. Also, age group, marital status, residency, educational level and monthly income were significantly associated with the willingness to pay for HPV vaccine and cervical cancer screening. Majority were willing to encourage and pay for their family member to get vaccinated and receive cervical screening. This supports the findings that lack of male involvement may be an overlooked obstacle to cervical cancer prevention in developing countries.
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Affiliation(s)
- Nkwonta Chigozie
- Registered Nurse, Federal Medical Center, Owerri, Imo State, Nigeria
| | | | | | - Tochukwu Ojiegbe
- Registered Nurse, Federal Medical Center, Owerri, Imo State, Nigeria
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Pandey K, Tandon M, Pradhan A, Bhagoliwal A, Agarwal A, Lal P, Gupta G. Can Optical Handheld Probe Based on Co-polarized and Cross-Polarized Fluorescence Spectroscopy Become the Face of Cervical Cancer Screening in Future in Developing Countries? INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2020. [DOI: 10.1007/s40944-020-00459-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jaya BK, Kumar SS. Image Registration based Cervical Cancer Detection and Segmentation Using ANFIS Classifier. Asian Pac J Cancer Prev 2018; 19:3203-3209. [PMID: 30486611 PMCID: PMC6318403 DOI: 10.31557/apjcp.2018.19.11.3203] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Cervical cancer is the leading cancer in women around the world. In this paper, Adaptive Neuro Fuzzy Inference System (ANFIS) classifier based cervical cancer detection and segmentation methodology is proposed. This proposed system consists of the following stages as Image Registration, Feature extraction, Classifications and Segmentation. Fast Fourier Transform (FFT) is used for image registration. Then, Grey Level Co-occurrence Matrix (GLCM), Grey level and trinary features are extracted from the registered cervical image. Next, these extracted features are trained and classified using ANFIS classifier. Morphological operations are now applied over the classified cervical image to detect and segment the cancer region in cervical images. Simulations on large cervical image dataset demonstrate that the proposed cervical cancer detection and segmentation methodology outperforms the state of-the-art methods in terms of sensitivity, specificity and accuracy.
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Affiliation(s)
- B Karthiga Jaya
- ECE, Dhanalakshmi Srinivasan Engineering College, Tamilnadu, India.
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Leno DWA, Diallo FD, Camara AY, Magassouba M, Komano FD, Traore A, Niamy D, Tolno J, Cissoko O, Bangoura M, Keita N. [Analysis of uterus cervical cancer screening campaign results in Conakry, Guinea]. Bull Cancer 2017; 104:914-920. [PMID: 29126586 DOI: 10.1016/j.bulcan.2017.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 09/14/2017] [Accepted: 09/21/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Reduce morbidity and death rates of women with cervical cancer in Guinea. METHODOLOGY This was a five-day cross-sectional study carried out in two successive years (2012 and 2013) at the CERFFO-PCG in Conakry. The target population was women aged 25-49. Approximately 500 women for 2012 and 900 women were expected in these cervical screening campaigns by visual methods (IVA and IVL) with immediate treatment of precancerous lesions. After histologic confirmation of the cancer lesions, the management was carried out according to the protocols in force in the country. We performed a simple descriptive analysis and the results expressed as a percentage and on average. RESULTS The target population represented 60.4% in 2012 and 76.2% in 2013, of the total number of women received. The incidence rate of high-grade intraepithelial lesions and cancers increased from 2.6% in 2012 to 0.9% in 2013. In 2012, the 57 precancerous lesions were treated with immediate treatment and 10 cases of cancers out of the 16 had a surgical treatment. Also in 2013, all precancerous lesions were treated immediately and 2 cancers out of the 4 benefited from surgery. CONCLUSION Our research shows that, with creativity, flexibility, good organization and efficient use of resources, morbidity and death rates of women with cervical cancer in a very resources can be significantly reduced.
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Affiliation(s)
- Daniel William Athanase Leno
- Hôpital national Donka, centre régional francophone de formation pour la prévention des cancers gynécologiques (CERFFO-PCG), PB 834 Conackry, Guinée.
