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Hariprasad R, Mittal S, Basu P. Role of colposcopy in the management of women with abnormal cytology. Cytojournal 2022; 19:40. [PMID: 35928528 PMCID: PMC9345135 DOI: 10.25259/cmas_03_15_2021] [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: 11/15/2021] [Accepted: 11/15/2021] [Indexed: 11/04/2022] Open
Abstract
Cytology identifies the women who are at higher risk of harboring high-grade cervical premalignant lesions or invasive cancer. However, a diagnostic test such as colposcopy is crucial for women with abnormal cytology for localization of the abnormality, confirmation of diagnosis, and appropriate management. To standardize this subjective technique and to minimize the interobserver variations, Swede scoring system was introduced. The revised colposcopic nomenclature of the International Federation of Cervical Pathology and Colposcopy in 2011 included various normal and abnormal colposcopic findings and gives a description of colposcopic features which improves its accuracy over the colposcopic indices. There is consensus agreement that cytology indicative of high-grade lesions (ASC-H and HSIL in the Bethesda system) should engender immediate referral for colposcopy and biopsy. The management of women who have equivocal or borderline cytology of low-grade abnormalities (ASCUS/LSIL) is still under deliberation. It is generally agreed to have an HPV triage for women with equivocal cytology. Based on the latest recommendations, the current chapter provides an extensive overview of the role of colposcopy in the management of women with various abnormalities reported on Pap smear.
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Affiliation(s)
- Roopa Hariprasad
- Department of Clinical Oncology, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Srabani Mittal
- Department of Preventive Oncology, Cancer Foundation of India, Principal investigator/BMGF Project, Child in Need Institute, Kolkata, India
| | - Partha Basu
- International Agency for Research on Cancer, World Health Organization, Lyon, France
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Nguyen NTK, Nguyen LT, Le HT, Nguyen BT, Pham NB, Pham PL, Vu LTH. How to integrate screening for cervical cancer into grassroots health services for low income countries: An implementation research. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2021. [DOI: 10.1080/20479700.2020.1729593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Ngan T. K. Nguyen
- Department of Epidemiology& Biostatistics, Hanoi University of Public Health, Hanoi, Vietnam
| | - Linh T. Nguyen
- Department of Epidemiology& Biostatistics, Hanoi University of Public Health, Hanoi, Vietnam
| | - Hoang T. Le
- Department of Epidemiology& Biostatistics, Hanoi University of Public Health, Hanoi, Vietnam
| | - Binh T. Nguyen
- Food Safety Management Board, Bac Ninh provincial People’s Committee, Bac Ninh, Vietnam
| | - Nha Ba Pham
- Department of Obstetrics and Gynecology, Bach Mai Hospital, Hanoi, Vietnam
| | - Phuong Lan Pham
- Department of Training, National Hospital for Obstetrics and Gynecology, Hanoi, Vietnam
| | - Lan T. H. Vu
- Department of Epidemiology& Biostatistics, Hanoi University of Public Health, Hanoi, Vietnam
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Kabanda R, Bikaitwoha Maniple E, Baluku JB, Kiconco A. Utilisation of Community Audio Towers in Health Education for Prevention of Cervical Cancer by Health Workers in Kyotera District, Uganda: A Cross-Sectional Study. Risk Manag Healthc Policy 2021; 14:3667-3673. [PMID: 34512054 PMCID: PMC8420789 DOI: 10.2147/rmhp.s321200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/23/2021] [Indexed: 12/05/2022] Open
Abstract
Purpose Community audio towers (CATs) are a communication resource that can be utilized by public health practitioners to enhance health communication in rural and peri-urban settings. However, information on availability of this channel of communication for use in health education and promotion remains scanty. We determined the availability of CATs for use in cervical cancer health education among health workers for prevention of cervical cancer in Kyotera District, Uganda. Methods Using a cross-sectional study design, health workers were randomly selected from health facilities in Kyotera District. Eligible participants were health workers who had worked in the district for at least one year. A pre-tested study questionnaire was self-administered. Descriptive statistics were used to determine availability and use of CATs, while factors associated with the use of CATs were determined by logistic regression analysis. Results Between March and April 2020, 160 health workers were enrolled, and of these, 102 (63.8%) were females and 69 (43.1%) were nurses. Most of them, ie, 143 (89.4%) reported that CATs were within walkable distance from their workplaces; 140 (87.5%) indicated that CATs are conveniently located, and 129 (80.6%) reported that it was easy to secure airtime to sensitise communities on health issues. Only 26 (16.3%) had ever used CATs for cervical cancer health education. Health workers at facilities without a plan that includes CATs as a channel of health communication were less likely to utilise CATs (OR = 0.04, 95% CI (0.0043–0.37), p = 0.005) while those who had ever managed a patient with cervical cancer (OR = 16.48, 95% CI (3.4–79.7), p < 0.001) were more likely to utilise CATs. Conclusion Although CATs were deemed readily available, there was low utilisation for cervical cancer education and promotion of preventive services by health workers. Health facilities need to strategically include CATs in their plans to increase utilisation.
