Early Diagnosis Of Cervical Cancer Research Articles

The Attitudes of Female Students Towards the Early Diagnosis of Cervical Cancer: Düzce University Case

Amaç: Araştırma; üniversitede eğitim gören kız öğrencilerin serviks kanserinin erken tanısına yönelik tutumlarını ve etkileyen faktörleri belirlemek amacıyla yapıldı.
 Gereç ve Yöntemler: Araştırma tanımlayıcı ve kesitsel desende yapıldı. Düzce Üniversitesi 2021- 2022 eğitim öğretim yılı bahar döneminde merkez kampüsünde lisans eğitimi gören 7736 kız öğrenci araştırmanın evrenini, 371 öğrenci ise araştırmanın örneklemini oluşturdu. Araştırmanın verileri; Kişisel Bilgi Formu ve Servikal Kanserin Erken Tanısına Yönelik Tutum Ölçeği ile yüz yüze görüşme yöntemiyle araştırmacı tarafından toplandı. Veriler SPSS 26,0 programı ile değerlendirildi.
 Bulgular: Öğrencilerin yaş ortalaması 21,28±1,63’ tür. Öğrencilerin %37,5’i Pap smear testini, %25,9’u HPV’ nin serviks kanserine neden olduğunu bildiğini ifade ederken, %86,5’inin HPV testini bilmediği, %56,6’sının HPV aşısını bildiği, sadece %7,3’ünün HPV aşısını yaptırdığı saptandı. Öğrencilerin Serviks Kanserinin Erken Tanısına İlişkin Tutum ölçek toplam puanı ortalaması 105,02±10,70 olup, serviks kanseri erken tanısına yönelik genel tutumlarının yüksek, duyarlılık ve ciddiyet algısı orta, yarar ve engel algılarının ise yüksek düzeyde olduğu belirlendi. Tıp fakültesinde öğrenim gören, ailesinde kanser öyküsü olan, serviks kanseri tanısı olan kişi ile yakınlığı olan ve HPV testini bilen öğrencilerin servikal kanserin erken tanısına yönelik tutum ölçeği toplam puanları daha yüksek bulundu.
 Sonuç: Üniversite öğrencilerine; serviks kanseri, risk faktörleri, risk faktörlerini azaltmaya yönelik koruyucu önlemler, tarama testleri ve profilaktik amaçlı aşılama ile ilgili eğitimler verilmelidir.

Application of Three-dimensional Coding Network in Screening and Diagnosis of Cervical Precancerous Lesions

Globally, the incidence of cervical cancer ranks fourth among female malignant tumors, seriously threatening the physical and mental health of women. Early detection and early treatment can greatly reduce the mortality of cervical cancer "cytology /HPV test, colposcopy and cervical biopsy" is the main method for clinical diagnosis of cervical cancer. The progress of medical technology has significantly improved the early diagnosis of cervical cancer, but due to various factors, there are still many cases of missed diagnosis and misdiagnosis. In recent years, artificial intelligence has developed rapidly in the medical field, and has also shown good applicability in the screening and diagnosis of cervical cancer. In this paper, we design an mcs-SEM structure that contains both channels and space compression excitation modules, which can retain comprehensive spatial information at a low computational cost. Then, the structure is embedded in a three-dimensional coding network to realize the combination of two-dimensional convolutional neural network and three-dimensional spatial information, so as to predict the DVH in the complex distribution scenario of multi-endangered organs with higher accuracy.

Rapid immunoassay for dual-mode detection of HPV16 and HPV18 DNA based on Au@PdPt nanoparticles.