| | - Fatoumata Diaraye Diallo
- Hôpital national Donka, centre régional francophone de formation pour la prévention des cancers gynécologiques (CERFFO-PCG), PB 834 Conackry, Guinée
| | - Ansoumane Yassima Camara
- Université de Conakry, faculté de médecine pharmacie et odontostomatologie, Agence de santé publique, Canada
| | - Mamadou Magassouba
- Hôpital national Donka, centre régional francophone de formation pour la prévention des cancers gynécologiques (CERFFO-PCG), PB 834 Conackry, Guinée
| | - Faya Dendo Komano
- Hôpital national Donka, centre régional francophone de formation pour la prévention des cancers gynécologiques (CERFFO-PCG), PB 834 Conackry, Guinée
| | - Ayelama Traore
- Hôpital national Donka, centre régional francophone de formation pour la prévention des cancers gynécologiques (CERFFO-PCG), PB 834 Conackry, Guinée
| | - Delphine Niamy
- Hôpital national Donka, centre régional francophone de formation pour la prévention des cancers gynécologiques (CERFFO-PCG), PB 834 Conackry, Guinée
| | - Julien Tolno
- Hôpital national Donka, centre régional francophone de formation pour la prévention des cancers gynécologiques (CERFFO-PCG), PB 834 Conackry, Guinée
| | - Oumou Cissoko
- Hôpital national Donka, centre régional francophone de formation pour la prévention des cancers gynécologiques (CERFFO-PCG), PB 834 Conackry, Guinée
| | - Mbalia Bangoura
- Hôpital national Donka, centre régional francophone de formation pour la prévention des cancers gynécologiques (CERFFO-PCG), PB 834 Conackry, Guinée
| | - Namory Keita
- Hôpital national Donka, centre régional francophone de formation pour la prévention des cancers gynécologiques (CERFFO-PCG), PB 834 Conackry, Guinée
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Ali M, Sarwar A, Sharma V, Suri J. Artificial neural network based screening of cervical cancer using a hierarchical modular neural network architecture (HMNNA) and novel benchmark uterine cervix cancer database. Neural Comput Appl 2017. [DOI: 10.1007/s00521-017-3246-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Uysal Toraman A, Yildirim N. Knowledge About Cervical Cancer Risk Factors and Practices of Pap Testing Among Turkish Immigrant Women in the United States. J Immigr Minor Health 2017; 20:1222-1229. [PMID: 28929252 DOI: 10.1007/s10903-017-0653-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The objective of this study was to examine knowledge about cervical cancer risk factors and practices of Pap testing among female Turkish immigrants in the state of Florida in the United States of America (USA). This descriptive study was conducted between April and September 2012. The study sampling was consist of 156 Turkish women living in the state of Florida. A questionnaire-based survey was conducted among the population of Turkish immigrant women. On the survey form comprised of a total of 37 questions and three sections there are questions pertaining to the socio-demographic characteristics of the individuals, their knowledge on the cervical cancer risk factors and their approach to getting Pap smear tests. Statistical Package for Social Sciences (version 16.0) was used to compute frequency and descriptive statistics related to demographic data. The average age of the women is 35.67 ± 10.0. More than half of women (66%) women reported cervical cancer screening at least one. Over two-thirds knew that having abnormal vaginal bleeding (85.8%) and vaginal infections (78.2%), having sexual activity with a man who has had multiple sexual partners (61.5%), and having multiple sexual partners (61.5%) increase the risk of cervical cancer. The result of the multivariate regression analysis have determined that the age of immigrant women (OR 11.3, 95 % CI 5.1-25.2, p:0.000) and the number of children ( OR 3.4, 95 % CI 1.7-6.9, p:0.000) are factors that impact pap smear testing behavior. Our study findings confirm low levels of Pap testing and show important knowledge deficits about cervical cancer risk factors and the importance of Pap testing among Turkish immigrant women. It is recommended that the immigrant women be educated about cervical cancer by means of organizing conferences in their own language and preparing informative materials.
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Affiliation(s)
- Aynur Uysal Toraman
- Department of Public Health Nursing, Faculty of Nursing, Ege University, 35100, Bornova, Izmir, Turkey.
| | - Nilufer Yildirim
- Department of Public Health Nursing, Faculty of Nursing, Ege University, 35100, Bornova, Izmir, Turkey
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Solomon C, Louw M, van Aardt M, Dreyer G. p16 and Ki-67 immunohistochemical staining reduces inter- and intra-observer variability in the grading of cervical squamous intraepithelial lesions of South African women. SOUTHERN AFRICAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY 2017. [DOI: 10.1080/20742835.2017.1370841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Christa Solomon
- National Health Laboratory Services (Tshwane Academic Division), Department of Anatomical Pathology, University of Pretoria, Pretoria, South Africa
| | - Melanie Louw
- National Health Laboratory Services (Tshwane Academic Division), Department of Anatomical Pathology, University of Pretoria, Pretoria, South Africa
| | - Mc van Aardt
- Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
| | - Greta Dreyer
- Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
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Jusman Y, Mat Isa NA, Ng SC, Hasikin K, Abu Osman NA. Automated cervical precancerous cells screening system based on Fourier transform infrared spectroscopy features. JOURNAL OF BIOMEDICAL OPTICS 2016; 21:75005. [PMID: 27403606 DOI: 10.1117/1.jbo.21.7.075005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 06/15/2016] [Indexed: 06/06/2023]
Abstract
Fourier transform infrared (FTIR) spectroscopy technique can detect the abnormality of a cervical cell that occurs before the morphological change could be observed under the light microscope as employed in conventional techniques. This paper presents developed features extraction for an automated screening system for cervical precancerous cell based on the FTIR spectroscopy as a second opinion to pathologists. The automated system generally consists of the developed features extraction and classification stages. Signal processing techniques are used in the features extraction stage. Then, discriminant analysis and principal component analysis are employed to select dominant features for the classification process. The datasets of the cervical precancerous cells obtained from the feature selection process are classified using a hybrid multilayered perceptron network. The proposed system achieved 92% accuracy.