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Affiliation(s)
- Richard Kabanda
- Faculty of Health Sciences, Uganda Martyrs University, Nkozi, Uganda
| | | | | | - Arthur Kiconco
- Faculty of Health Sciences, Uganda Martyrs University, Nkozi, Uganda
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Razzano D, Hall A, Gardner JM, Jiang X“S. Pathology Engagement in Global Health: Exploring Opportunities to Get Involved. Arch Pathol Lab Med 2019; 143:418-421. [DOI: 10.5858/arpa.2018-0280-ed] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Dana Razzano
- From the Department of Pathology, New York Medical College at Westchester Medical Center, Valhalla (Dr Razzano); the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Drs Hall and Jiang); and the Department of Pathology, University of Arkansas for Medical Sciences, Little Rock (Dr Gardner)
| | - Allison Hall
- From the Department of Pathology, New York Medical College at Westchester Medical Center, Valhalla (Dr Razzano); the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Drs Hall and Jiang); and the Department of Pathology, University of Arkansas for Medical Sciences, Little Rock (Dr Gardner)
| | - Jerad M. Gardner
- From the Department of Pathology, New York Medical College at Westchester Medical Center, Valhalla (Dr Razzano); the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Drs Hall and Jiang); and the Department of Pathology, University of Arkansas for Medical Sciences, Little Rock (Dr Gardner)
| | - Xiaoyin “Sara” Jiang
- From the Department of Pathology, New York Medical College at Westchester Medical Center, Valhalla (Dr Razzano); the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Drs Hall and Jiang); and the Department of Pathology, University of Arkansas for Medical Sciences, Little Rock (Dr Gardner)
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Sarwath H, Bansal D, Husain NE, Mohamed M, Sultan AA, Bedri S. Introduction of p16 INK4a as a surrogate biomarker for HPV in women with invasive cervical cancer in Sudan. Infect Agent Cancer 2017; 12:50. [PMID: 29021820 PMCID: PMC5622439 DOI: 10.1186/s13027-017-0159-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/08/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cervical cancer is the fourth most common cancer in women worldwide with highest incidence reported in Eastern Africa in 2012. The primary goal of this study was to study the expression of p16INK4a in squamous cell carcinoma (SCC) of the cervix by immunohistochemistry (IHC) and determine relation with clinico-pathological parameters. This study further explored the correlation of p16INK4a immunostaining with another proliferation marker, Ki-67 and to study if human papillomavirus (HPV) IHC can be used as a marker for detection of virus in high-grade dysplasia. METHODS A total of 90 samples, diagnosed for cervical cancer, were included in the study. Fixed Paraffin Embedded (FFPE) tissue sections were stained with anti-p16INK4a, anti-Ki-67 and anti-HPV antibodies using automated immunohistochemistry platform (ASLink 48-DAKO). RESULTS Immunohistochemical protein expression of p16INK4a positivity was found to be highest in SCC (92.2%, n = 71) than other HPV tumors (76.9%, n = 10). The majority of cases (97.4%) were p16INK4a positive in the age group 41-60 years. In addition, a statistically significant difference between p16INK4a and HPV was observed among total cervical tumor cases and SCC cases. CONCLUSIONS As expected staining of invasive cervical cancer with anti-HPV showed rare positivity because HPV heralds active infection in dysplastic lesions and not of frank cervical carcinoma. In contrast, anti-p16INK4a IHC results showed positive correlation in SCC and other cervical tumors.
