Pap Smear Research Articles

Atypical glandular cells and predictive features of malignancy in Pap smears: A retrospective monocentric study.

The introduction of cytological screening with the Papanicolau smear significantly reduced cervical cancer mortality. However, Pap smear examination can be challenging, being based on the observer ability to decode different cytological and architectural features. This study aims to evaluate the malignancy rate of AGC (atypical glandular cells) category, investigating the relationships between cytological and histological diagnosis. Eighty-nine patients, diagnosed as AGC at cytological evaluation and followed up with biopsy or surgical procedure at Policlinico Gemelli Hospital, Rome, Italy, were included in the study. The cytopathological architectural (feathering, rosette formation, overlapping, loss of polarity, papillary formation, three-dimensional formation) and nuclear (N/C ratio, nuclear enlargement and hyperchromasia, mitoses, nuclei irregularity, evident nucleoli) features of AGC were evaluated. Statistical analyses were performed to assess cyto-histological correlation and determine the relevance of architectural and nuclear features in the diagnosis of malignancy. Of the 89 AGC patients, 48 cases (53.93%) were diagnosed as AGC-NOS and 41 (46.07%) were diagnosed as AGC-FN, according to the Bethesda classification system. The follow-up biopsies or surgical resections revealed malignancy in 46 patients (51.69%). The rates of malignancy for AGC-NOS and AGC-FN were 35.41% and 70.73% respectively. Furthermore, analysing cytopathological features, we found that both architectural and nuclear criteria were statistically significant (p < 0.05). Only overlapping, nuclear irregularity and increased N/C ratio were not found to be statistically significant for detecting malignancy. Cytological diagnosis of glandular lesions remains a valid tool, when appropriate clinical correlation and expert evaluation are available.

Cervical Sampling and Preparation of Pap Smear

Since the middle of the 20th century, the cervical cancer screening test has been a widely used method for identifying precursor cells in cancer cases. The disease may be eradicated if premalignant cells are found early enough. According to studies, pap smear-based screening programs for cervical cancer can dramatically reduce the number of fatalities worldwide attributable to cervical cancer. Understanding the female reproductive system is crucial for the efficient and representative collection of cervical samples, and a methodical and cautious approach to sample collection is required. Following directions and using the appropriate instruments for collecting specimens are crucial for producing high-quality results. In order to help providers to better comprehend the subject, this work sheds light on the procedure and method of cervical sample collection.

An efficient Fusion-Purification Network for Cervical pap-smear image classification

Background and Objectives:In cervical cell diagnostics, autonomous screening technology constitutes the foundation of automated diagnostic systems. Currently, numerous deep learning-based classification techniques have been successfully implemented in the analysis of cervical cell images, yielding favorable outcomes. Nevertheless, efficient discrimination of cervical cells continues to be challenging due to large intra-class and small inter-class variations. The key to dealing with this problem is to capture localized informative differences from cervical cell images and to represent discriminative features efficiently. Existing methods neglect the importance of global morphological information, resulting in inadequate feature representation capability. Methods:To address this limitation, we propose a novel cervical cell classification model that focuses on purified fusion information. Specifically, we first integrate the detailed texture information and morphological structure features, named cervical pathology information fusion. Second, in order to enhance the discrimination of cervical cell features and address the data redundancy and bias inherent after fusion, we design a cervical purification bottleneck module. This model strikes a balance between leveraging purified features and facilitating high-efficiency discrimination. Furthermore, we intend to unveil a more intricate cervical cell dataset: Cervical Cytopathology Image Dataset (CCID). Results:Extensive experiments on two real-world datasets show that our proposed model outperforms state-of-the-art cervical cell classification models. Conclusions:The results show that our method can well help pathologists to accurately evaluate cervical smears.

