Early Detection Of Cervical Cancer Research Articles

Stratified K-fold cross validation optimization on machine learning for prediction

Cervical is the second most common malignant tumor in women, with 341,000 deaths worldwide in 2020, almost 80% of which occur in developing countries. One of the causes is infection with Human papillomavirus (HPV) types 16 and 18. The increasing incidence of cervical cancer in Indonesia makes this disease must be treated seriously because it is one of the main causes of death. In addition to the virus, external factors can be one of the causes. The high mortality rate in patients is caused by the patient's awareness of the emergence of cervical cancer which is only seen when it enters the final stage. One of the efforts to reduce the number of sufferers is to implement cervical cancer detection. Early detection of cervical cancer can also be identified by looking at external factors, such as behavioral factors, intentions, attitudes, norms, perceptions, motivations, social support, and empowerment. However, the data used has an imbalance in the distribution of the target class, namely more negative samples than positive ones. To overcome this, a technique called Stratified K-Fold Cross-Validation (SKCV) is used. Evaluation of the accuracy value using the Confusion matrix to determine the performance of each model. The best performance of the five classification algorithms used is 96 percent (RF), 94 percent (LR), 92 percent (XGBoost), 90 percent (KNN), and 88 percent (NB). The results show that the model formed by RF-based SKCV has the highest accuracy of other models.

The Relationship Of Husband Support With IVA Tests In Early Detection Of Cancer Of The Word Of Women In Mother In Aek Paing Atas Village Labuhan Batu Regency In 2022

Cervical cancer is a type of malignant tumor that affects the surface layer (epithelium) of the cervix. This cancer can occur because the surface cells have multiplied and changed properties unlike normal cells. This study aims to determine the relationship between husband's support and the IVA test in early detection of cervical cancer in Aek Paing Atas Village, Kel. Aek Paing Kec. North Rantau Kab. Labuhan Batu in 2022. This type of research is analytic observational with a cross sectional approach. The population is mothers as many as 88 people. The sample in this study was 88 people. The sampling technique was total sampling. Data analysis technique using chi square. The results obtained in this study were from 88 respondents. Based on age The results of the chi-square test showed that the age of the EFA mother had a significant relationship with the visual inspection examination (P<0.05). Based on education The results of the chi-square test showed that the education of EFA mothers had a significant relationship with the visual inspection examination (P<0.05). based on occupation The results of the chi-square test showed that the mother's occupation of EFA had a significant relationship with the visual inspection examination (p<0.05). based on knowledge The results of the chi-square test showed that knowledge of EFA mothers had a significant relationship with VIA examination (p<0.05). It is recommended to the puskesmas to improve health promotion to improve health status.

DETEKSI DINI KANKER SERVIKS DAN SAFARI KELUARGA BERENCANA DI EKS KAWEDANAN BOJA

Family Planning is one of the efforts to reduce maternal mortality, so that Indonesia is committed to participating in signing of the global development of the Millennium Development Goals (MDG's) but the evaluation of the MDG's achievements in Indonesia shows that the target achievement has not been satisfactory so that it is continued with the Sustainable development Goals / SDG's program. In 2018 the population of childbearing age in Kendal district, there were 273,848 women out of 503,710 people, while Fertile Age Couple (FAC) was 188,118, who became new family planning (FP) acceptors 124,869 (66.38%). This is still far from the national achievement target, namely the coverage of FAC to become family planning acceptors of 87%. Another problem that arises in FAC is the high incidence of cervical cancer, this condition is caused because the patient comes at an advanced stage. Family planning safaris and early detection of cervical cancer are important things that must be done. This service method uses field studies, Focus Group Discussion (FGDs), counseling and papsmer examination. The target of community service is FAC in Ex Kawedanan Boja. Health education about family planning and early detection of cervical cancer can change behavior. The number of acceptors 60 people with IUD contraception 16 (26%), Implant 26 (43.3%) and Failed 3 (8.3%), the failure to install this contraceptive device was due to inflammation of the cervix. 3 people (17.65%) were positive while negative 14 people (82.35%).Counseling can improve understanding and change the behavior of FAC regarding early detection of cervical cancer and the installation of free implants and IUDs on acceptors through family planning safari.