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Affiliation(s)
- Hina Sarwath
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Devendra Bansal
- Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | | | - Mahmoud Mohamed
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Ali A Sultan
- Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Shahinaz Bedri
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
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Gupta R, Gupta S, Mehrotra R, Sodhani P. Cervical Cancer Screening in Resource-Constrained Countries: Current Status and Future Directions. Asian Pac J Cancer Prev 2017; 18:1461-1467. [PMID: 28669152 PMCID: PMC6373785 DOI: 10.22034/apjcp.2017.18.6.1461] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Cervical cancer continues to be a major public health problem affecting large numbers of women in many developing countries. Limitations of various screening modalities and the lack of ready availability of a cost-effective point-of-care screening tool have hindered the efficient implementation of population-based screening programs in these settings. It has not proved possible for many countries to adopt cytology as a screening modality due to inadequate infrastructure and trained manpower. However, recent developments, notably design and testing of a low-cost HPV test kit and initiatives by countries like India in developing and putting into operation a framework for large-scale screening of women, have raised hopes that cervical cancer control may be possible even in resource-constrained locations. With the advent of HPV vaccination, primary prevention of cervical cancer also seems a distinct possibility. However, wide availability and acceptability of vaccination is still an unresolved issue for developing countries. The possible future effects of vaccination on test characteristics of various screening strategies also need to be evaluated. This review gathers information on the current status of cervical cancer screening with a special focus on low resource settings. It revisits the strengths and limitations of the available screening modalities for cervical cancer viz. cytology, visual methods and HPV testing, in the context of their applicability in developing countries. In addition, the role of newer HPV-detection methods, for instance DNA, RNA and protein-based techniques, in triage of screen-positive women is discussed. The contemporary issue of impact of HPV vaccination on cervical cancer screening is also addressed briefly. The main highlight of the review is the reference to ‘operational framework guidelines’ for population-based cervical cancer screening, which have recently been formulated and are in the process of being implemented in India. The guidelines may serve as a model for other similar low-resource settings where implementation of cancer screening is desired.
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Affiliation(s)
- Ruchika Gupta
- Division of Cytopathology, National Institute of Cancer Prevention and Research, Noida, India
| | - Sanjay Gupta
- Division of Cytopathology, National Institute of Cancer Prevention and Research, Noida, India
| | - Ravi Mehrotra
- Division of Cytopathology, National Institute of Cancer Prevention and Research, Noida, India
| | - Pushpa Sodhani
- Division of Cytopathology, National Institute of Cancer Prevention and Research, Noida, India
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Weidemaier K, Carrino J, Curry A, Connor JH, Liebmann-Vinson A. Advancing rapid point-of-care viral diagnostics to a clinical setting. Future Virol 2015. [DOI: 10.2217/fvl.14.117] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
ABSTRACT We discuss here critical factors in ensuring the success of a viral diagnostic at the point of care. Molecular and immunoassay approaches are reviewed with a focus on their ability to meet the infrastructure and workflow limitations in clinical settings in both the developed and developing world. In addition to being low cost, easy-to-use, accurate and adapted for the intended laboratory and healthcare environment, viral diagnostics must also provide information that appropriately directs clinical treatment decisions. We discuss the challenges and implications of linking diagnostics to clinical decision-making at the point of care using three examples: respiratory viruses in the developed world, differential fever diagnosis in the developing world and HPV detection in resource-limited settings.
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Affiliation(s)
- Kristin Weidemaier
- Diagnostic Sciences Department, BD Technologies, 21 Davis Drive, Research Triangle Park, NC 27709, USA
| | - John Carrino
- BD Diagnostics, 10865 Road to the Cure, Suite 200, San Diego, CA 92121, USA
| | - Adam Curry
- Diagnostic Sciences Department, BD Technologies, 21 Davis Drive, Research Triangle Park, NC 27709, USA
| | - John H Connor
- Department of Microbiology, Boston University School of Medicine, 620 Albany Street, Boston, MA 02118, USA
| | - Andrea Liebmann-Vinson
- Diagnostic Sciences Department, BD Technologies, 21 Davis Drive, Research Triangle Park, NC 27709, USA
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Patrizzi B. Screening for Cervical Cancer in Low-Resource Settings in 2011. Arch Pathol Lab Med 2014; 138:156. [DOI: 10.5858/arpa.2013-0438-le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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