Pap Smear Rates Research Articles

Colposcopy-A Valuable Diagnostic Tool for Pregnant Women With Unexplained Vaginal Bleeding.

We aimed to examine the diagnostic value of colposcopy in a large cohort of pregnant women with unexplained vaginal bleeding during the second or third trimester. This retrospective study included women who underwent colposcopy due to vaginal bleeding in the second and third trimesters during 2012-2022 at a tertiary care hospital. Demographics, obstetric data, bleeding characteristics, colposcopy results, cervical cytology testing, a sonogram directed at the placenta, and birth details were collected. In total, 364 women were included. The mean maternal age was 29.7 years and the mean gestational age at examination was 30.7 weeks. Vaginal bleeding was mild in 80.8%, moderate in 14.6%, and severe in 4.7%. Only 3.3% had been vaccinated against human papilloma virus and 25.5% underwent a Pap smear study before pregnancy. Colposcopy diagnosed the bleeding source in 83 women (22.8%). The colposcopic examination revealed vaginal bleeding due to contact bleeding from ectropion in 46 (12.6%), a decidual/cervical polyp in 37 (10.2%), acetowhite epithelium in 12 (3.3%), herpes genetalis in 2 (0.5%), and bleeding from vaginal varices in 2 (0.5%). Of those who were recommended a follow-up examination after the postpartum period, only 49.1% completed such.Among women with compared to without postcoital bleeding ( N = 72), the risk of abnormal colposcopic findings was higher (24 [33.3%] vs 54 [19.7%], p = .017) and the rate of abnormal Pap smear was higher (7 [13.2%] vs 7 [3.2%], p = .008). Colposcopy can be a valuable diagnostic tool for women with unexplained vaginal bleeding in the second or third trimester.

Text messaging intervention for Pap smear uptake: a single-institution study.

Cervical cancer continues to be one of the leading causes of death among women in many parts of the world. With the increasing proliferation of mobile technology, text messaging interventions have been effective in improving Pap smear uptake in non-United States populations. This study evaluated whether text message reminders from a health system in Galveston, Texas, USA increased uptake of cervical cancer screening as compared to usual care. A single text message reminder was sent to 16,002 unique patient phone numbers using the Televox Communication Program from February 20, 2019, to April 4, 2019. The institution's population health database was subsequently used to determine if patients received cervical cancer screening (Pap smear) following the text message transmission. Patient demographics within text message and control groups were compared using Chi-square tests. Our text messaging intervention to improve Pap smear rates did not show a statistically significant difference between the intervention group receiving a text message and the control. However, there were significant interactions between text messages and age, financial class, and county (P=0.0023, 0.0299, and <0.0001, respectively). Text messaging did have a positive impact on our most vulnerable patient populations given that the text messaging intervention showed a marginally higher rate of Pap smear among Medicaid and low-income/uninsured (MLIU) patients. Text messaging interventions do have effectiveness in increasing Pap smear uptake in populations which are most impacted by health disparities.

Cervical Cancer Disparities in the American Indian/Alaska Native Population: Are Prevention Tools Being Utilized? (108)