Early Detection of Cervical Cancer by Fluorescence Lifetime Imaging Microscopy Combined with Unsupervised Machine Learning.

Cervical cancer has high morbidity and mortality rates, affecting hundreds of thousands of women worldwide and requiring more accurate screening for early intervention and follow-up treatment. Cytology is the current dominant clinical screening approach, and though it has been used for decades, it has unsatisfactory sensitivity and specificity. In this work, fluorescence lifetime imaging microscopy (FLIM) was used for the imaging of exfoliated cervical cells in which an endogenous coenzyme involved in metabolism, namely, reduced nicotinamide adenine dinucleotide (phosphate) [NAD(P)H], was detected to evaluate the metabolic status of cells. FLIM images from 71 participants were analyzed by the unsupervised machine learning method to build a prediction model for cervical cancer risk. The FLIM method combined with unsupervised machine learning (FLIM-ML) had a sensitivity and specificity of 90.9% and 100%, respectively, significantly higher than those of the cytology approach. One cancer recurrence case was predicted as high-risk several months earlier using this method as compared to using current clinical methods, implying that FLIM-ML may be very helpful for follow-up cancer care. This study illustrates the clinical applicability of FLIM-ML as a detection method for cervical cancer screening and a convenient tool for follow-up cancer care.

Gambaran Perilaku Wanita Usia Subur (Wus) dalam Upaya Deteksi Dini Kanker Serviks dengan Metode Acetic Acid Visual Inspection (IVA) di Wilayah Kerja Puskesmas Simpang Baru

Cervical cancer is a major health problem in women in the world, cervical cancer can be prevented by early detection, one of which is the VIA examination. According to data from the Pekanbaru city office in 2019, there were 5 people carrying out an IVA examination at the Simpang Baru Health Center. Factors that influence WUS in the IVA examination behavior are knowledge, attitudes and actions. This study aims to describe the behavior of WUS in an effort to detect cervical cancer using the IVA method in the work area of the Simpang Baru Health Center. Methodology on this research was a quantitative descriptive. The sample in this research were 100 respondents who live in Simpang Baru with propotional random Sampling technique. The variables in this study are behavior with the variable domains of knowledge, attitudes and actions. Measuring instruments used was a questionnaire. The analysis used was univariate. The results of the study based on WUS behavior, it was found that respondents with a row level of knowledge about cervical cancer and early detection efforts were (65%), respondents had a bad attitude about early detection efforts (54%), most of the respondents did not want to take early detection efforts. cervical cancer (54%). and WUS behavior is categorized as negative (61,0%). Behavior will be realized if high knowledge is followed by good attitudes and good actions, therefore it is recommended to increase promotion and counseling about cervical cancer and early detection efforts, so that it will increase awareness and willingness to improve health behavior in efforts to detect cervical cancer early with the IVA method. The conclusion of the study is that most respondents have low knowledge, bad attitudes, do not want to do early detection and negative WUS behavior towards knowledge of early detection of cervical cancer

Women's Reproductive Health for Housewives in the Work Area of the Passo Health Center, Ambon City

Reproductive health for housewives in the work area of the Passo Health Center is carried out based on problems from the partner group, namely low knowledge and minimal information about women's reproductive health, especially cervical cancer and breast cancer as well as skills in practicing or performing the BSE method resulting in low awareness of the importance women's reproductive health, this is shown through the low behavior of early detection carried out by housewives both the IVA test for early detection of cervical cancer and the application of the BSE method for early detection of breast cancer. With the aim of increasing the knowledge, skills and health of housewives in the target group regarding reproductive health, especially cervical cancer and breast cancer as a prevention effort. As well as increasing the knowledge of mothers about basic clinical information on cervical cancer and breast cancer, methods of detection as prevention and treatment methods, the number of mothers who are detected and can be treated. The solutions applied to the above problems are (1). Counseling to increase the knowledge of housewives about women's reproductive health (cervical Ca and breast Ca); (2). perform early detection of cervical cancer and early detection (screening) of breast cancer. The method used for the implementation of the solution is (1). Lectures, questions and answers and discussions both audio (sound) and visual (pictures and video) to increase mothers' knowledge about women's reproductive health; (2). Visual inspection method with acetic acid, also known as visual inspection with acetic acid (IVA test) for early detection of cervical cancer in housewives of the target group; Evaluation is carried out for each implementation of activities to encourage understanding of housewives to behave healthily towards reproductive health.