Cervical cancer (CC) remains one of the most severe global health challenges affecting women, primarily due to persistent infection with high-risk human papillomavirus (HPV) subtypes, particularly with HPV16 and HPV 18. Effective detection of these high-risk HPV strains is crucial for CC prevention. Current screening programs for HPV DNA include PCR and in situ hybridization, which are accurate and sensitive. However, these approaches demand a high level of expertise, along with expensive instruments and consumables, thus hindering their widespread use. Therefore, there is a compelling demand to develop an efficient, straightforward, and cost-effective method. Herein, we propose a lateral flow immunoassay (LFIA) method based on Au@PdPt nanoparticles for the simultaneous detection and genotyping of HPV16 and HPV18 within 15 min. This innovative approach allows for qualitative assessment by the naked eye and enables semi-quantitative detection through a smartphone. In this study, under optimal conditions, the qualitative visual limits of detection (vLOD) for HPV16 and HPV18 reached 0.007 nM and 0.01 nM, respectively, which were 32-fold and 20-fold more sensitive than conventional AuNPs-LFIA for HPV16 and HPV18, respectively. Meanwhile, semi-quantitative limits of detection (qLOD) for HPV16 and HPV18 were 0.05 nM and 0.02 nM, respectively. In conclusion, our formulated approach represents a significant step forward in HPV detection and genotyping, with the potential to enhance accessibility and effectiveness in the early diagnosis of CC at the point of care and beyond.

THE RELATIONSHIP BETWEEN WOMEN'S ATTITUDES TOWARDS EARLY DIAGNOSIS OF CERVICAL CANCER AND HEALTH LITERACY LEVELS

Abstract: The purpose of this study is to determine the relationship between women's attitudes toward early diagnosis of cervical cancer and their health literacy levels.The sample of the descriptive and cross-sectional study consisted of 714 women aged over 18 who lived in a district center. Data were collected through the "Personal Information Form", the "Attitude Scale Towards Early Diagnosis of Cervical Cancer (ASTEC)" and the "Health Literacy Scale (HLS)". Data were analyzed using SPSS (Statistical Package for Social Sciences) for Windows 16.0 program. Percentage distribution, t-test, ANOVA test, and Spearman correlation were used for data analysis, and statistical significance was accepted p

Pap test: significance in early diagnosis of cervical cancer

Cervical cancer refers to a malignancy of the lower part of uterus i.e. cervix. It is the fourth most prevalent among women worldwide and tallies for about 30% of cancer cases in the developing world and 5% in the developed world.

Онлайн-обучение врачей неонкологических специальностей по профилактике и ранней диагностике злокачественных новообразований кожи.

One of the reasons for the late diagnosis of malignant skin neoplasms (hereinafter referred to as MNS) is the insufficient knowledge of doctors in non-oncology specialties [1], [2]. The sensitivity for recognizing cutaneous melanoma (hereinafter referred to as MNS) during a visual examination by primary care physicians is 40,2% [3]. The sensitivity of recognizing MNS for an inexperienced dermatologist is 69%, compared to the sensitivity of diagnosing MNS by an experienced dermatologist is 92% [4]. Also, the reason for the late diagnosis of MNS is an insufficiently complete examination of patients. Evidence suggests that doctors do not routinely offer full body mole screening. Up to 63% of patients diagnosed with MK visited their GP in the year before diagnosis. Only 30% of dermatologists perform a full body skin examination on all of their patients [5]. Thus, an important method is the education of doctors of non-oncology specialties in the form of training programs in the principles of early diagnosis of cancer, which in turn can help improve the oncological epidemiological situation [9]. The purpose of this study is to study the effectiveness of organizing an 8-hour online training aimed at raising the awareness of nononcology doctors on the prevention and early diagnosis of cancer. Material and methods. An 8-hour online course «Early diagnosis of skin tumors» was conducted for doctors, created by a group of authors on the platform «Personal Account of a Doctor at the Volga Research Medical University.» The training course included the following issues: risk factors for MK and other cancers, a description of the diagnostic algorithm using the ABCDE method with an illustration of each sign on photographic images, differential diagnosis of skin tumors, prevention with an emphasis on protection from ultraviolet radiation. The course used 82 photographs of MNS. The illustrated material consisted of 30 images of MK, 25 images of basal cell skin cancer (BCSC), 15 images of seborrheic keratoma of the skin, 12 images of skin hemangiomas. Conclusion. As a result of online training, one can note an improvement in the level of knowledge of doctors after completing an online course aimed at the prevention and early diagnosis of cervical cancer. Increasing the specificity of diagnosing nevi (0,846, 0,953) before and after, respectively, can help reduce costs in the “secondary level” of healthcare. The topic of prevention presented in the course also contributes to conducting preventive conversations with patients and correct patient routing. Thus, conducting online training has a number of advantages and shows good learning results. The diagnostic methods discussed in the course, aimed at clarifying the diagnosis of cancer, especially in the early stages of the disease, predetermine the choice of optimal treatment tactics and are the key to ensuring the best prognosis of the disease.