Association between HIV Serostatus and premalignant cervical lesions among women attending a cervical cancer screening clinic at a tertiary care facility in southwestern Uganda: a comparative cross-sectional study

BackgroundUganda has approximately 1.2 million people aged 15–64 years living with human immunodeficiency virus (HIV). Previous studies have shown a higher prevalence of premalignant cervical lesions among HIV-positive women than among HIV-negative women. Additionally, HIV-infected women are more likely to have human papilloma virus (HPV) infection progress to cancer than women not infected with HIV. We determined the prevalence of premalignant cervical lesions and their association with HIV infection among women attending a cervical cancer screening clinic at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda.MethodsWe conducted a comparative cross-sectional study of 210 women aged 22–65 years living with HIV and 210 women not living with HIV who were systematically enrolled from March 2022 to May 2022. Participants were subjected to a structured interviewer-administered questionnaire to obtain their demographic and clinical data. Additionally, Papanicolaou smears were obtained for microscopy to observe premalignant cervical lesions. Multivariate logistic regression was performed to determine the association between HIV status and premalignant cervical lesions.ResultsThe overall prevalence of premalignant cervical lesions in the study population was 17% (n = 72; 95% C.I: 14.1–21.4), with 23% (n = 47; 95% C.I: 17.8–29.5) in women living with HIV and 12% (n = 25; 95% C.I: 8.2–17.1) in women not living with HIV (p < 0.003). The most common premalignant cervical lesions identified were low-grade squamous intraepithelial lesions (LSIL) in both women living with HIV (74.5%; n = 35) and women not living with HIV (80%; n = 20). HIV infection was significantly associated with premalignant lesions (aOR: 2.37, 95% CI: 1.27–4.42; p = 0.007).ConclusionPremalignant cervical lesions, particularly LSILs, were more common in HIV-positive women than in HIV-negative women, highlighting the need to strengthen the integration of cervical cancer prevention strategies into HIV care programs.

Prevalence and trends of cervical cancer screening among women in Fiji from 2014 to 2018

IntroductionCervical cancer is the third most common cancer in women both in developed and developing countries. This study aimed to determine the prevalence of cervical cancer and the trends of cervical cancer screening among women who had cervical cancer screening in Suva, Fiji between 2014 and 2018. Materials and methodThis study applied a 5-year retrospective electronic chart review of data from all women attending the Women's Wellness Clinic (WWC) in Suva, Fiji. The women who were selected for this study and screened for cervical cancer were Fijian citizens above 18 years of age and were registered in 2014–2018. A data collection form was used to collect data. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 24; p <0.05 % was considered as the level of significance. ResultsAmong the 39,579 women who attended WWC for other family planning services, 12,074 women screened for cervical cancer with a prevalence of 30.5 %. The overall mean age for women screened for cervical cancer was 37.6 (SD ± 11.2). Two-thirds (76.4 %) of the women screened for cervical cancer were less than 46 years of age and 53.9 % were I-taukei. The number of women who came for Pap smear increased in 2015, however, a slight decline was observed in 2016 which was later improved to 35.1 % in 2018. Malignancy was more common in the age range of 42–49 respectively. In this study, women of 46 years and above had an OR of 0.51 (95 % CI: 0.36, 0.72), other ethnicity OR was 1.73 (95 % CI: 1.27, 2.35), and the Muslim religion OR recorded was 1.44 (95 % CI: 1.03, 2.01) which was comparatively considered a high-risk group. Women who are widowed 1.57 (95 % CI: 0.798, 3.11), single 1.29 (95 % CI: 0.87, 1.92) or divorced 1.08 (95 % CI: 0.59, 1.99), employed 1.01 (95 % CI: 0.83, 1.24) and are living in rural areas 1.19 (95 % CI: 0.82, 1.73) are also associated with higher odds of having abnormal results. ConclusionCervical cancer is listed as the first and most common type of cancer in women which is noticeably increasing in Fiji. Even though cervical cancer screening has improved over the years, adequate surveillance systems and ongoing programs should be designed and implemented to increase awareness and monitor the trend of cervical cancer screening in order to reduce cervical cancer prevalence and mortality rates.

Sociodemographics, behaviour and knowledge of first South African HPV-vaccine recipients.

