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Verma ML, Singh U, Kumari R, Sachan R, Sankhwar PL, Solanki V. Randomized controlled study for comparison of efficacy and safety between thermocoagulation and cryotherapy in visual inspection with acetic acid positive cervical lesions. J Cancer Res Ther 2022; 18:603-611. [PMID: 35900529 DOI: 10.4103/jcrt.jcrt_832_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Less literature is available on the performance of thermocoagulation for treatment of premalignant cervical lesions and its comparison with cryotherapy from low- and middle-income countries like India. Materials and Methods : A prospective randomized controlled study was done in the Department of Obstetrics and Gynecology from August 2018 to September 2019 after obtaining ethical clearance from Institutional Review Board (Reg no: ECR/262/Inst/Up/2013/RR/16) Ref no: 278/Ethics/R. cell-18). A total of 68 women with Visual inspection with acetic acid (VIA) positive cervical lesion were randomized into two groups. Group A was treated with cryotherapy and Group B was treated with thermocoagulation. Estimates of cure, adverse effects or complications were presented as frequencies, percentages, and mean ± standard deviation. Results Out of 667 patients, 624 patients underwent VIA testing among which 68 were VIA positive (10.89%, 68/624). The efficacy of thermocoagulation was 93.54% and that of cryotherapy was 90.32%. Immediate side effects were significantly lesser in thermocoagulation group (P = 0.008) in comparison to cryotherapy. Conclusion Thermocoagulation is better treatment modality than cryotherapy for VIA-positive cervical lesions may not be in terms of efficacy but definitely in terms of patient comfort and safety.
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Affiliation(s)
- Manju Lata Verma
- Department of Obstetrics and Gynaecology, KGMU, Lucknow, Uttar Pradesh, India
| | - Uma Singh
- Department of Obstetrics and Gynaecology, KGMU, Lucknow, Uttar Pradesh, India
| | - Ruby Kumari
- Department of Obstetrics and Gynaecology, KGMU, Lucknow, Uttar Pradesh, India
| | - Rekha Sachan
- Department of Obstetrics and Gynaecology, KGMU, Lucknow, Uttar Pradesh, India
| | - Pushp Lata Sankhwar
- Department of Obstetrics and Gynaecology, KGMU, Lucknow, Uttar Pradesh, India
| | - Vandana Solanki
- Department of Obstetrics and Gynaecology, KGMU, Lucknow, Uttar Pradesh, India
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Amin S, Abdullahi K, Muhammad M, Mohammed L, Mahmoud R, Muhammad R. Perception of cervical cancer and its cytological screening among medical students. SAHEL MEDICAL JOURNAL 2020. [DOI: 10.4103/smj.smj_26_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Pourasad-Shahrak S, Salehi-Pourmehr H, Mostafa-Garebaghi P, Asghari-Jafarabadi M, Malakouti J, Haghsay M. Comparing the results of Pap smear and Direct Visual Inspection (DVI) with 5% acetic acid in cervical cancer screening. Niger Med J 2015; 56:35-8. [PMID: 25657491 PMCID: PMC4314857 DOI: 10.4103/0300-1652.149168] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Cervical cancer is the most second common cancer among Iranian women. This study was carried out to compare the results of Pap smear method and Direct Visual Inspection (DVI) with 5% acetic acid in cervical cancer screening in Tabriz, Iran. Material and Methods: This cross-sectional study was carried out in Alzahra Therapeutic-Educational Centre, Tabriz, Iran in 2013 on 1000 women. First, Pap smear was done for all women, and then the cervix exposed with 5% acetic acid by cotton swab for 30 seconds and observed under adequate light. At the end, women with abnormal results in Pap smear or DVI method were referred to colposcopy and biopsy. Test's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), LR+, LR- and confidence interval (CI) were determined (P < 0.05). Results: Nine-hundred and seventy-four (94.7%) cases were normal and had no abnormal findings and 26 (2.6%) participants had positive results in Pap smear or DVI test. Twelve women had abnormal Pap smear (nine women with atypical squamous cells of undetermined significance, ASCUS, three women with dysplasia, atypical endocervical, and low-grade squamous intraepithelial lesion, LSIL results) and 14 women had positive DVI (four women with human papillomavirus, HPV or koilocyte,) and one women with abnormality in both method had carcinoma in biopsy that referred to oncologist. In this study the sensitivity, specificity, PPV and NPV for DVI were 71.4%, 50%, 35.7%, and 81.8% respectively in comparison with 14.3%, 50%, 10%, and 60% for Pap smear. Conclusion: As the DVI method has higher sensitivity and positive predictive value than Pap smear, it could be used as a useful method beside the Pap smear.