EE526 Health Benefits and Cost-Effectiveness Analysis of Early Cervical Cancer Diagnosis in Bulgaria

EE526 Health Benefits and Cost-Effectiveness Analysis of Early Cervical Cancer Diagnosis in Bulgaria

RETRACTED ARTICLE: Meta-analysis of Artificial Intelligence-Assisted Pathology for the Detection of Early Cervical Cancer

The objective of this study is to evaluate the accuracy of AI in the diagnosis of early cervical cancer using a systematic evaluation/meta-analysis approach and a comprehensive search of published literature. A comprehensive computer search of foreign language databases such as PubMed/MEDLINE, Embase, Cochrane Library, and IEEE; and Chinese databases such as China Knowledge Network, Wan fang Data Knowledge Platform, and Wipu.com (VIP) was conducted to retrieve reports on diagnostic accuracy of AI in early cervical cancer included between 1946 and December 2022. The literature was screened according to inclusion and exclusion criteria, and the quality of the included literature was evaluated using the QUADAS-2 quality evaluation chart. 2 × 2 diagnostic data in text were extracted and complete data were calculated using Review Manager 5.3. Heterogeneity between studies was analyzed using Stata SE 15.0 software with Meta Di Sc 1.4 and causes of heterogeneity were sought. A total of 42 data sets were included in the study of AI for the identification of benign and malignant cervical vitreous nodules, with a combined Sen value of 0.90; a combined Spe value of 0.90; a combined + LR value of 9.0; a combined −LR combined value was 0.11; DOR combined value was 83; and AUC was 0.96. The Fagan plot suggested a 50% pre-test probability and a 90% post-test probability of confirming diagnosis when the AI model diagnosed a glassy nodule positively, and a 10% probability of misdiagnosing the nodule when the result was negative. A total of 34 data sets were included in the study to determine benignity and malignancy of solid cervical nodules by AI, showing a combined Sen value of 0.92; a combined Spe value of 0.93; a combined + LR value of 13.37; a combined −LR combined value of 0.08; DOR combined value of 164; AUC of 0.97. The Fagan plot suggested a 50% pre-test probability and a 93% post-test probability of confirming the diagnosis of a solid cervical nodule when the AI model was positive, and an 8% probability of misdiagnosing the nodule when the result was negative. The results of likelihood ratio dot plots suggest that the use of an AI model for cervical detection in the clinical setting has a good exclusionary diagnostic power. Summing up the accuracy and specificity of the A1 model for diagnosis of early cervical cancer, accuracy for diagnosis of solid cervical nodules (0.90) > diagnosis of cervical nodules (0.92), and specificity for diagnosis of solid cervical nodules (0.90) > diagnosis of cervical nodules (0.93). The AI model is highly accurate in diagnosing early cervical cancer and has high clinical diagnostic value. The accuracy of the AI model in diagnosing solid nodules in the cervical region was higher than diagnosing ground glass nodules in the cervical region. The labeling method, image pre-processing method, and feature learning method affected the accuracy of the AI model in diagnosing early cervical cancer, while the choice of learning image library and validation database did not usually affect the accuracy of the model.