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Affiliation(s)
- Yessi Jusman
- University of Malaya, Department of Biomedical Engineering, Faculty of Engineering, 50603 Kuala Lumpur, MalaysiabUniversitas Abdurrab, Department of Informatics Engineering, Faculty of Engineering, Pekanbaru, 28291 Riau, Indonesia
| | - Nor Ashidi Mat Isa
- University of Science Malaysia, School of Electrical and Electronic Engineering, Engineering Campus, Nibong Tebal, 14300 Penang, Malaysia
| | - Siew-Cheok Ng
- University of Malaya, Department of Biomedical Engineering, Faculty of Engineering, 50603 Kuala Lumpur, Malaysia
| | - Khairunnisa Hasikin
- University of Malaya, Department of Biomedical Engineering, Faculty of Engineering, 50603 Kuala Lumpur, Malaysia
| | - Noor Azuan Abu Osman
- University of Malaya, Department of Biomedical Engineering, Faculty of Engineering, 50603 Kuala Lumpur, Malaysia
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Finocchario-Kessler S, Wexler C, Maloba M, Mabachi N, Ndikum-Moffor F, Bukusi E. Cervical cancer prevention and treatment research in Africa: a systematic review from a public health perspective. BMC Womens Health 2016; 16:29. [PMID: 27259656 PMCID: PMC4893293 DOI: 10.1186/s12905-016-0306-6] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 05/21/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Women living in Africa experience the highest burden of cervical cancer. Research and investment to improve vaccination, screening, and treatment efforts are critically needed. We systematically reviewed and characterized recent research within a broader public health framework to organize and assess the range of cervical cancer research in Africa. METHODS We searched online databases and the Internet for published articles and cervical cancer reports in African countries. Inclusion criteria included publication between 2004 and 2014, cervical cancer-related content pertinent to one of the four public health categories (primary, secondary, tertiary prevention or quality of life), and conducted in or specifically relevant to countries or regions within the African continent. The study design, geographic region/country, focus of research, and key findings were documented for each eligible article and summarized to illustrate the weight and research coverage in each area. Publications with more than one focus (e.g. secondary and tertiary prevention) were categorized by the primary emphasis of the paper. Research specific to HIV-infected women or focused on feasibility issues was delineated within each of the four public health categories. RESULTS A total of 380 research articles/reports were included. The majority (54.6 %) of cervical cancer research in Africa focused on secondary prevention (i.e., screening). The number of publication focusing on primary prevention (23.4 %), particularly HPV vaccination, increased significantly in the past decade. Research regarding the treatment of precancerous lesions and invasive cervical cancer is emerging (17.6 %), but infrastructure and feasibility challenges in many countries have impeded efforts to provide and evaluate treatment. Studies assessing aspects of quality of life among women living with cervical cancer are severely limited (4.1 %). Across all categories, 11.3 % of publications focused on cervical cancer among HIV-infected women, while 17.1 % focused on aspects of feasibility for cervical cancer control efforts. CONCLUSIONS Cervical cancer research in African countries has increased steadily over the past decade, but more is needed. Tertiary prevention (i.e. treatment of disease with effective medicine) and quality of life of cervical cancer survivors are two severely under-researched areas. Similarly, there are several countries in Africa with little to no research ever conducted on cervical cancer.
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Affiliation(s)
| | - Catherine Wexler
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, USA
| | - May Maloba
- Family AIDS Care and Education Services, Kenya Medical Research Institute, Kisumu, Kenya
| | - Natabhona Mabachi
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, USA
| | - Florence Ndikum-Moffor
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, USA
| | - Elizabeth Bukusi
- Family AIDS Care and Education Services, Kenya Medical Research Institute, Kisumu, Kenya
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
- Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
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Oga EA, Brown JP, Brown C, Dareng E, Adekanmbi V, Odutola M, Olaniyan O, Offiong R, Obende K, Adewole AS, Peter A, Dakum P, Adebamowo C. Recurrence of cervical intraepithelial lesions after thermo-coagulation in HIV-positive and HIV-negative Nigerian women. BMC WOMENS HEALTH 2016; 16:25. [PMID: 27169666 PMCID: PMC4864941 DOI: 10.1186/s12905-016-0304-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 05/04/2016] [Indexed: 01/30/2023]
Abstract
BACKGROUND The burden of cervical cancer remains huge globally, more so in sub-Saharan Africa. Effectiveness of screening, rates of recurrence following treatment and factors driving these in Africans have not been sufficiently studied. The purpose of this study therefore was to investigate factors associated with recurrence of cervical intraepithelial lesions following thermo-coagulation in HIV-positive and HIV-negative Nigerian women using Visual Inspection with Acetic Acid (VIA) or Lugol's Iodine (VILI) for diagnosis. METHODS A retrospective cohort study was conducted, recruiting participants from the cervical cancer "see and treat" program of IHVN. Data from 6 sites collected over a 4-year period was used. Inclusion criteria were: age ≥18 years, baseline HIV status known, VIA or VILI positive and thermo-coagulation done. Logistic regression was performed to examine the proportion of women with recurrence and to examine factors associated with recurrence. RESULTS Out of 177 women included in study, 67.8 % (120/177) were HIV-positive and 32.2 % (57/177) were HIV-negative. Recurrence occurred in 16.4 % (29/177) of participants; this was 18.3 % (22/120) in HIV-positive women compared to 12.3 % (7/57) in HIV-negative women but this difference was not statistically significant (p-value 0.31). Women aged ≥30 years were much less likely to develop recurrence, adjusted OR = 0.34 (95 % CI = 0.13, 0.92). Among HIV-positive women, CD4 count <200cells/mm(3) was associated with recurrence, adjusted OR = 5.47 (95 % CI = 1.24, 24.18). CONCLUSION Recurrence of VIA or VILI positive lesions after thermo-coagulation occurs in a significant proportion of women. HIV-positive women with low CD4 counts are at increased risk of recurrent lesions and may be related to immunosuppression.
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Affiliation(s)
- Emmanuel A Oga
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, 21201, USA. .,Institute of Human Virology Nigeria (IHVN), Abuja, Nigeria.