Objectives: Our group published data demonstrating that American Indian/Alaska Native (AI/AN) women have had persistently higher incidence and mortality from cervical cancer than Non-Hispanic White women in the Pacific Northwest (WA, ID, OR). Cervical cancer screening is an essential tool for detecting pre-invasive and early-stage, curable disease. We sought to longitudinally evaluate the participation of AI/AN women in the Pacific Northwest in cervical cancer screening. Results: In the PNW, we identified a total of 34,278 patients eligible for cervical cancer screening within the 10-year period. The aggregate up-to-date pap smear rate was 63.5% for the three-state region (Figure 1). Between the two time periods assessed (January 2010 to December 2014 and January 2015 to July 2020), cervical cancer screening rates increased slightly in all three states of interest, with the greatest increase seen in Washington state (4.0%) and least in Idaho (1.3%). Despite these modest increases, cervical cancer screening rates remain below the 2018 calculated national screening average of 80.5% and the Healthy People 2030 target of 84.3%. Conclusions: In order to reduce the invasive cervical cancer disparities faced by AI/ANs, enhanced efforts should be directed toward identifying and reducing barriers to increase participation in cervical cancer screening. Objectives: Our group published data demonstrating that American Indian/Alaska Native (AI/AN) women have had persistently higher incidence and mortality from cervical cancer than Non-Hispanic White women in the Pacific Northwest (WA, ID, OR). Cervical cancer screening is an essential tool for detecting pre-invasive and early-stage, curable disease. We sought to longitudinally evaluate the participation of AI/AN women in the Pacific Northwest in cervical cancer screening. Results: In the PNW, we identified a total of 34,278 patients eligible for cervical cancer screening within the 10-year period. The aggregate up-to-date pap smear rate was 63.5% for the three-state region (Figure 1). Between the two time periods assessed (January 2010 to December 2014 and January 2015 to July 2020), cervical cancer screening rates increased slightly in all three states of interest, with the greatest increase seen in Washington state (4.0%) and least in Idaho (1.3%). Despite these modest increases, cervical cancer screening rates remain below the 2018 calculated national screening average of 80.5% and the Healthy People 2030 target of 84.3%. Conclusions: In order to reduce the invasive cervical cancer disparities faced by AI/ANs, enhanced efforts should be directed toward identifying and reducing barriers to increase participation in cervical cancer screening.

Abstract 441: The impact of the COVID-19 on the screening of breast and cervical cancer in Korea

Abstract Background: The COVID-19 pandemic has affected use of healthcare services, especially disrupting individual participation in cancer screening programs. The National Cancer Screening Program (NCSP) of Korea provides screening services for six common cancers - stomach, liver, colorectum, breast, cervix, and lung. As complete national lockdown measures were not implemented, the NCSP continued operation during the three major COVID-19 waves in Korea, which allowed us to assess the changes in health-seeking behavior. We examined the cancer screening rates for breast and cervical cancers among NCSP participants in different geographic regions and by age group, in association with the COVID-19 pandemic. Methods: From the National Health Insurance Service database, we obtained information on the number of eligible population and NCSP participants from January 2019 to December 2020. The target group for biennial mammography screening is women aged 40 years and over, and that for biennial pap smear is women aged 20 years and over. We compared monthly screening rates for breast and cervical cancer between 2020 vs 2019 and described them as a percentage change. Results: The overall cancer screening rate has decreased in both cancers in 2020 compared with that of 2019: breast (55.8% vs 63.8%), cervical (52.2% vs 57.8%). Screening rates for both cancers declined in all age groups in March and December of 2020, which corresponds to the first and third COVID-19 wave. The month of March 2020 had the sharpest drop in screening rates, by 57.9% for breast cancer and 43.7% for cervical cancer compared with March 2019. In June 2020, screening rates for both cancers rebounded compared with 2019 (breast, +29.2%; cervical, +26.3%), which remained higher compared with the same months in 2019 until November 2020. By December 2020, screening rates for both cancers have dropped, compared with December 2019 (breast, -19.5%; cervical, -21.0%). For breast cancer, the screening rate decreased in all age groups, and the largest decline was observed in women aged 80 years and over. Although the cervical cancer screening rate has been steadily increasing since 2010, it decreased in all age groups in 2020 compared with that of 2019, with the exception of the 20-29 age group. Considering social distancing measures that were implemented nationwide during each COVID-19 wave, we observed a similar pattern of cancer screening rates in major cities. Conclusions: It was observed that after the two major COVID-19 waves, mammography and pap smear rates declined compared with that of 2019. The largest decline in cancer screening rates was seen in elderly women. The pattern of screening rate changes was comparable according to geographic region. In contrast to reports showing a deficit in cancer screening in other countries, our results suggest a substantial recovery in cancer screening in Korea. Additional analyses are needed to assess the effect of the 6-month extension of NCSP. Citation Format: Hyeree Park, Seung Hee Seo, Jong Heon Park, Bhumsuk Keam, Shin Hye Yoo, Aesun Shin. The impact of the COVID-19 on the screening of breast and cervical cancer in Korea [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 441.

Impact of COVID-19 in Cervical and Breast Cancer Screening and Systemic Treatment in São Paulo, Brazil: An Interrupted Time Series Analysis.