Serum microRNAs dysregulation in cervical cancer and their diagnostic role: A systematic review

Cervical cancer is the fourth-highest prevalent tumor among women in the world. Though the development in the early diagnosis of cervical cancer in developed countries, developing countries are still suffering from it. Among the different biomarkers, serum microRNAs (miRNAs) were reported as valuable tools in the diagnosis of cervical cancer. To highlight the most recent studies of the serum miRNAs in cervical cancer diagnosis, we systematically searched science direct and Web of Science databases using keywords, and the articles that meet inclusion criteria and do not meet exclusion criteria are included in the current review for further analysis. After applying the current study inclusion and exclusion criteria we found 42 dysregulated miRNAs, among them miR-21 was the most investigated, and most of them were capable of distinguishing between healthy and cervical cancer subjects. The current study shows the importance of serum miRNAs as biomarkers in cervical cancer diagnosis.

Knowledge about Cervical Cancer Prevention and Screening in Women with Cervical Cancer Attending Gynecological Services in Southern Mozambique.

Mozambique has high rates of cervical cancer and cancer-related deaths among women. A high rate of refusal and low acceptance of treatment is observed among cervical cancer patients. The extent of their knowledge of the disease is unknown. To assess knowledge about this disease (prevention, risk factors, and the possibilities of early diagnosis) in women with cervical cancer attended in gynecological services in Gaza province, Mozambique. This cross-sectional study took place in the city of Xai-Xai at the Provincial Hospital of Xai-Xai (HPXX) in the southern province of Gaza (Mozambique). Non-probability convenience sampling was used. Eligible patients (women) aged 35-50 years, diagnosed with cervical cancer and followed at the HPXX in the second quarter of 2021 (n = 60), took part in the survey during their scheduled consultations. Descriptive statistics were calculated using SPSS statistical software (version 16). The study included 60 women, 39 (65%) HIV positive. More than half (55.0%) believed that having a single sexual partner was an effective form of prevention; 50.0% reported that excessive alcohol consumption and having many sexual partners could cause the disease, and 46.7% affirmed that having many children increased the risk. Thirty-eight (63.3%) women reported that early diagnosis of cervical cancer was important for receiving prompt treatment, and 54 (90.0%) said regular visits to the gynecologist were important for an early diagnosis. Thirty-five (58.3%) mentioned acetic acid screening as a diagnostic test. There are significant gaps in awareness of cervical cancer among high-risk groups.

The Effect of Multimodal Interventions Regarding Early Cervical Cancer Diagnosis on the Women's Knowledge, Attitude and Participation in Cervical Screening Program.

The objective of the present study was to assess the effect of multimodal interventions on women's knowledge, attitude, and behavior towards the participation in the cervical screening test. A quasi-experimental design is executed with a multi-stage sampling of 300 women residing in rural India. Various multimodal interventions, including a documentary film, face-to-face meetings, written booklets, reminder letters, SMS, and telephone calls, are used to motivate the women for cervical cancer screening. Following the interventions, 99% of the participants became aware of cervical cancer and increased their participation in screening from 3.0 % (Pretest) to 79.9% (Posttest). Three reminders have been sent to the participants, throughout the intervention period which has led to a considerable rise in the participants' willingness to participate in screening, hiking from 58% to 79.9%. The Pap smear test results have shown that: among 288 women, 21 have Typical Malignant cells on their cervix, and two women have been diagnosed with cervical cancer (Stage 1a and Stage 1b). The findings of the study indicate that utilizing diverse interventions in health education alters women's behavior, enhances the compliance of cervical cancer screening, and ultimately helps to prevent life-threatening risks.

292P Comparative characteristics of early cervical cancer diagnosis methods for Tashkent women

292P Comparative characteristics of early cervical cancer diagnosis methods for Tashkent women

Vertically ordered mesoporous silica film-assisted electrochemical cytosensor for the sensitive detection of HeLa cells.