Retrenchment of Wisconsin’s Well Woman Program and changes in insurance coverage around the Affordable Care Act

Since before the Affordable Care Act (ACA), states have partnered with the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to support access to cancer screening and treatment for uninsured/underinsured women. The Wisconsin Well Woman Program (WWWP) was one such program, supporting low-income women across the state. With ACA introduction, Wisconsin substantially downsized/restructured the WWWP, expecting the reduction in services to be offset by the rise in ACA-provided insurance coverage. This study assesses whether retrenchment in the WWWP following the ACA indeed prompted a differential rise in insurance coverage among the program’s target population. We use a difference-in-differences (DID) design to contrast changes in county-level, target-population insurance rates, over 2008–2018, in Wisconsin counties previously most served by the WWWP vs those least served, adjusting for systematic differences across counties, including pre-policy trends. Pre-ACA (2011–2013), most-served counties had lower insurance rates by 2.5 percentage points (pp) than least-served counties; WWWP services likely compensated for some of that gap. In 2014–2015, along with WWWP’s steep contraction, insurance rates rose sharply across all counties. Our primary DID analysis and event study suggest that WWWP contraction might have differentially driven more insurance take-up in most-served counties, by 1.88 pp [95 % Confidence Interval: 0.23,3.54], thus narrowing the pre-ACA gap. Sensitivity analyses suggest much smaller gains. Notwithstanding such potential insurance gains following program contraction, continued support for care navigation and coordination remain necessary to truly meet the needs of the vulnerable women previously served by the WWWP and similar programs across states.

Geographic Examination of COVID-19 Test Percent Positivity and Proportional Change in Cancer Screening Volume, National Breast and Cervical Cancer Early Detection Program.

IntroductionIn 2020, the COVID-19 pandemic led to significant declines in cancer screening, including among women served by the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). This study examined the spatial association between state-based COVID-19 test percent positivity and proportional change in NBCCEDP screening volume.MethodsUsing the COVID-19 Diagnostic Laboratory Testing dataset, we calculated state-based monthly COVID-19 test percent positivity from July through December 2020 and categorized rates into low, medium, and high groups. We used data from 48 NBCCEDP state awardees to calculate the state-based monthly proportional change in screening volume and compared data for July–December 2020 with the previous 5-year average for those months. We categorized changes in screening volume into large decrease, medium decrease, and minimal change and created maps of the associations between variable subgroups by using bivariate mapping in QGIS.ResultsBivariate relationships between COVID-19 test percent positivity and proportional change in cancer screening volume varied over time and geography. In 5 of 6 months, 4 states had high COVID-19 test percent positivity and minimal change in breast or cervical cancer screening volume; 2 states had high COVID-19 test percent positivity and minimal change in breast and cervical cancer screening volume.ConclusionSome states maintained pre–COVID-19 screening volumes despite high COVID-19 test percent positivity. Follow-up research will be conducted to determine how these states differ from those with consistent decreases in screening volume and identify factors that may have contributed to differences. This information could be useful for planning to maximize NBCCEDP awardees’ ability to maintain screening volume during future public health emergencies.

FAKTOR-FAKTOR YANG MEMPENGARUHI KESIAPAN WANITA USIA SUBUR DALAM PEMERIKSAAN IVA DI UPT PUSKESMAS PASAR SABTU

Background: Cervical cancer is the most common cancer in women in developing countries, where three-quarters of the estimated half a million new cases occur each year. Deaths from cervical cancer will continue to increase in the next 10 years if adequate measures and treatment are not taken. Cervical cancer can be prevented through early detection, one of which is the IVA method, but the percentage of coverage for early detection of cervical cancer (IVA) is still lower than the Ministry of Health's plan. Objective: To find out the factors that influence the readiness of women of childbearing age in conducting VIA examinations at UPT Pasar Sabtu Public Health Center. Methods: This type of research was descriptive quantitative with a cross sectional design. The sample is WUS who are married, totaling 100 people, that were taken using a purposive sampling technique. The data was taken questionnaire. The data was analyzed using Chi-Square test. Result: There is no correlation between education (p-value 0.090 > 0.05) and occupation (p-value 0.416 > 0.05) with WUS readiness in conducting VIA examinations at UPT Pasar Sabtu Public Health Center. There is a correlation between knowledge (p-value 0.000 < 0.05) and husband's support (p-value 0.000 < 0.05) with WUS readiness in conducting VIA examinations at UPT Pasar Sabtu Public Health Center. Conclusion: Knowledge and husband's support has a relationship with WUS readiness in conducting VIA examinations at UPT Pasar Sabtu Public Health Center. FAKTOR-FAKTOR YANG MEMPENGARUHI KESIAPAN WANITA USIA SUBUR DALAM PEMERIKSAAN IVA DI UPT PUSKESMAS PASAR SABTU