Infection with the human papillomavirus (HPV) is a necessary cause of cervical cancer and is one of the most prevalent sexually transmitted infections worldwide. Primary prevention strategies target reducing HPV acquisition through vaccination, limiting exposure (e.g. delayed sexual debut, barrier contraception) and health education focusing on sexual behaviour and tobacco use. The ImmunoVACCS study, conducted from 2019 to 2022 in two provinces in South Africa, examined sociodemographic characteristics, sexual practices, and knowledge of cervical cancer and the HPV vaccine among young female vaccine recipients. It encompassed participants from the previously conducted vaccine implementation trials, VACCS 1 and VACCS 2 (2011-2014). Recruitment involved telephonic contact with eligible potential participants. Data were collected through self-administered questionnaires. One hundred and eleven participants took part in the current study (median age: 20 years; age range: 16-22 years). Most sexually active participants had their first engagement in secondary school (96.2%), and 77.2% used contraception during their last sexual activity. Knowledge gaps were evident, with only 13.5% recognising cervical cancer's cervix origin and 3.6% attributing it to a virus. Despite this, 70.3% had heard of a vaccine for cervical cancer. Less than half knew about the importance of regular Pap smears (49.5%), vaccine protection (44.1%) or condom use (20.7%) against HPV and cervical cancer. The current study demonstrates that young women still lack complete information on cervical cancer and its risk factors even after receiving health education linked with vaccination.Contribution:This study underscores the necessity of ongoing education about HPV, its risks and preventive measures among young women to combat cervical cancer.

Socioeconomic and cultural factors associated with pap smear screening among French women living in Réunion Island

BackgroundRéunion Island is a French overseas territory located in the southern Indian Ocean, with a challenging socioeconomic and multicultural context. Compared to mainland France, Réunion has an overincidence and overmortality of cervical cancer. In order to investigate these two issues, it is important to evaluate the barriers and potential levers to Pap smear screening among female inhabitants of the island. We aimed to identify the specific socio-demographic factors, cultural factors, and living conditions associated with Pap smear screening in Réunion, with a view to increasing uptake.MethodsWe conducted a Knowledge Attitude Behavior and Practices (KABP) survey on cervical cancer screening practices among women aged between 25 and 65 years old living in Réunion Island, selected using random digit dialing sampling. Data were collected using Computer Assistant Telephone Interviews. Weighted chi-squared tests and Student’s t-tests were used to compare women who had up-to-date Pap smear screening with women who did not. Weighted logistic models were used to identify the factors associated with not having up-to-date screening.ResultsA total of 1000 women were included in the study. Of these, 88.1% had a Pap smear test during the previous three years. Factors independently associated with not being up to date were as follows: aged over 55 (AOR 2.3 [1.2–4.3]), no children (AOR 2.5 [1.4–4.3]), having free universal health coverage (AOR 1.7 [1.1–2.7]), an income per unit consumption lower than 1500€ per month (AOR 2.0 [1.1–3.7]), low health literacy (AOR 2.7 [1.7–4.1]), not consulting a general practitioner in the prior 12 months (AOR 3.6 [2.0-6.5]), and a BMI > 30 (AOR 2.6 [1.5–4.4]).ConclusionsThis is the first large-scale survey focusing on recommended Pap smear screening uptake in Réunion Island. Although self-reported screening incidence was higher than in mainland France, national screening policies must take into account the island’s diverse social and cultural characteristics (e.g., an ageing population, low health literacy), while implementing actions to fight against poverty and increase general access to healthcare.

P16/Ki67 Dual Staining in Glandular Cell Abnormalities of the Uterine Cervix.

Very limited information exists about the role of p16/Ki67 dual staining on glandular cells in detecting glandular precancerous lesions and cervical adenocarcinoma. In this study, we investigated the diagnostic accuracy of p16/Ki67 dual staining for the detection of glandular and squamous lesions on the uterine cervix and for cancer of the upper reproductive tract. We performed a retrospective analysis of prospectively collected data on 96 patients with glandular cell abnormalities. We analyzed the diagnostic accuracy of p16/Ki67 dual staining for atypical glandular cells, not otherwise specified (AGC-NOS); atypical glandular cells, favor neoplastic (AGC-FN); adenocarcinoma in situ (AIS); and A-CA (cervical adenocarcinoma). A separate analysis for the detection of squamous precancerous lesions and squamous-cell carcinoma (CIN3+) and for cancer of the upper reproductive tract (EC/OC) was performed. Among patients who had normal histology or a low-grade lesion on final analysis, only 8.5% had positive dual staining. On the other hand, 85.7% of patients with AIS+ on final histology had positive dual staining. The respective specificities of p16/Ki67 dual staining on AGC-NOS for the detection of AIS+ (adenocarcinoma in situ or cervical adenocarcinoma), CIN3+ and EC/OC were 91.5%, 88.7% and 86.4%. High specificity values of p16/Ki67 dual staining on cervical smears labelled as AGC-NOS for the detection of CIN3+ and AIS+ suggest that this method might be a useful addition in cervical cancer screening.