Designing fast and simple quantitative methods on cheap and disposable electrodes for the early detection of HeLa cells is highly desirable for clinical diagnostics and public health. In this work, we developed a label-free and sensitive electrochemical cytosensor for HeLa cell detection based on the gated molecular transport across vertically ordered mesoporous silica films (VMSFs) on the disposable indium tin oxide (ITO) electrode. As high affinity for a folate receptor existed on the membrane of HeLa cancer cells, folic acid (FA) functionalized VMSF could regulate the transport of electrochemical probe (Fe(CN)6 3-) by the specific recognition and adhesion of HeLa cells toward the VMSF surface. In addition, VMSF, served as a solid skeleton, is able to effectively prevent the direct contact of cells with the underlying electrode, remaining the underlying electrode activity and favoring the diffusion of Fe(CN)6 3-. Once specific adhesion of HeLa cells to the VMSF surface happens, Fe(CN)6 3- redox probe exhibits impeded transport in the silica nanochannels, ultimately resulting in the decreased electrochemical responses and realizing the quantitative determination of HeLa cells with a broad linear range (101-105 cells/mL) and a low limit of detection (4 cells/mL). The proposed electrochemical cytosensor shows a great potential application for the early diagnosis of cervical cancer.

Smartphone-based fluorescence spectroscopic device for cervical precancer diagnosis: a random forest classification of in vitro data.

Cervical cancer can be treated and cured if diagnosed at an early stage. Optical devices, developed on smartphone-based platforms, are being tested for this purpose as they are cost-effective, robust, and field portable, showing good efficiency compared to the existing commercial devices. This study reports on the applicability of a 3D printed smartphone-based spectroscopic device (3D-SSD) for the early diagnosis of cervical cancer. The proposed device has the ability to evaluate intrinsic fluorescence (IF) from the collected polarized fluorescence (PF) and elastic-scattering (ES) spectra from cervical tissue samples of different grades. IF spectra of 30 cervical tissue samples have been analyzed and classified using a combination of principal component analysis (PCA) and random forest (RF)-based multi-class classification algorithm with an overall accuracy above 90%. The usage of smartphone for image collection, spectral data analysis, and display makes this device a potential contender for use in clinics as a regular screening tool.

Analysis of WSI Images by Hybrid Systems with Fusion Features for Early Diagnosis of Cervical Cancer.

Cervical cancer is one of the most common types of malignant tumors in women. In addition, it causes death in the latter stages. Squamous cell carcinoma is the most common and aggressive form of cervical cancer and must be diagnosed early before it progresses to a dangerous stage. Liquid-based cytology (LBC) swabs are best and most commonly used for cervical cancer screening and are converted from glass slides to whole-slide images (WSIs) for computer-assisted analysis. Manual diagnosis by microscopes is limited and prone to manual errors, and tracking all cells is difficult. Therefore, the development of computational techniques is important as diagnosing many samples can be done automatically, quickly, and efficiently, which is beneficial for medical laboratories and medical professionals. This study aims to develop automated WSI image analysis models for early diagnosis of a cervical squamous cell dataset. Several systems have been designed to analyze WSI images and accurately distinguish cervical cancer progression. For all proposed systems, the WSI images were optimized to show the contrast of edges of the low-contrast cells. Then, the cells to be analyzed were segmented and isolated from the rest of the image using the Active Contour Algorithm (ACA). WSI images were diagnosed by a hybrid method between deep learning (ResNet50, VGG19 and GoogLeNet), Random Forest (RF), and Support Vector Machine (SVM) algorithms based on the ACA algorithm. Another hybrid method for diagnosing WSI images by RF and SVM algorithms is based on fused features of deep-learning (DL) models (ResNet50-VGG19, VGG19-GoogLeNet, and ResNet50-GoogLeNet). It is concluded from the systems' performance that the DL models' combined features help significantly improve the performance of the RF and SVM networks. The novelty of this research is the hybrid method that combines the features extracted from deep-learning models (ResNet50-VGG19, VGG19-GoogLeNet, and ResNet50-GoogLeNet) with RF and SVM algorithms for diagnosing WSI images. The results demonstrate that the combined features from deep-learning models significantly improve the performance of RF and SVM. The RF network with fused features of ResNet50-VGG19 achieved an AUC of 98.75%, a sensitivity of 97.4%, an accuracy of 99%, a precision of 99.6%, and a specificity of 99.2%.