Hybrid Techniques for Diagnosis with WSIs for Early Detection of Cervical Cancer Based on Fusion Features

Cervical cancer is a global health problem that threatens the lives of women. Liquid-based cytology (LBC) is one of the most used techniques for diagnosing cervical cancer; converting from vitreous slides to whole-slide images (WSIs) allows images to be evaluated by artificial intelligence techniques. Because of the lack of cytologists and cytology devices, it is major to promote automated systems that receive and diagnose huge amounts of images quickly and accurately, which are useful in hospitals and clinical laboratories. This study aims to extract features in a hybrid method to obtain representative features to achieve promising results. Three proposed approaches have been applied with different methods and materials as follows: The first approach is a hybrid method called VGG-16 with SVM and GoogLeNet with SVM. The second approach is to classify the cervical abnormal cell images by ANN classifier with hybrid features extracted by the VGG-16 and GoogLeNet. A third approach is to classify the images of abnormal cervical cells by an ANN classifier with features extracted by the VGG-16 and GoogLeNet and combine them with hand-crafted features, which are extracted using Fuzzy Color Histogram (FCH), Gray Level Co-occurrence Matrix (GLCM) and Local Binary Pattern (LBP) algorithms. Based on the mixed features of CNN with features of FCH, GLCM, and LBP (hand-crafted), the ANN classifier reached the best results for diagnosing abnormal cells of the cervix. The ANN network achieved with the hybrid features of VGG-16 and hand-crafted an accuracy of 99.4%, specificity of 100%, sensitivity of 99.35%, AUC of 99.89% and precision of 99.42%.

Effects of mobile Health (mHealth) application on cervical cancer prevention knowledge and screening among women social support groups with low-socioeconomic status in Mysuru city, Southern India.

Cervical cancer is an important area of action because of the mortality and morbidity of the disease, and the potential for effective prevention by screening. Involving the social support groups by health education improves cervical cancer screening and early detection of the disease in the community. In the ongoing efforts to strengthen cervical cancer prevention, control, and management, digital health and technology will have a significant role to play. To assess the effectiveness of the mHealth-based intervention on cervical cancer preparedness among women social support groups. A pre-post interventional study was conducted among women social support groups from lower socio-economic status, identified from the field practice area. Purposive sampling technique was employed. A Cervical Cancer Awareness Measure (CAM) instrument was used to assess the cancer preparedness among the social support group women After taking inputs from the stakeholders' mobile health application was developed. The mHealth educational intervention was given to 102 women. Both pre-and post-test questionnaires were administered through mHealth application to assess the change in knowledge after a gap of 1 month to 2 months. The data obtained was coded and entered into Microsoft Excel worksheet 2016 and was later imported and analyzed using SPSS version 22 (licensed to the Institute). The difference in median scores of knowledge and practice were interpreted as statistically significant at p value of < 0.05. Before the intervention only 13 (12.7%) of them had heard about cervical cancer. There was a significant increase in the knowledge about warning signs & symptoms, risk factors of cervical cancer, and HPV vaccination. Around 5% increase in Pap smear test uptake.