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Affiliation(s)
| | | | - Parvin Mostafa-Garebaghi
- Professor of Gynecology, Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
| | | | - Jamileh Malakouti
- Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Monireh Haghsay
- Alzahra Therapeutic Educational Hospital of Tabriz, Tabriz, Iran
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Nessa A, Nahar KN, Begum SA, Anwary SA, Hossain F, Nahar K. Comparison between visual inspection of cervix and cytology based screening procedures in Bangladesh. Asian Pac J Cancer Prev 2014; 14:7607-11. [PMID: 24460341 DOI: 10.7314/apjcp.2013.14.12.7607] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cervical cancer continues to be a major problem in Bangladesh with approximately 18,000 new cases annually of which over 10,000 women die from it. Visual inspection of the cervix after 3-5% acetic acid (VIA) application is a simple and easy to learn method for cervical cancer screening, although cytology-based screening is more often applied in developed countries where it has successfully reduced the prevalence of cervical cancer. OBJECTIVE To compare the efficacy of VIA and cytology-based primary methods for cervical cancer screening in Bangladesh. MATERIALS AND METHODS This hospital based comparative study was conducted at the VIA centre and Colposcopy Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) from October 2008 to October 2010. RESULTS Among 650 women, 74 (11.4%) were VIA+ve and 8 (1.2%) had abnormalities in their Pap smear reports. During colposcopy, 38 (7.7%) women had different grades of CIN and 4 (0.6%) had cervical cancer. The gold standard histology findings proved 20 women had CIN I, 14 had CIN II/II and 4 had cervical cancer. Among the 38 histology diagnosed abnormalities, VIA test could identify 30 abnormalities including two cervical cancers. However, Pap smear could detect only 8 cases of histological abnormalities (2 low grade and 6 had high grade lesion) and it missed all the cervical cancer cases. The sensitivity and specificity of VIA were 88.9% and 52.1%. The positive predictive value (PPV) and negative predictive value (NPV) were 41.0%, and 92.6% respectively. Moreover, the sensitivity, specificity, PPV and NPV of Pap smear were 33.3%, 95.8%, 75.0% and 79.3%, respectively. CONCLUSIONS VIA test should be used as the primary screening tool even with its low sensitivity and specificity in low resource countries like Bangladesh. False positive results may be greater, but overtreatment can be minimized by colposcopy evaluation of the VIA positive women.
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Affiliation(s)
- Ashrafun Nessa
- Gyne-oncology Unit, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh E-mail :
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Ezechi OC, Petterson KO, Gbajabiamila TA, Idigbe IE, Kuyoro O, Ujah IAO, Ostergren PO. Predictors of default from follow-up care in a cervical cancer screening program using direct visual inspection in south-western Nigeria. BMC Health Serv Res 2014; 14:143. [PMID: 24678898 PMCID: PMC3986612 DOI: 10.1186/1472-6963-14-143] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 03/27/2014] [Indexed: 11/24/2022] Open
Abstract
Background Increasingly evidence is emerging from south East Asia, southern and east Africa on the burden of default to follow up care after a positive cervical cancer screening/diagnosis, which impacts negatively on cervical cancer prevention and control. Unfortunately little or no information exists on the subject in the West Africa sub region. This study was designed to determine the proportion of and predictors and reasons for default from follow up care after positive cervical cancer screen. Method Women who screen positive at community cervical cancer screening using direct visual inspection were followed up to determine the proportion of default and associated factors. Multivariate logistic regression was used to determine independent predictors of default. Results One hundred and eight (16.1%) women who screened positive to direct visual inspection out of 673 were enrolled into the study. Fifty one (47.2%) out of the 108 women that screened positive defaulted from follow-up appointment. Women who were poorly educated (OR: 3.1, CI: 2.0 – 5.2), or lived more than 10 km from the clinic (OR: 2.0, CI: 1.0 – 4.1), or never screened for cervical cancer before (OR: 3.5, CI:3:1–8.4) were more likely to default from follow-up after screening positive for precancerous lesion of cervix . The main reasons for default were cost of transportation (48.6%) and time constraints (25.7%). Conclusion The rate of default was high (47.2%) as a result of unaffordable transportation cost and limited time to keep the scheduled appointment. A change from the present strategy that involves multiple visits to a “see and treat” strategy in which both testing and treatment are performed at a single visit is recommended.