Hubungan Rendahnya Pengetahuan Tentang Imunisasi Kanker Serviks Pada Wanita Usia Subur (WUS) Di RT 05 RW 02 Kelurahan Telaga Asih Bekasi Tahun 2023

Globocan data for 2020 recorded that the total cancer cases in Indonesia in 2020 reached 396,914 cases and the total deaths were 234,511 cases. Cervical cancer (cervix) ranks second with 36,633 cases or 9.2% of total cancer cases. One of the factors that contributes to the high incidence of cervical cancer in Indonesia is the lack of awareness and access to routine examinations and vaccinations. Cervical cancer is one of the cancers that can be prevented, namely by immunization with the HPV vaccine and early detection of cervical cancer with a Pap smear or IVA examination (visual inspection using acetic acid). The aim of this research is to analyze factors related to WUS knowledge about the low level of Human Papilloma Virus (HPV) immunization in RT 05 RW 02, Telaga Asih Bekasi Village in 2023. The research method used is a cross sectional survey method. The population in this study was 50 female respondents of childbearing age in RT 05 RW 02. The sample was taken using a total sampling technique of 50 female respondents of childbearing age in RT 05 RW 02. Univariate analysis used frequency distribution and for bivariate tests used the Chi Square test. This research uses primary data from filling out questionnaires by respondents. Based on the results of the analysis of the 50 respondents, 31 people (62.0%) had the most good knowledge, 41 people aged 20-35 years (82.0%). There were 29 women whose parity was not at risk (58%), 29 people had at least high school education (58%), and 34 people got information sources electronically (68%). Variables related to knowledge are education and sources of information with a value of 0.000 &lt; 0.05. Meanwhile, variables that are not related are age and parity. It is hoped that this research will become a reference for increasing knowledge and an intensive approach to WUS. The results of this research can also be used as an opener to wider insight into midwifery and especially in the field of reproductive health.

Adequacy and Acceptability of the Self-Collected Anal Pap Smear in People Living With Human Immunodeficiency Virus in the Infectious Diseases Clinic.

Background Anal Pap smears are imperative to screening for human papillomavirus (HPV)-associated anal squamous cell cancers, particularly in patients living withhuman immunodeficiency virus (HIV) given a higher incidence of disease. Self-collection of specimens may be favored by patients and more feasible to collect, increasing screening. Methods This was a single-center observational cohort study at a single academic medical center Infectious Diseases clinic from October to December 2021. We aimed to improve compliance of anal Pap collection documentation of "self-collected" versus "physician-collected" as well as verify if self-collected specimens (SCS) were adequate for interpretation equivalent to physician-collected specimens (PCS). Additionally, we aimed to evaluate patient and provider satisfaction with self-collected anal Paps. Results Sixty anal Pap smears were available for evaluation. The rate of documentation of the collection method (self-collected vs. physician-collected) was 88% during the intervention. A total of 75% of patients opted for self-collection, and 35/45 (78%) of these samples were adequate for interpretation. There was no difference in the adequacy of specimen (the ability of a cytopathologist to interpret the specimen) between the SCS and PCS. Conclusion Limited prior data suggest self-collected anal Pap specimens are adequate for interpretation only slightly less often than PCS. In our small cohort, there was no statistically significant difference between collection methods. Satisfaction with self-collection of specimens was high for both patients and providers. Additional validation in more diverse/larger clinical settings may be helpful to support this practice.

Discovery and technical validation of high-performance methylated DNA markers for the detection of cervical lesions at risk of malignant progression in low- and middle-income countries