Faktor – Faktor yang Berpengaruh terhadap Deteksi Dini Kanker Leher Rahim Metode IVA di Kabupaten Banyumas (Studi di Puskesmas Cilongok I)

Background: Cases of cervical cancer in Banyumas Regency have increased over the last four years but the coverage of early detection of VIA is still very low. The purpose of this study was to determinant factors of early detection of cervical cancer using visual inspection with acetic acid (VIA) method in Banyumas Regency (Study at Puskesmas Cilongok I).Methods: The research used cross-sectional design in 2021 with population of 13.679 women of childbearing. A sample of 93 women used purposive sampling technique. The research variables are knowledge, attitude, education, economic level, age, parity, access to health facilities, access to information, family support and support for health workers. The research instrument used google form. The data analysis performed was univariate analysis, bivariate analysis using chi square, and multivariate analysis using logistic regression.Result: Most of the respondents did not perform early detection of cervical cancer using VIA method (62.4%). The results of the analysis showed that there was a relationship between knowledge, attitudes, education, and family support (p-value= 0.027; 0.031; 0.025; 0.039) with early detection of cervical cancer using VIA method. Determinant factors of early detection of cervical cancer using VIA were are knowledge, attitudes, education, and family support (POR=3.984; 7.273; 0.187; 3.863).Conclusion : Attitude is the most determining factor in early detection of cervical cancer using the VIA method. Women should increase their positive attitude in supporting early detection of cervical cancer.

The performance of midwives in early detection of cervical cancer using visual inspection test with acetic acid

HIGHLIGHTS 1. Visual Inspection with Acetic Acid (VIA) method is used in midwifery for early detection of cervical cancer.2. Service period, knowledge, and attitudes are factors that affect a midwife's performance in using VIA method for cervical cancer detection. ABSTRACT Objective: This study examined the association between service period, knowledge, and attitudes toward the performance of midwives in the early detection of cervical cancer using the Visual Inspection with Acetic Acid (VIA) method in Banjarmasin, Indonesia. Materials and Methods: This is a cross-sectional study done in 26 Public Health Centers in Banjarmasin, Indonesia, from March to November 2020 involving 172 respondents. Samples were purposively selected using a non-probability sampling technique. Data collection instruments were questionnaire and Health Service reports. Data analysis was done computerized. Results: Out of 172 respondents, 67.4% of which had &gt; 10 years of service period, 67.4% had inadequate knowledge and 86% showed a positive attitude about early detection of cervical cancer using the IVA method, and 79.9% had poor performance in conducting early detection of cervical cancer using the IVA method. Results of Chi-square test showed the associations between the service period (p = 0.005), knowledge (p = 0.0001), and attitude (p = 0.005) with the performance of midwives in early detection of cervical cancer using the VIA method. Conclusion: Service period, knowledge, and attitudes were associated with the performance of midwives in the early detection of cervical cancer using the VIA method in Banjarmasin, Indonesia. Professional training programs should be taken into consideration in improving the performance of midwives in cervical cancer detection.

BEHAVIORAL RELATIONSHIPS MAINTENANCE OF REPRODUCTIVE HEALTH AGAINST THE INCIDENCE OF SEXUALLY TRANSMITTED INFECTIONS

Background: Sexually Transmitted Infections (STIs) are infections that are transmitted through sexual intercourse both vaginally, anally, and orally. The formulation of the problem in this study is what factors are related to the behavior of the Male Sex Group (LSL) to the transmission of sexually transmitted infections. Research methods: This study aims to analyze the relationship of reproductive health maintenance behavior to the incidence of Sexually Transmitted Infections, this type of study is analytical and observational with a Cross-Sectional design. The population consisted of the entire LSL group of 148 people; the study sample numbered 30. The data analysis technique uses the Fisher Exact and Kolmogorov Smirnov tests. Research results; showed that there was a relationship between reproductive health knowledge to the transmission of sexually transmitted infections (P=0.007), no relationship between reproductive organ maintenance behavior to early detection of cervical cancer (P=0.586), there was a relationship between risky sexual behavior to the transmission of sexually transmitted infections (p=0.005). Conclusion; Reproductive health maintenance behavior affects the risk of STI transmission in the LSL group.Keywords: Risky Sexual Behavior; LSL; LMS.

An Electroanalytical Flexible Biosensor Based on Reduced Graphene Oxide-DNA Hybrids for the Early Detection of Human Papillomavirus-16.