| | - Jessica P Brown
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Clayton Brown
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Eileen Dareng
- Institute of Human Virology Nigeria (IHVN), Abuja, Nigeria.,Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | | | | | | | | | | | | | - Patrick Dakum
- Institute of Human Virology Nigeria (IHVN), Abuja, Nigeria
| | - Clement Adebamowo
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.,Institute of Human Virology Nigeria (IHVN), Abuja, Nigeria.,University of Maryland Marlene and Stewart Greenebaum Cancer Center, Baltimore, MD, USA.,Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
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Mpiga É, Ivanga M, Koumakpayi IH, Engohan-Aloghe C, Ankély JC, Belembaogo E, Meye JF. [Interest in visual inspection with acetic acid and Lugol iodine with colposcope in screening of cervical lesions in Gabon]. Pan Afr Med J 2015; 22:165. [PMID: 26893799 PMCID: PMC4747445 DOI: 10.11604/pamj.2015.22.165.7038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 10/12/2015] [Indexed: 12/03/2022] Open
Abstract
Introduction Au Gabon, le dépistage des lésions précancéreuses et cancéreuses du col de l'utérus n'est pas systématique. La vulgarisation de ce dépistage suppose l'utilisation d'un test efficace et adapté aux réalités locales. Méthodes L'objectif de cette étude était de comparer les performances du frottis cervico-vaginal (FCV) conventionnel et de l'inspection visuelle à l'acide acétique (IVA) et au soluté de Lugol (IVL) couplée à la colposcopie, dans la détection des lésions du col utérin au Gabon. Des tests IVA/IVL et FCV ont été effectués chez 309 femmes gabonaises âgées de 18 à 75 ans. Des biopsies ont été réalisées en cas de résultat positif. Résultats 5 cancers épidermoïdes (1,6%) et 4 lésions précancéreuses (1,3%) ont été confirmées par l'histologie. L'IVA/IVL a présenté une meilleure sensibilité (100%) que le FCV (89%). Toutefois, le FCV est apparu plus spécifique (100% versus 92%). Avec une valeur prédictive (VP) négative de 100%, l'IVA/IVL a permis d'exclure avec certitude la présence de cancer du col lorsque le résultat était négatif, contrairement au FCV (92%). L'IVA/IVL et le FCV ont présenté des VP positives respectivement de 90% et 100%. Conclusion Cette étude montre que l'IVA/IVL avec colposcope couplée à l'histologie en cas de résultat positif apparaît plus performante que le FCV.
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Affiliation(s)
- Édith Mpiga
- Hôpital d'Instruction des Armées Omar Bongo Ondimba, Libreville, Gabon; Centre Hospitalier Universitaire d'Angondjé, Service de Gynécologie Obstétrique, Libreville, Gabon
| | - Mahinè Ivanga
- Institut de Cancérologie de Libreville, Département de Biologie des tumeurs et d'Anatomie Pathologique, Libreville, Gabon
| | - Ismaël Hervé Koumakpayi
- Institut de Cancérologie de Libreville, Département de Biologie des tumeurs et d'Anatomie Pathologique, Libreville, Gabon; Institut de Cancérologie de Libreville, Département d'Oncologie Médicale, Libreville, Gabon
| | - Corinne Engohan-Aloghe
- Hôpital d'Instruction des Armées Omar Bongo Ondimba, Libreville, Gabon; Institut de Cancérologie de Libreville, Département de Biologie des tumeurs et d'Anatomie Pathologique, Libreville, Gabon
| | - Junie Chansi Ankély
- Institut de Cancérologie de Libreville, Département de Biologie des tumeurs et d'Anatomie Pathologique, Libreville, Gabon
| | - Ernest Belembaogo
- Institut de Cancérologie de Libreville, Département d'Oncologie Médicale, Libreville, Gabon
| | - Jean-François Meye
- Centre Hospitalier Universitaire d'Angondjé, Service de Gynécologie Obstétrique, Libreville, Gabon
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Demment MM, Peters K, Dykens JA, Dozier A, Nawaz H, McIntosh S, Smith JS, Sy A, Irwin T, Fogg TT, Khaliq M, Blumenfeld R, Massoudi M, De Ver Dye T. Developing the Evidence Base to Inform Best Practice: A Scoping Study of Breast and Cervical Cancer Reviews in Low- and Middle-Income Countries. PLoS One 2015; 10:e0134618. [PMID: 26325181 PMCID: PMC4556679 DOI: 10.1371/journal.pone.0134618] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 07/12/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Breast and cervical cancers have emerged as major global health challenges and disproportionately lead to excess morbidity and mortality in low- and middle-income countries (LMICs) when compared to high-income countries. The objective of this paper was to highlight key findings, recommendations, and gaps in research and practice identified through a scoping study of recent reviews in breast and cervical cancer in LMICs. METHODS We conducted a scoping study based on the six-stage framework of Arskey and O'Malley. We searched PubMed, Cochrane Reviews, and CINAHL with the following inclusion criteria: 1) published between 2005-February 2015, 2) focused on breast or cervical cancer 3) focused on LMIC, 4) review article, and 5) published in English. RESULTS Through our systematic search, 63 out of the 94 identified cervical cancer reviews met our selection criteria and 36 of the 54 in breast cancer. Cervical cancer reviews were more likely to focus upon prevention and screening, while breast cancer reviews were more likely to focus upon treatment and survivorship. Few of the breast cancer reviews referenced research and data from LMICs themselves; cervical cancer reviews were more likely to do so. Most reviews did not include elements of the PRISMA checklist. CONCLUSION Overall, a limited evidence base supports breast and cervical cancer control in LMICs. Further breast and cervical cancer prevention and control studies are necessary in LMICs.