BackgroundCervical cancer remains a leading cause of death, particularly in developing countries. WHO screening guidelines recommend human papilloma virus (HPV) detection as a means to identify women at risk of developing cervical cancer. While HPV testing identifies those at risk, it does not specifically distinguish individuals with neoplasia. We investigated whether a quantitative molecular test that measures methylated DNA markers could identify high-risk lesions in the cervix with accuracy.ResultsMarker discovery was performed in TCGA-CESC Infinium Methylation 450 K Array database and verified in three other public datasets. The panel was technically validated using Quantitative Multiplex-Methylation-Specific PCR in tissue sections (N = 252) and cervical smears (N = 244) from the USA, South Africa, and Vietnam. The gene panel consisted of FMN2, EDNRB, ZNF671, TBXT, and MOS. Cervical tissue samples from all three countries showed highly significant differential methylation in squamous cell carcinoma (SCC) with a sensitivity of 100% [95% CI 74.12–100.00], and specificity of 91% [95% CI 62.26–99.53] to 96% [95% CI 79.01–99.78], and receiver operating characteristic area under the curve (ROC AUC) = 1.000 [95% CI 1.00–1.00] compared to benign cervical tissue, and cervical intraepithelial neoplasia 2/3 with sensitivity of 55% [95% CI 37.77–70.84] to 89% [95% CI 67.20–98.03], specificity of 93% [95% CI 84.07–97.38] to 96% [95% CI 79.01–99.78], and a ROC AUC ranging from 0.793 [95% CI 0.68–0.89] to 0.99 [95% CI 0.97–1.00] compared to CIN1. In cervical smears, the marker panel detected SCC with a sensitivity of 87% [95% CI 77.45–92.69], specificity 95% [95% CI 88.64–98.18], and ROC AUC = 0.925 [95% CI 0.878–0.974] compared to normal, and high-grade squamous intraepithelial lesion (HSIL) at a sensitivity of 70% (95% CI 58.11–80.44), specificity of 94% (95% CI 88.30–97.40), and ROC AUC = 0.884 (95% CI 0.822–0.945) compared to low-grade intraepithelial lesion (LSIL)/normal in an analysis of pooled data from the three countries. Similar to HPV-positive, HPV-negative cervical carcinomas were frequently hypermethylated for these markers.ConclusionsThis 5-marker panel detected SCC and HSIL in cervical smears with a high level of sensitivity and specificity. Molecular tests with the ability to rapidly detect high-risk HSIL will lead to timely treatment for those in need and prevent unnecessary procedures in women with low-risk lesions throughout the world. Validation of these markers in prospectively collected cervical smear cells followed by the development of a hypermethylated marker-based cervical cancer detection test is warranted.

SCREENING FOR HUMAN PAPILLOMAVIRUS USING SELF-COLLECTED CERVICAL SAMPLES FROM WOMEN DEPRIVED OF LIBERTY IN THE STATE OF AMAZONAS, BRAZIL

Objective: The aim of the study was to identify the prevalence of human papillomavirus (HPV) infections using a self-collection device and also describe the frequency of P16INK4a overexpression in women deprived of liberty (WDL). Methods: This observational, cross-sectional, descriptive, analytical, and epidemiological study of the prevalence of HPV infection included 268 women deprived of liberty (WDL) in the state of Amazonas who performed self-collection using the Roche® HPV CTNG test. Patients with positive HPV results were submitted to a Pap smear in liquid medium, colposcopy, an immunocytochemistry evaluation using P16INK4a, and a biopsy, when necessary. Results: The age of the 268 women ranged from 19 to 64 years (mean±standard deviation: 33.5±9.1 years). HPV was detected in 66 (24.6%) women: 12 (4.5%) had HPV 16, 3 (1.1%) had HPV 18, 51 (19%) had other high-risk HPV genotypes, 21 (7.8%) had inconclusive results and 181 (67.5%) had negative results. Two women had a high-grade lesion and 13 had a low-grade lesion. Eight women showed alterations in their Pap smear and 32 (64%) presented overexpression of P16INK4a. Self-collection was well-accepted by 95.9% of the WDL. Conclusion: This study shows that the prevalence of HPV among the sample of WDL was high, that self-collection as a screening method was well-accepted and that the prison population has peculiar characteristics since there is a higher prevalence of other high-risk HPV genotypes.

Trends in the Prevalence and Mortality of Cervical Cancer in the Kyrgyz Republic.