Human Papilloma Virus 16 (HPV 16) is the well-known causative species responsible for triggering cervical cancer. When left undiagnosed and untreated, this disease leads to life-threatening events among the female populace, especially in developing nations where healthcare resources are already being stretched to their limits. Considering various drawbacks of conventional techniques for diagnosing this highly malignant cancer, it becomes imperative to develop miniaturized biosensing platforms which can aid in early detection of cervical cancer for enhanced patient outcomes. The current study reports on the development of an electrochemical biosensor based on reduced graphene oxide (rGO)/DNA hybrid modified flexible carbon screen-printed electrode (CSPE) for the detection of HPV 16. The carbon-coated SPEs were initially coated with rGO followed by probe DNA (PDNA) immobilization. The nanostructure characterization was performed using UV-Vis spectroscopy, Fourier transform infrared (FTIR) spectroscopy, Raman spectroscopy and X-ray diffraction (XRD) techniques. Cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) were employed to study the electrochemical characterization of the nano-biohybrid sensor surface. The optimization studies and analytical performance were assessed using differential pulse voltammetry (DPV), eventually exhibiting a limit of detection (LoD) ~2 pM. The developed sensor was found to be selective solely to HPV 16 target DNA and exhibited a shelf life of 1 month. The performance of the developed flexible sensor further exhibited a promising response in spiked serum samples, which validates its application in future point-of-care scenarios.

Comprehensive analyses identify RIPOR2 as a genomic instability-associated immune prognostic biomarker in cervical cancer

Cervical cancer (CC) is a malignancy that tends to have a poor prognosis when detected at an advanced stage; however, there are few studies on the early detection of CC at the genetic level. The tumor microenvironment (TME) and genomic instability (GI) greatly affect the survival of tumor patients via effects on carcinogenesis, tumor growth, and resistance. It is necessary to identify biomarkers simultaneously correlated with components of the TME and with GI, as these could predict the survival of patients and the efficacy of immunotherapy. In this study, we extracted somatic mutational data and transcriptome information of CC cases from The Cancer Genome Atlas, and the GSE44001 dataset from the Gene Expression Omnibus database was downloaded for external verification. Stromal components differed most between genomic unstable and genomic stable groups. Differentially expressed genes were screened out on the basis of GI and StromalScore, using somatic mutation information and ESTIMATE methods. We obtained the intersection of GI- and StromalScore-related genes and used them to establish a four-gene signature comprising RIPOR2, CCL22, PAMR1, and FBN1 for prognostic prediction. We described immunogenomic characteristics using this risk model, with methods including CIBERSORT, gene set enrichment analysis (GSEA), and single-sample GSEA. We further explored the protective factor RIPOR2, which has a close relationship with ImmuneScore. A series of in vitro experiments, including immunohistochemistry, immunofluorescence, quantitative reverse transcription PCR, transwell assay, CCK8 assay, EdU assay, cell cycle detection, colony formation assay, and Western blotting were performed to validate RIPOR2 as an anti-tumor signature. Combined with integrative bioinformatic analyses, these experiments showed a strong relationship between RIPOR2 with tumor mutation burden, expression of genes related to DNA damage response (especially PARP1), TME-related scores, activation of immune checkpoint activation, and efficacy of immunotherapy. To summarize, RIPOR2 was successfully identified through comprehensive analyses of the TME and GI as a potential biomarker for forecasting the prognosis and immunotherapy response, which could guide clinical strategies for the treatment of CC patients.

Do products containing Calendula officinalis have a positive role in treating uterine cervix disorders?

Once screening tests and national programs for early detection of cervical cancer have been widely developed, a significant number of patients are diagnosed with preneoplastic lesions at this level; therefore, in such cases, a conservative treatment is feasible, increasing therefore the possibility of fertility preservation and conceiving. Meanwhile, after performing an invasive maneuver at this level attention should be focused on obtaining an adequate healing process at this level. The aim of the current paper is to conduct a literature review regarding the benefits of Calendula officinalis in maximizing the healing process after local invasive procedures at the level of the uterine cervix as well as on human papilloma virus infection prevention.