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Affiliation(s)
- Margaret M. Demment
- Clinical and Translational Research Institute, University of Rochester, Rochester, New York, United States of America
| | - Karen Peters
- Division of Community Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - J. Andrew Dykens
- Department of Family Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Ann Dozier
- Department of Public Health Sciences, University of Rochester, Rochester, New York, United States of America
| | - Haq Nawaz
- Department of Medicine, Griffin Hospital & Yale University-Griffin Prevention Research Center, New Haven, Connecticut, United States of America
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester, Rochester, New York, United States of America
| | - Jennifer S. Smith
- Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Angela Sy
- School of Nursing and Dental Hygiene, University of Hawai’i at Mānoa, Honolulu, Hawaii, United States of America
| | - Tracy Irwin
- Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, United States of America
| | - Thomas T. Fogg
- Clinical and Translational Research Institute, University of Rochester, Rochester, New York, United States of America
| | - Mahmooda Khaliq
- Department of Community and Family Health, University of South Florida, Tampa, Florida, United States of America
| | - Rachel Blumenfeld
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mehran Massoudi
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Timothy De Ver Dye
- Clinical and Translational Research Institute, University of Rochester, Rochester, New York, United States of America
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
- * E-mail:
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Ports KA, Haffejee F, Mosavel M, Rameshbabu A. Integrating cervical cancer prevention initiatives with HIV care in resource-constrained settings: A formative study in Durban, South Africa. Glob Public Health 2015; 10:1238-51. [PMID: 25654190 DOI: 10.1080/17441692.2015.1008021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Cervical cancer screening rates remain suboptimal among women in South Africa (SA), where cervical cancer prevalence is high. The rollout of HIV-related services across SA may provide a means to deliver cervical cancer screening to populations with limited access to health care systems. In this mixed methods study, psychosocial factors influencing cervical cancer prevention and perceptions of the provision of Pap smears in HIV care settings were examined. Structured interviews were conducted with women (n = 67) from a municipal housing estate in Durban, SA. Key informants (n = 12) also participated in semi-structured interviews. Findings revealed that participants had low cervical cancer knowledge, but desired more information. Relevant themes included the normalisation of HIV and beliefs that cervical cancer might be worse than HIV. A comprehensive community clinic was desired by most, even if HIV-positive patients were treated there. This study provides important insight into integrating cervical cancer screening with HIV clinics, which may increase cancer screening among South African women.
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Affiliation(s)
- Katie A Ports
- a Department of Social and Behavioral Health , Virginia Commonwealth University School of Medicine , Richmond , VA , USA
| | - Firoza Haffejee
- b Department of Basic Medical Sciences , Durban University of Technology , Durban , South Africa
| | - Maghboeba Mosavel
- a Department of Social and Behavioral Health , Virginia Commonwealth University School of Medicine , Richmond , VA , USA
| | - Anjali Rameshbabu
- c Department of Psychology , University of Wisconsin Milwaukee , Milwaukee , WI , USA
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Investigation of CPD and HMDS sample preparation techniques for cervical cells in developing computer-aided screening system based on FE-SEM/EDX. ScientificWorldJournal 2014; 2014:289817. [PMID: 25610902 PMCID: PMC4291196 DOI: 10.1155/2014/289817] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/24/2014] [Indexed: 11/22/2022] Open
Abstract
This paper investigated the effects of critical-point drying (CPD) and hexamethyldisilazane (HMDS) sample preparation techniques for cervical cells on field emission scanning electron microscopy and energy dispersive X-ray (FE-SEM/EDX). We investigated the visualization of cervical cell image and elemental distribution on the cervical cell for two techniques of sample preparation. Using FE-SEM/EDX, the cervical cell images are captured and the cell element compositions are extracted for both sample preparation techniques. Cervical cell image quality, elemental composition, and processing time are considered for comparison of performances. Qualitatively, FE-SEM image based on HMDS preparation technique has better image quality than CPD technique in terms of degree of spread cell on the specimen and morphologic signs of cell deteriorations (i.e., existence of plate and pellet drying artifacts and membrane blebs). Quantitatively, with mapping and line scanning EDX analysis, carbon and oxygen element compositions in HMDS technique were higher than the CPD technique in terms of weight percentages. The HMDS technique has shorter processing time than the CPD technique. The results indicate that FE-SEM imaging, elemental composition, and processing time for sample preparation with the HMDS technique were better than CPD technique for cervical cell preparation technique for developing computer-aided screening system.
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Demirhindi H, Nazlican E, Akbaba M. Cervical cancer screening in Turkey: a community-based experience after 60 years of pap smear usage. Asian Pac J Cancer Prev 2014; 13:6497-500. [PMID: 23464481 DOI: 10.7314/apjcp.2012.13.12.6497] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Cervical cancer is the second most common cancer in females in the World with around 500,000 new cases occurring annually, but the first in the developing countries with a high mortality if not diagnosed early. Papanicolau (Pap) smear is a cheap, easy-to-apply and widely accepted test which has been long used to detect cervical cancer at very early stages. However, despite being available for nearly 60 years, the test can hardly be considered to have become successfully applied in many communities. We aimed in this study to present the results of a screening survey for cervical cancer which targeted a women population aged between 35 and 40 living in a semi-rural area in the province of Hatay, located in the eastern Mediterranean region of Turkey, with specific aims of increasing early diagnosis, education and raising population awareness about cancers. This community-based descriptive study covered 512 women between 35 and 40 years of age living at Armutlu with a mean age of 37.6±1.7. Gynecologic examinations revealed cervical erosion in 8 (1.6%), vaginitis in 193 (37.7%) and normal findings in 311 (60.7%); pathological evaluation reports of the smears were negative in 290 (56.6%), inflammation in 218 (42.6%) and ASC-US in 4 (0.8%), according to the 2001 Bethesda classification. It can be concluded that Pap smear test - proven to be a very valuable test at the clinical level- should also be widely used at the community level to detect cervical cancer at very early stages to reduce both the mortality and morbidity among healthy people. The need for continuous community-based cervical cancer screening programs is strongly suggested.
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Affiliation(s)
- Hakan Demirhindi
- Department of Public Health, Faculty of Medicine, Cukurova University, Adana, Turkey.