Cervical cancer represents a significant health concern globally and is the fourth most common cancer among women, leading to substantial morbidity and mortality. The primary cause is persistent infection with high-risk human papillomavirus (HPV) types. Despite advancements in prevention, screening, diagnosis, and treatment, disparities in cervical cancer outcomes persist due to variations in screening accessibility and socioeconomic factors. This study focuses on women in the Kyrgyz Republic, highlighting regional disparities and the critical role of early detection. A retrospective data analysis was conducted on 1,338 women diagnosed with cervical cancer from 2012 to 2017 in the Kyrgyz Republic. Data were sourced from national health centers, focusing on sociodemographic metrics, clinical staging, and regional distributions. The study utilized statistical analysis to evaluate prevalence and mortality rates, employing the analysis of variance for comparison, significance, and analyzing trends over time. The prevalence of cervical cancer in the Kyrgyz Republic increased from 97.5 per 100,000 females in 2012 to 105.3 per 100,000 in 2017, with mortality rates of 8.3-9.7%. Notably, regional disparities were evident, with Chui, Osh, Jalal-Abad, and Bishkek experiencing increased prevalence rates, while Talas, Issyk-Kul, Naryn, and Batken reported decreased prevalence. Screening programs, particularly the introduction of Pap smears, have been effective in reducing both prevalence and mortality rates in areas with broad population coverage. However, the study highlighted significant variations in outcomes across different regions, underscoring the importance of targeted prevention and screening efforts. The study confirms the ongoing challenge of cervical cancer in the Kyrgyz Republic, emphasizing the need for improved screening and prevention strategies to address disparities in outcomes. The introduction of pilot screening programs represents a crucial step forward. However, the findings also point to the necessity for enhanced oncological literacy among primary care physicians and the implementation of comprehensive strategies to overcome socioeconomic and regional barriers to effective cervical cancer prevention and treatment. The reduction in prevalence observed in 2016 suggests progress, highlighting the potential impact of focused prevention and screening initiatives.

Prevalence of Trichomonas Infection in Relation to Human Papillomavirus (HPV) in Pap Smear Samples of Female Patients Referred to Shahid Sadoughi Hospital, Yazd (Iran).

Objectives Human papillomavirus (HPV) and Trichomonas vaginalis (TV) infections have been proposed as risk factors for cervical cancer. This study has been conducted with the aim of investigating the prevalence of TV and its relationship with HPV in women who underwent Pap smear testing as part of cancer screenings. Materials and methods The sampling of liquid-based cervical tissue was conducted among 500 women referred to the women's clinic of Shahid Sadoughi Hospital in Yazd, Iran. The studied samples were examined for Pap smear tests and microscopic identification of TV, as well as HPV-DNA detection and the determination of high-risk and low-risk HPV types by the polymerase chain reaction (PCR) method. The results were analyzed using the IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York) software. Results The individuals included in the study were 16-72 years old. The prevalence rate of TV infection in this population was found to be 29.2%, and the frequency rate of HPV was reported to be approximately 19.4%, with high-risk HPV, including HPV-56, having the highest frequency. The Pap smear test results were reported as abnormal in 20.2%, anda significant correlation was observed between HPV infection and an abnormal Pap smear test (P < 0.05). In addition, a notable correlation was detected between TV infection and high-risk and low-risk HPV (P < 0.05). Conclusion According to the significant relationship found between the two pathogens, TV and HPV, in the abnormal Pap smear test results, TV infection can be considered a risk factor for HPV infection, as well as uterine lesions and cancer.

Hubungan Self Efficacy, Peran Bidan, Dan Dukungan Suami Terhadap Pemeriksaan Pap Smear Pada PUS Di Rumah Sakit Tugu Ibu Depok

Introduction: Cervical cancer is still an issue that is often discussed in the world of health. Cervical cancer is the most common malignant tumor found in the reproductive organs. All women are at risk of suffering from this cancer especially women who are sexually active. Pap smear is a type of examination that can be done to identify cervical cancer. The prevalence of cancer in women in Indonesia in 2021 is 30.8% for breast cancer, 17.2% for cervical cancer, and 7% for ovarian cancer. The purpose of this study was to determine the relationship between self-efficacy, the role of midwives, and husband's support for pap smear examinations at PUS at Tugu Ibu Hospital in Depok in 2022. Methods: This type of research used descriptive analytic with a cross-sectional approach. The sampling technique used is simple random sampling with a total of 53 respondents. Results: The results of the study showed that there was a relationship between self-efficacy (p-value 0,001); the role of the midwife (p-value 0,026); and husband's support (p-value 0,008) for pap smear examination in PUS at Tugu Ibu Hospital. Discussion: The conclusion is that there is a relationship between self-efficacy the role of midwives, and husband's support for pap smear examination at PUS at Tugu Capital Hospital in Depok City in 2023. Suggestions for couples of childbearing age to be able to increase self-efficacy by increasing understanding of the benefits and importance of Pap Semar examination through asking to health workers, attending counseling classes, health seminars or reading from trusted sources.