The Relationship Between Knowledge and Attitudes of Women of Reproductive Age Regarding Early Detection of Cervical Cancer with Iva Examination

Cervical cancer is a major health issue for women all over the globe. Human papillomavirus (HPV) infection is the leading cause of cervical cancer, which is a cancer of the cervix. The more convenient, less costly, and doable Visual Inspection Method with Acetic Acid test (IVA) is in Indonesia. The researchers at Sigambal Health Center wanted to learn more about the WUS's expertise and perspectives on IVA screening for cervical cancer in order to better serve their patients. This study used a cross-sectional, descriptive analytic strategy. Using data from 38 reproductive-age females. Study findings showed that among 38 responders, only 5 (31.2%) had a strong understanding of cervical cancer and 12 (63.2%) were supportive, whereas 22 (57.6%) WUS did not get IVA screening. There is a correlation between WUS knowledge of cervical cancer early detection and IVA, as measured by chi-square analysis, with a P-value of 0.045 0.05, rejecting H0 and accepting Ha. The link between WUS attitudes about acetate visual inspection (IVA) for the early diagnosis of cervical cancer and its prevalence was statistically significant (P = 0.009 0.05; Chi square analysis test on attitude). Health officers should encourage women to have Pap tests and use the IVA technique for WUS to screen for cervical cancer.

A barrier to participation in cervical cancer screenings: fatalism

ABSTRACT Cervical cancer is a significant disease affecting women’s health in terms of its incidence and is one of the most preventable cancers. However, participation in early cervical cancer-screening programs has been unsatisfactory for various reasons. In this descriptive, relationship-seeking study, we examined the relationship between fatalism tendency, an individual barrier to participation in early cancer screening programs, and women’s attitudes toward the early diagnosis of cervical cancer and undergoing the Pap smear test. Research data were collected between August 1, 2019 and December 1, 2019, in a city in northern Turkey from 602 women using a participant information form, the Attitudes Toward Early Diagnosis in Cervical Cancer Scale, and the Fatalism Tendency Scale. We found that fatalistic tendencies in women were a predictor of their attitudes toward the early diagnosis of cervical cancer (odds ratio [OR] = −0.64, β = .47, p < .001) and undergoing the Pap smear test (OR = 1.01, β = −.15, p < .001). Women with high fatalism tendencies had a more negative attitude toward the early diagnosis of cervical cancer and their participation rate in Pap smear screening programs was low. Therefore, nurses must consider women’s fatalistic tendencies and attitudes toward cancer when organizing educational and informational programs that encourage participation in cervical cancer screening.

A graphitic nano-onion/molybdenum disulfide nanosheet composite as a platform for HPV-associated cancer-detecting DNA biosensors

An electrochemical DNA sensor that can detect human papillomavirus (HPV)-16 and HPV-18 for the early diagnosis of cervical cancer was developed by using a graphitic nano-onion/molybdenum disulfide (MoS2) nanosheet composite. The electrode surface for probing DNA chemisorption was prepared via chemical conjugation between acyl bonds on the surfaces of functionalized nanoonions and the amine groups on functionalized MoS2 nanosheets. The cyclic voltammetry profile of an 1:1 nanoonion/MoS2 nanosheet composite electrode had an improved rectangular shape compared to that of an MoS2 nanosheet elecrode, thereby indicating the amorphous nature of the nano-onions with sp2 distancing curved carbon layers that provide enhanced electronic conductivity, compared to MoS2 nanosheet only. The nanoonion/MoS2 sensor for the DNA detection of HPV-16 and HPV-18, respectively, was measured at high sensitivity through differential pulse voltammetry (DPV) in the presence of methylene blue (MB) as a redox indicator. The DPV current peak was lowered after probe DNA chemisorption and target DNA hybridization because the hybridized DNA induced less effective MB electrostatic intercalation due to it being double-stranded, resulting in a lower oxidation peak. The nanoonion/MoS2 nanosheet composite electrodes attained higher current peaks than the MoS2 nanosheet electrode, thereby indicating a greater change in the differential peak probably because the nanoonions enhanced conductive electron transfer. Notably, both of the target DNAs produced from HPV-18 and HPV-16 Siha and Hela cancer cell lines were effectively detected with high specificity. The conductivity of MoS2 improved by complexation with nano-onions provides a suitable platform for electrochemical biosensors for the early diagnosis of many ailments in humans.Graphical