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Zhang B, Zhou AF, Zhu CC, Zhang L, Xiang B, Chen Z, Hu RH, Zhang YQ, Qiu L, Zhang YM, Xiong CD, Du YK, Shi YQ. Risk factors for cervical cancer in rural areas of Wuhan China: a matched case-control study. Asian Pac J Cancer Prev 2014; 14:7595-600. [PMID: 24460339 DOI: 10.7314/apjcp.2013.14.12.7595] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Cervical cancer is a serious public health problem in developing countries. We investigated possible risk factors for cervical cancer in rural areas of Wuhan China using a matched case-control study with 33 women diagnosed with cervical cancer and 132 healthy women selected from the same area as matched controls. A questionnaire, which included questions about general demography conditions, environmental and genetic factors, the first sexual intercourse, first marriage age, age at first pregnancy, pregnancy first child's age, female personal health history, social psychological factors, dietary habits, smoking and alcohol status and other living habits was presented to all participants. At the same time, HPV infection of every participant was examined in laboratory testing. Results showed HPV infection (P<0.000, OR=23.4) and pregnancy first child's age (P<0.000, OR=13.1) to be risk factors for cervical cancer. Menopause (P=0.003, OR=0.073) was a protective factor against cervical cancer. However, there was no indication of associations of environmental (drinking water, insecticide, disinfectant) genetic (cancer family history), or life-style factors (smoking status, alcohol status, physical training, sleep quality), including dietary habits (intake of fruit and vegetable, meat, fried food, bean products and pickled food) or social psychological factors with cervical cancer. The results suggest that the risk of cervical cancer in Chinese rural women may be associated with HPV infection, menopause and the pregnancy first child's age.
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Affiliation(s)
- Bin Zhang
- Wuhan Women and Children's Medical Center Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China E-mail : ,
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Liu AH, Sun X, Wei XQ, Zhang YZ. Efficacy of multiple low-dose photodynamic TMPYP4 therapy on cervical cancer tumour growth in nude mice. Asian Pac J Cancer Prev 2014; 14:5371-4. [PMID: 24175828 DOI: 10.7314/apjcp.2013.14.9.5371] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Photodynamic therapy (PDT) is an emerging therapeutic procedure suitable for the treatment of cervical cancer. However, the side effects of PDT are severe, including skin ulceration, so we designed an experiment to examine the effects of multiple low- dose photodynamic therapy of 5, 10, 15, 20-tetrakis(1- methylpyridinium-4-yl) porphyrin (Tmpyp4) on tumour growth by utilizing a model in nude mice implanted with Hela cervical cancer cells. MATERIALS AND METHODS Female BALB/c nude mice (aged 5-6 weeks, weighing 18-20 g) were used. Hela cervical cancer cells were injected subcutaneously (1 x 10(7) cells/200 μL). Ten days after injection, the mice were divided into three groups (n=6), the A group of controls without any treatment, the B group receiving a single-treatment with Tmpyp4 (10 mg/kg, intratumor injection) and irradiation (blue laser, 108 J/cm(2)), and the C group given three-treatments with Tmpyp4 (10 mg/ kg, intratumor injection) and irradiation at intervals of two days. After starting treatment, tumours were measured every two days, to assess growth. At 2 weeks after the last treatment of C group, tumour tissue and organs were collected from each mouse to evaluate tumor histology and organ damage. RESULTS Tumour growth in C group was significantly inhibited compared with A and B groups (P <0.05), without any injury to the skin and internal organs. CONCLUSION Our novel findings demonstrated that multiple low-dose photodynamic therapy of Tmpyp4 could inhibit cervical cancer growth significantly with no apparent side effects.
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Affiliation(s)
- Ai-Hong Liu
- Department of Gynecology and Obstetrics, Qilu Hospital of Shandong Univeristy, Jinan, China E-mail :
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Innovative approaches to cervical cancer screening for sex trade workers: an international scoping review. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2014; 36:231-239. [PMID: 24612892 DOI: 10.1016/s1701-2163(15)30631-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Female sex trade workers are among those at highest risk for developing and dying of cervical cancer, and yet many-particularly the most marginalized-are less likely than other women to be screened. This review summarizes global findings on innovative approaches to cervical cancer screening for female sex trade workers, highlights current gaps in the delivery of cervical cancer screening for female sex trade workers globally, and suggests areas for future research and policy development. DATA SOURCES A scoping review of peer-reviewed publications and grey literature was conducted. Medline (OVID), PubMed, EMBASE, and SCOPUS were searched for relevant studies written in English. There were no limitations placed on dates. Grey literature was identified by hand searching and through discussion with health care providers and community outreach workers currently working with sex trade workers. STUDY SELECTION Twenty-five articles were deemed suitable for review. Articles detailing innovative ways for female sex trade workers to access cervical cancer screening were included. Articles about screening for sexually transmitted infections were also included if the findings could be generalized to screening for cervical cancer. Articles limited to exploring risk factors, knowledge, awareness, education, prevalence, and incidence of cervical cancer among sex trade workers were excluded from the review. DATA EXTRACTION AND SYNTHESIS Successful screening initiatives identified in the studies reviewed had unconventional hours of operation, understood the difference between street-based and venue-based sex trade workers, and/or used peers for outreach. CONCLUSION Two significant gaps in health care service delivery were highlighted in this review: the limited use of unorthodox hours and the nearly exclusive practice of providing sexually transmitted infection screening for female sex trade workers without cervical cancer screening. In addition, although street-based (as opposed to venue-based) sex trade workers are likely at higher risk for developing cervical cancer, they are much less likely than other eligible women to participate in screening programs, meaning traditional outreach methods are unlikely to be successful.
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Jusman Y, Ng SC, Abu Osman NA. Intelligent screening systems for cervical cancer. ScientificWorldJournal 2014; 2014:810368. [PMID: 24955419 PMCID: PMC4037632 DOI: 10.1155/2014/810368] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 02/11/2014] [Indexed: 12/20/2022] Open
Abstract
Advent of medical image digitalization leads to image processing and computer-aided diagnosis systems in numerous clinical applications. These technologies could be used to automatically diagnose patient or serve as second opinion to pathologists. This paper briefly reviews cervical screening techniques, advantages, and disadvantages. The digital data of the screening techniques are used as data for the computer screening system as replaced in the expert analysis. Four stages of the computer system are enhancement, features extraction, feature selection, and classification reviewed in detail. The computer system based on cytology data and electromagnetic spectra data achieved better accuracy than other data.