Comparative pilot study about HPV test with partial genotyping in primary screening versus other strategies for cervical cancer population screening, CRYGEN 16/18 study

IntroductionThe early detection of cervical cancer requires the implementation of molecular screening programmes for human papillomavirus (HPV). However, there are discrepancies in the optimization of screening protocols. The performance of 10 primary screening strategies based on molecular, cytological or combined techniques is now evaluated. Material and MethodsA blind, prospective, and interventional study was designed in 1.977 35-year-old women. The molecular determination was carried out by the Cobas 4800 HPV platform. Cytological analysis were performed on the same samples without knowledge of the result of the molecular assay. All women in whom HPV-16/HPV-18 was detected or presented cytological alteration together with detection of other high-risk genotypes (HPVhr) were referred to colposcopy. ResultsThe molecular assay detected the presence of HPVhr genotypes in 12.5% of the women, while only 8.1% of the cytologies were pathological. Among the patients referred to colposcopy, in 19.5% high-grade lesions were observed, being HPV-16 present in 65.3% of them. In six of these high-grade lesions (associated with HPV-16 in all cases), cytology was reported as normal. The follow-up one year later, of women with normal cytology and HPVhr detection a HSIL/CIN2+ lesion was detected (associated to HPV-33). In the comparative study with other strategies, the protocol called CRYGEN 16/18 yielded the best balance of sensitivity and specificity with the least referral to colposcopy. ConclusionsPerforming molecular detection of HPVhr with partial first-line genotyping of at least HPV-16, with direct referral to colposcopy, increases the detection rate of HSIL/CIN2+ lesions.

Predisposing, enabling and reinforcing factors of fertile age women in early detection of cervical cancer

The study aims to determine predisposing, enabling, and reinforcing factors of fertile age women in early detection of cervical cancer. The study was descriptive that conducted on 100 of fertile age women. Data were collected from April to August 2020 using a questionnaire based on Lawrence Green's theory by Google form. Data were analysed using a descriptive test and SPSS version 22 was applied. The study result found that the level of knowledge was good (46%), the negative attitude was 68%, to get early detection information was never (70%), Education level was high school (56%). The health service places were mostly unreachable (52%), 70% had never done early detection of cervical cancer, and the husband's motivation for decision making was 59%. The religious figures were not there 85%, the role of community leaders was not thereby 87% and the role of health Kader was not there by 75%. Predisposing, Enabling, Reinforcing Factors of Fertile Age Women greatly influence the behaviour of women of childbearing age in Early Detection of Cervical Cancer.

Promoter methylation analysis of DKK2 may be a potential biomarker for early detection of cervical cancer.

Dickkopf 2 (DKK2) plays an important role in multiple cancers. Its potential value in the clinical diagnosis of cervical cancer has remained unclear. To investigate the expression and promoter methylation levels of DKK2 in cervical cancer and their clinicopathological associations. We used the Gene Expression Omnibus, Oncomine, Cancer Genome Atlas, and University of ALabama at Birmingham CANcer data analysis databases, reverse transcription-PCR, and methylation-specific PCR analysis to predict and examine the expression of DKK2 mRNA and DKK2 methylation levels in cell lines and cervical cancer tissues from 79 patients with cervical cancer and 63 with cervical precancerous lesions including 25 with low-grade squamous intraepithelial lesions (LSIL) and 38 patients with high-grade squamous intraepithelial lesions (HSIL). DKK2 mRNA expression was downregulated in all cancer cell lines and cervical cancer tissues, whereas hypermethylation of DKK2 was higher in cervical cancer tissue samples. DKK2 methylation in cervical cancer was significantly higher than that in HSIL (χ2 = 8.346, P = 0.004), whereas DKK2 methylation in HSIL was significantly higher than that in normal cervical samples (χ2 = 7.934, P = 0.005) and in LSIL samples (χ2 = 4.375, P = 0.037). DKK2 silencing caused by its promoter hypermethylation was confirmed by treatment with the methyltransferase inhibitor 5-Aza-dC in cell lines. Patients with lymph node metastasis exhibited increased promoter methylation frequency (χ2 = 5.239, P = 0.022) and low DKK2 mRNA expression (χ2 = 3.958, P = 0.047) compared with patients with no lymph node metastasis. Patients with high-risk human papillomavirus infection exhibited increased promoter methylation frequency (χ2 = 6.279, P = 0.015). DKK2 epigenetic changes of DKK2 may play a key role in the development of cervical cancer, suggesting that DKK2 hypermethylation could be used as a triage test for screening, early diagnosis, or risk prediction of cervical cancer.