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Sando Z, Fouogue JT, Fouelifack FY, Fouedjio JH, Mboudou ET, Essame JLO. [Profile of breast and gynecological cancers in Yaoundé--Cameroon]. Pan Afr Med J 2014; 17:28. [PMID: 24932339 PMCID: PMC4048679 DOI: 10.11604/pamj.2014.17.28.3447] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 11/09/2013] [Indexed: 01/31/2023] Open
Affiliation(s)
- Zacharie Sando
- Département des sciences morphologiques de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Cameroun ; Chef Service de l'unité d'anatomie pathologique de l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé, Cameroun
| | - Jovanny Tsuala Fouogue
- Département de Gynécologie et obstétriques de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé I, Cameroun
| | | | - Jeanne Hortence Fouedjio
- Département de Gynécologie et obstétriques de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé I, Cameroun ; Unité de Gynécologie et d'Obstétrique de l'Hôpital Central de Yaoundé, Cameroun
| | - Emile Telesphore Mboudou
- Département de Gynécologie et obstétriques de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé I, Cameroun ; Chef de l'Unité de Gynécologie et Obstétriques de l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé-Cameroun
| | - Jean Louis Oyono Essame
- Chef de département des sciences morphologiques de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Cameroun
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Ezechi OC, Gab-Okafor CV, Ostergren PO, Odberg Pettersson K. Willingness and acceptability of cervical cancer screening among HIV positive Nigerian women. BMC Public Health 2013; 13:46. [PMID: 23327453 PMCID: PMC3567931 DOI: 10.1186/1471-2458-13-46] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 01/08/2013] [Indexed: 12/02/2022] Open
Abstract
Background The proven benefit of integrating cervical cancer screening programme into HIV care has led to its adoption as a standard of care. However this is not operational in most HIV clinics in Nigeria. Of the various reasons given for non-implementation, none is backed by scientific evidence. This study was conducted to assess the willingness and acceptability of cervical cancer screening among HIV positive Nigerian women. Methods A cross sectional study of HIV positive women attending a large HIV treatment centre in Lagos, Nigeria. Respondents were identified using stratified sampling method. A pretested questionnaire was used to obtain information by trained research assistants. Obtained information were coded and managed using SPSS for windows version 19. Multivariate logistic regression model was used to determine independent predictor for acceptance of cervical cancer screening. Results Of the 1517 respondents that returned completed questionnaires, 853 (56.2%) were aware of cervical cancer. Though previous cervical cancer screening was low at 9.4%, 79.8% (1210) accepted to take the test. Cost of the test (35.2%) and religious denial (14.0%) were the most common reasons given for refusal to take the test. After controlling for confounding variables in a multivariate logistic regression model, having a tertiary education (OR = 1.4; 95% CI: 1.03-1.84), no living child (OR: 1.5; 95% CI: 1.1-2.0), recent HIV diagnosis (OR: 1.5; 95% CI: 1.1-2.0) and being aware of cervical cancer (OR: 1.5; 95% CI: 1.2-2.0) retained independent association with acceptance to screen for cervical cancer. Conclusions The study shows that HIV positive women in our environment are willing to screen for cervical cancer and that the integration of reproductive health service into existing HIV programmes will strengthen rather than disrupt the services.
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Affiliation(s)
- Oliver C Ezechi
- Clinical Sciences Division, Nigerian Institute of Medical Research, Lagos, Nigeria.