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Affiliation(s)
- Yessi Jusman
- Department of Biomedical Engineering, Faculty of Engineering Building, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Siew Cheok Ng
- Department of Biomedical Engineering, Faculty of Engineering Building, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Noor Azuan Abu Osman
- Department of Biomedical Engineering, Faculty of Engineering Building, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Multiple adaptive neuro-fuzzy inference system with automatic features extraction algorithm for cervical cancer recognition. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2014; 2014:181245. [PMID: 24707316 PMCID: PMC3953496 DOI: 10.1155/2014/181245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 12/13/2013] [Accepted: 12/17/2013] [Indexed: 01/10/2023]
Abstract
To date, cancer of uterine cervix is still a leading cause of cancer-related deaths in women worldwide. The current methods (i.e., Pap smear and liquid-based cytology (LBC)) to screen for cervical cancer are time-consuming and dependent on the skill of the cytopathologist and thus are rather subjective. Therefore, this paper presents an intelligent computer vision system to assist pathologists in overcoming these problems and, consequently, produce more accurate results. The developed system consists of two stages. In the first stage, the automatic features extraction (AFE) algorithm is performed. In the second stage, a neuro-fuzzy model called multiple adaptive neuro-fuzzy inference system (MANFIS) is proposed for recognition process. The MANFIS contains a set of ANFIS models which are arranged in parallel combination to produce a model with multi-input-multioutput structure. The system is capable of classifying cervical cell image into three groups, namely, normal, low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL). The experimental results prove the capability of the AFE algorithm to be as effective as the manual extraction by human experts, while the proposed MANFIS produces a good classification performance with 94.2% accuracy.
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Jia Y, Li S, Yang R, Zhou H, Xiang Q, Hu T, Zhang Q, Chen Z, Ma D, Feng L. Knowledge about cervical cancer and barriers of screening program among women in Wufeng County, a high-incidence region of cervical cancer in China. PLoS One 2013; 8:e67005. [PMID: 23843976 PMCID: PMC3699583 DOI: 10.1371/journal.pone.0067005] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 05/16/2013] [Indexed: 12/17/2022] Open
Abstract
Purpose Cervical cancer screening is an effective method for reducing the incidence and mortality of cervical cancer, but the screening attendance rate in developing countries is far from satisfactory, especially in rural areas. Wufeng is a region of high cervical cancer incidence in China. This study aimed to investigate the issues that concern cervical cancer and screening and the factors that affect women’s willingness to undergo cervical cancer screening in the Wufeng area. Participants and Methods A cross-sectional survey of women was conducted to determine their knowledge about cervical cancer and screening, demographic characteristics and the barriers to screening. Results Women who were willing to undergo screenings had higher knowledge levels. “Anxious feeling once the disease was diagnosed” (47.6%), “No symptoms/discomfort” (34.1%) and “Do not know the benefits of cervical cancer screening” (13.4%) were the top three reasons for refusing cervical cancer screening. Women who were younger than 45 years old or who had lower incomes, positive family histories of cancer, secondary or higher levels of education, higher levels of knowledge and fewer barriers to screening were more willing to participate in cervical cancer screenings than women without these characteristics. Conclusion Efforts are needed to increase women’s knowledge about cervical cancer, especially the screening methods, and to improve their perceptions of the screening process for early detection to reduce cervical cancer incidence and mortality rates.
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Affiliation(s)
- Yao Jia
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Shuang Li
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Ru Yang
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Hang Zhou
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Qunying Xiang
- Maternity and Child Health Care Hospital, Tujia Nationality Autonomous County, Wufeng, P.R. China
| | - Ting Hu
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Qinghua Zhang
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Zhilan Chen
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Ding Ma
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
- * E-mail: (DM); (LF)
| | - Ling Feng
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
- * E-mail: (DM); (LF)
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Chubak J, Rutter CM, Kamineni A, Johnson EA, Stout NK, Weiss NS, Doria-Rose VP, Doubeni CA, Buist DSM. Measurement in comparative effectiveness research. Am J Prev Med 2013; 44:513-9. [PMID: 23597816 PMCID: PMC3631525 DOI: 10.1016/j.amepre.2013.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 10/09/2012] [Accepted: 01/08/2013] [Indexed: 01/11/2023]
Abstract
Comparative effectiveness research (CER) on preventive services can shape policy and help patients, their providers, and public health practitioners select regimens and programs for disease prevention. Patients and providers need information about the relative effectiveness of various regimens they may choose. Decision makers need information about the relative effectiveness of various programs to offer or recommend. The goal of this paper is to define and differentiate measures of relative effectiveness of regimens and programs for disease prevention. Cancer screening is used to demonstrate how these measures differ in an example of two hypothetical screening regimens and programs. Conceptually and algebraically defined measures of relative regimen and program effectiveness also are presented. The measures evaluate preventive services that range from individual tests through organized, population-wide prevention programs. Examples illustrate how effective screening regimens may not result in effective screening programs and how measures can vary across subgroups and settings. Both regimen and program relative effectiveness measures assess benefits of prevention services in real-world settings, but each addresses different scientific and policy questions. As the body of CER grows, a common lexicon for various measures of relative effectiveness becomes increasingly important to facilitate communication and shared understanding among researchers, healthcare providers, patients, and policymakers.
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Affiliation(s)
- Jessica Chubak
- Group Health Research Institute, Seattle, WA 98101, USA.