TRANSLACOL project: Nodal human papillomavirus tumoral DNA detection by ddPCR for survival prediction in early cervical cancer patients without pelvic lymph node invasion

In early cervical cancer (EEC), 10 to 15% of patients without nodal metastasis (N-) will suffer from recurrences with further similar survival as N+ patients. However, no clinical, imaging or pathological risk-factor is today available to identify them. In the present study, we hypothesized that the N- histologically characterized patients who present a poor prognosis could be patients for whom metastasis are missed by classical procedure. Therefore, we propose to research HPV tumoral DNA (HPVtDNA) in pelvic Sentinel Lymph Nodes (SLN) biopsy using ultrasensitive droplet-based digital PCR (ddPCR) to detect eventual occult metastasis. Sixty HPV16, HPV18 or HPV33 positive EEC N- patients with available SLN were included. In SLN, HPV16 E6, HPV18 E7 and HPV33 E6 gene were respectively detected using ultrasensitive ddPCR technology. Survival data were analysed using Kaplan-Meier-curves and log-rank-test to compare progression-free survival (PFS) and disease-specific survival (DSS) in two groups according to their HPVtDNA status in SLN. More than half (51.7%) of the patients finally showed HPVtDNA positivity in SLN initially diagnosed as negative by histology. Two patients with negative HPVtDNA SLN and 6 with positive HPVtDNA SLN group presented recurrence. Finally, all of the 4 deaths listed in our study occurred in the positive HPVtDNA SLN group. These observations hint that the use of ultrasensitive ddPCR to detect HPVtDNA in SLN could allow the identification of two subgroups of histologically N- patients that may have different prognosis and outcome. To our knowledge, our study is the first one to evaluate the detection of HPVtDNA in SLN in early cervical cancer using ddPCR highlighting its interest as a complementary tool for N- specific early cervical cancer diagnosis.

Barriers to early diagnosis of cervical cancer: a mixed-method study in Côte d’Ivoire, West Africa

BackgroundCervical cancer, a major public health problem in many developing countries, is usually associated with a poor survival related to an advanced disease at diagnosis. In Côte d’Ivoire and other developing countries with high cervical cancer prevalence, little is known about factors associated with advanced cervical cancer stages in a context of limited access to screening services.MethodsFrom May to July 2019, we conducted a cross-sectional study using a mixed, quantitative and qualitative method. Information on socio-demographic and history of the disease was extracted from a rapid case ascertainement study performed by the cancer registry of Côte d’Ivoire that enrolled all women diagnosed with cervical cancer between July 2018 and June 2019. In-depth semi-structured interviews were conducted among a subset of these women (12 women) and six healthcare providers to further capture barriers to early cervical cancer diagnosis. Factors associated with an advanced stage III, IV (according to FIGO classification) were estimated by a logistic regression model. Qualitative data were analyzed using a thematic analysis technique guided by the treatment pathway model and triangulated with quantitative data.ResultsIn total, 95 women with cervical cancer [median age = 51 (IQR 42–59)] years, were included. Among them, 18.9% were living with HIV and only 9.5% were covered by a health insurance. The majority (71.5%) were diagnosed with advanced cervical cancer. Being HIV-uninfected (aOR = 5.4; [1.6–17.8], p = 0.006) and being uninsured (aOR = 13.1; [2.0-85.5], p = 0.007) were independently associated with advanced cervical cancer in multivariable analysis. Qualitative data raised additional factors potentially related to advanced cervical cancer stages at diagnosis, including the lack of patient information on cervical cancer by healthcare providers and inadequate national awareness and screening campaigns.ConclusionIn a context of challenges in access to systematic cervical cancer screening in Côte d’Ivoire, access to health insurance or integrated healthcare program appear to be key determinants of early diagnosis of cervical cancer.