Prevalence of Cervical Cancer and Premalignant Cases Based on Pap Smear Screening in Iran in 2022

Background: Oral or cervical cancer is caused by the abnormal growth of cells, which in 90% of cases is caused by the human papillomavirus infection. Objective: The present study aimed to determine the prevalence of cervical cancer and premalignant cases based on the results of Pap smears performed in Jiroft health centers in 2022. Methods: This cross-sectional study was conducted on 440 women using a census method, and the demographic information of the people and the results of their Pap smears were recorded using a researcher- made questionnaire. Results: The average age of the investigated women was 37.20 ± 9.09 years, with the highest frequency in the age group of 30 to 40 years (44.7%), and the average number of previous pregnancies was 3.06 ± 2.26 times, with the highest frequency observed in the group 1 to 2 times (50.6%). The average number of abortions was 0.45 ± 0.86, with the highest frequency (70.4%) related to the group that had no history of abortion. Out of 440 people examined, 6 (1.4%) with a 95% confidence interval equal to 0.50-2.94% had abnormal Pap smears. Conclusion: The number of pregnancies and the increase in the number of abortions can be factors influencing the incidence of cervical cancer. By performing a Pap smear screening test with early diagnosis of the disease in the early stages, it is possible to prevent the spread of this disease in the body and the transformation of these cells into cancer.

Abstract LB140: Age difference in cervical cancer stigma among Caribbean population

Abstract Introduction Cervical cancer (CCA) is the second most common cancer and one of the leading causes of death among women in the Caribbean region. CCA stigma impedes women from seeking and obtaining relevant healthcare. This study aimed to evaluate age difference in cancer stigma among non-patient populations in Jamaica, Grenada, and Trinidad and Tobago, utilizing a culturally trans-created scale. Methods A cross-sectional study involving 1207 participants was conducted. The survey comprised the adapted Cancer Stigma Scale, supplemented with questions on cervical cancer knowledge and beliefs. Participants' knowledge and attitudes towards the HPV vaccine were also assessed. Data was collected online from October 2022 to March 2023. Statistical analysis was performed using SAS. Results This study included 33.4% of total participants aged 18-25 years, 23.4% aged 26-35 years, 21.4 aged 36-45 years, 10.7% aged 46-55 years, 7.5% aged 56-65 years, and 3.6% aged 65+ years. Chi-squared tests showed age is significantly related to respondents’ opinions on women with CCA are treated with less respect than usual by others (p&amp;lt;.0001), women with CCA must keep it a secret (p=0.03), women with CCA are rejected by family members (p=0.0007), women with CCA are rejected by intimate partners (p&amp;lt;.0001), and intimate partners blame women for having CCA (p=0.003). Additionally, age has significant associations with agreements on negative views of cervical cancer from the community (p&amp;lt;.0001) and family (p&amp;lt;.0001) may discourage women from seeking and obtaining screening and treatment and community members believe CCA is viewed as shameful (p=.0001). Notably, there are more younger respondents (18-25 years) who agreed that women with CCA are rejected by intimate partners (32.3%), and the fear of family reaction and rejection may discourage women from getting further diagnosis after an abnormal Pap smear (48.1%). Discussion Age is an important factor that influences cervical cancer stigma even in Caribbean contexts. Findings of this study indicate younger people may have a more serious stigma, which calls for proper educational programs for cervical cancer screening and treatment. Citation Format: Kamilah Thomas-Purcell, Gaole Song, Diadrey-Anne Sealy, Althea Bailey, Kimlin T. Ashing. Age difference in cervical cancer stigma among Caribbean population [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB140.