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Cervical cancer screening: women's knowledge, attitudes, and practices in the region of Monastir (Tunisia). Rev Epidemiol Sante Publique 2012; 60:431-6. [PMID: 23127786 DOI: 10.1016/j.respe.2012.03.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Revised: 02/19/2012] [Accepted: 03/27/2012] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In Tunisia, cervical cancer is considered the second leading cancer in women and causes high morbidity and mortality. This study aimed to investigate women's knowledge, attitudes, and practices of cervical cancer screening in the region of Monastir (Tunisia). METHODS We conducted a cross-sectional study exploring the cervical cancer screening knowledge, attitudes, and practices of women in the region of Monastir. The study was conducted in health centers in this region from 1st March to 30th June 2009. Data were collected using a structured questionnaire containing 15 items on demographic status, knowledge of risk factors and screening methods, and attitudes toward the relevance and effectiveness of cervical cancer screening. RESULTS A total of 900 women agreed to take part in the study. Their mean age was 41.6±12.4 years and 64% did not exceed the primary level of education. According to the constructed scores, 22.8% of the participants had good knowledge of cervical cancer risk factors and 38.2% had good knowledge of screening methods. Multiple logistic regression analysis showed that women aged 45 and older, married, with good knowledge of risk factors and screening methods were more likely to undergo cervical cancer screening (P-value<0.01). CONCLUSION This study provides useful information that could be utilized by both researchers and those involved in public health programs. The results show the need for educational programs to enhance women's adherence to cervical cancer screening programs in Tunisia.
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Mehmetoglu HC, Sadikoglu G, Ozcakir A, Bilgel N. Pap smear screening in the primary health care setting: A study from Turkey. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2012; 2:467-72. [PMID: 22558549 PMCID: PMC3339109 DOI: 10.4297/najms.2010.2468] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Cervical cancer is one of the ten most frequent cancers in Turkey. It is well known that cervical cancer morbidity and mortality could be significantly reduced with an active cervical smear screening (Pap smear) program. AIMS THE AIMS OF THIS STUDY WERE: 1) to evaluate the knowledge and attitudes of women about cervical smear testing; 2) to establish a cervical smear screening program and to evaluate the cervical cytological abnormalities that were found; 3) to determine the applicability, limitations and effectiveness of this screening in a primary health care unit. PATIENTS AND METHODS A total of 332 married women were included in our study. We collected data concerning socio-demographic and fertility characteristics, and knowledge about Pap smear testing was determined through printed questionnaires. A gynecological examination and Pap smear screening was performed on every woman in our study group. RESULTS Over ninety percent of our study group had never heard of and had not undergone Pap smear screening before. Of the 332 smears evaluated, 328 (98.8%) were accepted as normal, whereas epithelial cell anomalies were seen in 4 (1.2%), infection in 59 (17.7%), and reactive cell differences in 223 (67.2%) of the smears. CONCLUSIONS The frequency of epithelial cell anomalies in our study group was less than the frequencies reported from Western countries. Knowledge regarding cervical cancer and Pap smear screening was very low. Pap smears can be easily taken and evaluated through a chain built between the primary health care unit and laboratory, and this kind of screening intervention is easily accepted by the population served.
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Botha MH, Dochez C. Introducing human papillomavirus vaccines into the health system in South Africa. Vaccine 2012; 30 Suppl 3:C28-34. [DOI: 10.1016/j.vaccine.2012.03.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Revised: 02/20/2012] [Accepted: 03/15/2012] [Indexed: 10/27/2022]
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Cronjé HS. Cervical screening strategies in resourced and resource-constrained countries. Best Pract Res Clin Obstet Gynaecol 2012; 25:575-84. [PMID: 21689987 DOI: 10.1016/j.bpobgyn.2011.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Revised: 04/28/2011] [Accepted: 05/09/2011] [Indexed: 10/18/2022]
Abstract
Screening for cervical cancer is well established in resourced countries, but in resource-constrained countries, it is almost non-existent at national level. In resourced countries, the Pap test forms the hallmark of screening, with the human papillomavirus DNA test a recent adjunct. In many resourced countries, however, screening for cervical cancer is still far from ideal. A coverage around 50% prevails in some countries, and few have reached the target of 80% or more. Furthermore, the human papillomavirus test and newly developed biomarkers may lead to the development of a 'super test', which could be applied less frequently compared with present-day cytological screening. In resource-constrained countries, the movement is towards a 'screen and treat' approach. The main screening methods under investigation are the visual inspection after diluted acetic acid application test and the human papillomavirus test. Cryotherapy and large loop excision of the transformation zone have been used most often as treatment methods. The ideal seems to be the human papillomavirus test with large loop excision of the transformation zone, provided a low-cost human papillomavirus test becomes available. Coverage is even a greater problem in resource-constrained countries, a problem in need of urgent attention. Resource-constrained countries, however, must curtail the high incidence of cervical cancer, which is often a lower priority than other pressing healthcare needs.
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Affiliation(s)
- H S Cronjé
- Department of Obstetrics and Gynaecology, University of the Free State, Bloemfontein, South Africa.
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Feng CY, Lin M, Lakhaney D, Sun HK, Dai XB, Zhao FH, Qiao YL. The association between dietary intake and cervical intraepithelial neoplasia grade 2 or higher among women in a high-risk rural area of china. Arch Gynecol Obstet 2010; 284:973-80. [DOI: 10.1007/s00404-010-1743-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2010] [Accepted: 10/19/2010] [Indexed: 11/28/2022]
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IS THE PAP TEST ON ITS WAY OUT? J Midwifery Womens Health 2008. [DOI: 10.1016/j.jmwh.2007.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Affiliation(s)
- Anne Szarewski
- Wolfson Institute of Preventive Medicine, London EC1M 6BQ, UK.
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