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Albert SO, Oguntayo OA, Samaila MOA. Comparative study of visual inspection of the cervix using acetic acid (VIA) and Papanicolaou (Pap) smears for cervical cancer screening. Ecancermedicalscience 2012; 6:262. [PMID: 22855689 PMCID: PMC3408898 DOI: 10.3332/ecancer.2012.262] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Indexed: 11/30/2022] Open
Abstract
This article is a comparative study of two screening methods for pre-invasive lesions of the cervix. The Papanicolaou (Pap) smear, an old and tested screening method, is compared with the findings from visual inspection of the cervix following acetic acid (VIA) wash. VIA is a new screening method being advocated by the World Health Organization as an alternative to Pap smear in low-resource settings.
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Affiliation(s)
- SO Albert
- Department of Obstetrics and Gynaecology, ABU Teaching Hospital, Zaria, Nigeria
| | - OA Oguntayo
- Department of Obstetrics and Gynaecology, ABU Teaching Hospital, Zaria, Nigeria
| | - MOA Samaila
- Department of Pathology, ABU Teaching Hospital, Zaria, Nigeria
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Yusuf N, Ali MA, Islam MF, Khanam JA. Screening of cervical cancer by VIA among women in Rajshahi Medical College Hospital. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2012. [DOI: 10.1016/s2222-1808(12)60017-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bhatla N, Puri K, Kriplani A, Iyer VK, Mathur SR, Mani K, Pandey RM. Adjunctive testing for cervical cancer screening in low resource settings. Aust N Z J Obstet Gynaecol 2012; 52:133-9. [DOI: 10.1111/j.1479-828x.2011.01402.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Accepted: 11/26/2011] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | | | | | - Kalaivani Mani
- Department of Biostatistics; All India Institute of Medical Sciences (AIIMS); New Delhi; India
| | - Ravindra M. Pandey
- Department of Biostatistics; All India Institute of Medical Sciences (AIIMS); New Delhi; India
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Iliyasu Z, Abubakar IS, Aliyu MH, Galadanci HS. Cervical cancer risk perception and predictors of human papilloma virus vaccine acceptance among female university students in northern Nigeria. J OBSTET GYNAECOL 2010; 30:857-62. [DOI: 10.3109/01443615.2010.511724] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | | | - M. H. Aliyu
- Department of Preventive Medicine and Institute for Global Health, Vanderbilt University, Nashville, Tennessee, USA
| | - H. S. Galadanci
- Obstetrics and Gynaecology, Aminu Kano Teaching Hospital and Bayero University Kano, Nigeria
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Palaoro L, Rocher A. AgNOR technique could be useful for differential diagnosis of squamous carcinomatous cells and atypical cells related to human papillomavirus in cervical smears. Biotech Histochem 2009; 84:73-8. [PMID: 19333799 DOI: 10.1080/10520290902853412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The human papillomavirus (HPV)-associated effect can mimic invasive squamous cell carcinoma. Measurements of the argyrophilic nucleolar organizer region (AgNOR) area of cells from smears with HPV infection of the cervix with marked atypia were carried out to differentiate this pathology from keratinizing carcinomas. After destaining, the smears were incubated in the dark for 25 min with a mixture of silver nitrate and gelatin in formic acid. After washing with deionized water and sodium thiosulfate, the slides were dehydrated and mounted with Canada balsam. The average AgNOR area was determined by image cytometry using the immersion oil objective and selecting 100 cells in each smear. Twenty-three patients with a mean AgNOR area of 1.32 microm(2) among their samples showed normal colposcopies and cervical smears after 18 months. In four patients, whose samples were diagnosed as atypical squamous cells of undetermined significance with viral atypia, the average AgNOR area was 7.70 microm(2); biopsies showed keratinizing squamous carcinomas in three of these cases and moderately differentiated squamous carcinoma in one of them. We propose a cutoff of 2.2 microm(2) for the AgNOR area of cells from smears with HPV infection of the cervix with marked atypia to differentiate this group from keratinizing carcinomas.
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Affiliation(s)
- L Palaoro
- Clinical Hospital (UBA) - Biochemistry, Buenos Aires, Argentina.
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Ahmed T, Ashrafunnessa, Rahman J. Development of a visual inspection programme for cervical cancer prevention in Bangladesh. REPRODUCTIVE HEALTH MATTERS 2008; 16:78-85. [DOI: 10.1016/s0968-8080(08)32419-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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