Causes of abnormal uterine bleeding in women of 20–60 years of age based on polyp, adenomyosis, leiomyoma, malignancy, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not-yet-classified at a tertiary care hospital: A cross-sectional study

Abstract Background: Approximately 10%–25% of women are affected with abnormal uterine bleeding (AUB). It is essential to have a thorough understanding and knowledge about the disease, causative factors, pathophysiology, incidence and prevalence of various causative factors, clinical presentations, and diagnostic aids for an early prediction and diagnosis of disease to treat the condition at the earliest possible phase and with minimum morbidity and costs. Objective: The objective of this study was to study the causes of AUB women of 20–60 years of age based on polyp, adenomyosis, leiomyoma, malignancy, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not-yet-classified (PALM COEIN). Materials and Methods: It was a hospital-based prospective study among 136 patients with AUB aged 20–60 years. History, general and gynecological examination, and routine gynecological examination were done using speculum examination of the vagina and the cervix and a bimanual examination. Routine investigations and an ultrasonography were done. Some were subjected to PAP smear as a routine procedure. Results: Women aged 31–50 years and multiparous were most affected with AUB in 84.6% and 88.9% of cases, respectively. According to the International Federation of Gynecology and Obstetrics type classification, the most common type of presentation was heavy menstrual bleeding in 54% of cases. The most common presenting symptom was pain in the abdomen in 4.4%. The most common-related symptom was spasmodic dysmenorrhea in 36%. The most common clinical sign was pallor in 25%. The most common associated comorbidity was anemia in 49%. Leiomyoma was the most common ultrasound diagnosis of underlying pathology in 52.2%. The most common cause of AUB as per PALM COEIN was AUB leiomyoma in 52.2%. Conclusion: Our study shows that the causation of AUB was multifactorial (though in some cases, solitary lesions were found) involving the entire female reproductive system resulting in a single common presentation as AUB.

Cytologic Parameters in Predicting the Outcome of Atypical Glandular Cells on Papanicolaou Smears: A Single-Institutional Experience.

Atypical glandular cells (AGCs) diagnosis on Pap (Papanicolaou) smears are uncommon and may represent various benign and malignant lesions. This study aims to report the incidence of AGC on Pap smear, to study the relationship of AGC with malignancy, and to determine cytomorphological features that help in predicting malignancy. Retrospective analytical study conducted in the Department of Oncopathology at Tertiary Cancer and Research Institute. In this retrospective study, we included cases diagnosed with AGC between July 2017 to July 2022. All slides were reviewed and subclassified according to the Bethesda 2014 classification system (TBS). The predetermined cytomorphological features observed in the smears were recorded. The follow-up histopathological diagnoses of the cases were retrieved. The significant cytomorphological and clinicopathological findings for malignancy were determined. Pearson χ2 test with SPSS software version 22 to compare cytologic features of cases with benign and malignant follow-up. The significant cytomorphological features observed in neoplastic cases were cells in 3-dimensional clusters, nuclear overlapping, reniform nucleus, irregular nuclear membrane, increased nuclear size, single macronucleoli, engulfed neutrophils, and prominently vacuolated cytoplasm. The diagnosis of AGC on cytology is associated with clinically significant lesions, and cytomorphologic parameters can be used to predict the benign and malignant outcome.

Gastric Type Endocervical Adenocarcinoma With Concurrent High-Grade Squamous Intraepithelial Lesion: A Clinicopathologic Study of Three Patients.

We investigate gastric-type endocervical adenocarcinoma (ECA), a prominent HPV-independent adenocarcinoma, and its coexistence with high-grade squamous intraepithelial lesion (HSIL) through the examination of three such tumors. In this study, we conducted an in-depth review of three patients with gastric-type ECA, each associated with high-risk HPV infection as detected on Pap smears. We detailed the clinical and pathological features of each patient and utilized RNAscope for high-risk HPV testing to ascertain HPV status in both gastric-type ECA and HSIL components. Immunohistochemistry with p16, p53, and other biomarkers was also applied. The gastric-type ECA component, characterized by well-differentiated glands with abundant, clear to eosinophilic cytoplasm, distinct cellular borders, and pale nuclei with conspicuous nucleoli, tested negative for both p16 and high-risk HPV, unlike the concurrent HSIL components which were positive. Additionally, two tumors showed aberrant p53 protein expression in the gastric-type ECA areas, and elevated carbohydrate antigen19-9 levels were noted in two patients. Treatment consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy, supplemented by chemotherapy and/or radiation, with disease-free intervals of 24, 12, and 40 months post-treatment, respectively. This study highlights the critical need for meticulous diagnostic protocols that combine morphological examination, immunohistochemistry, and HPV RNA in situ hybridization. The rarity of gastric-type ECA coexisting with HPV infection underscores the necessity for continuous research and vigilant monitoring in the field of gynecological oncology.