PURPOSECOVID-19 caused a disruption in cancer management around the world, resulting in an estimated excess burden secondary to screening disruption and excess lag time for treatment initiation.METHODSWe gathered information from primary reimbursement data sets of the public health system of São Paulo, Brazil, from April 2020 to November 2021, and compared these data with those of the pre–COVID-19 period. We used an interrupted time series model to estimate the effect of the COVID-19 pandemic on the rate of key procedures of breast and cervical cancer health care chain.RESULTSWe estimated that 1,149,727, 2,693, and 713,616 pap smears, conizations, and mammograms, respectively, were missed or delayed during the COVID-19 pandemic, compared with those in the years immediately before the COVID-19 stay-at-home restrictions. Specifically, we observed an acute decrease of procedures after the COVID-19 stay-at-home restrictions, with a trend to recovery in the long term. Regarding the systemic treatment analysis, we observed a 25% reduction in the rate of initiation of adjuvant systemic treatment for early breast cancer (stage I/II). However, we did not find a clear effect on the other settings of systemic treatment for breast cancer. We estimated an excess of 156 patients starting palliative care for cervical cancer after the COVID-19 stay-at-home restrictions.CONCLUSIONThe COVID-19 pandemic significantly reduced the performance rate of pap smears, conizations, and mammograms. The initiation of adjuvant treatment for early-stage breast cancer was most susceptible to COVID-19's health system disruption. Furthermore, the downward trend of treatment of advanced cervical cancer was interrupted. Therefore, public health policies are urgently needed to decrease the incidence of advanced cervical and breast cancers caused by delayed diagnosis and treatment initiation.The COVID-19 control policies resulted in reduction of cancer patients' delivery of care. This study evaluated the pandemic's influence in key procedures of breast and cervical cancer chain of care in São Paulo, Brazil. We observed a substantial reduction in the number of mammograms, pap smears, and conizations performed since the onset of the COVID-19 pandemic. In addition, stage I and II breast cancer adjuvant treatment presented a reduced realization rate, whereas palliative treatment delivered for advanced cervical cancer increased. Our results support the need for public health policies focused on mitigating the long-term effects of COVID-19 in cancer-related mortality.

Pap Smear and Mammogram Screening Rates in a Refugee and General OB/GYN Clinic: A Retrospective Review.

Although multiple studies have shown that resettled refugee women are less likely to receive preventative cancer screenings like pap smears and mammograms, a small number have demonstrated the opposite. This retrospective chart review, conducted between January 2017 and October 2018, compares pap smear and mammogram rates of patients seen in a refugee-specific OB/GYN clinic with patients from the general OB/GYN clinic at the same institution. Data from 298 patients (149 refugee and 149 general clinic patients matched by age and date-of-visit) were analyzed. Pap smear screening rates were 90.60% in the refugee group and 73.83% in the general group [p < 0.009, aOR 3.46 (1.36-8.81)], while mammogram screening rates were 36.84% and 38.60%, respectively (p = 0.46). The provision of holistic services meeting refugee women's unique needs can effectively increase pap smear screening rates.

Human Papillomavirus Vaccination and Pap Smear Rates Among Burmese Refugee Girls in a Healthcare System in Omaha, Nebraska.

While human papilloma virus (HPV) vaccinations and Pap smear screenings are known to improve the survival rates and incidence of cervical cancer, refugee populations have traditionally been disadvantaged within this arena. Due to past and recent political issues in Myanmar, Burmese refugee women in Nebraska may be at particular risk due to their increasing numbers. This study examined 65 female Burmese refugees who were candidates for HPV vaccinations and 106 female Burmese refugees who could have received Pap smear screenings between 2010 and 2020. Of the 65 patients aged 11-26, 49.2% initiated the HPV vaccine series and 30.8% completed the series. In patients aged 13-17, 86.4% initiated the vaccine series and 54.6% completed the series. Of the 106 patients over 18years of age, 32.1% had a Pap smear within the last 3years. The need to improve HPV vaccine and Pap smear rates in refugee populations is clear. While focusing on the designated refugee exam may have improved HPV vaccine rates, it is important to examine gaps in knowledge with regards to attitudes surrounding HPV vaccines and Pap smears within the Burmese refugee population.

A Retrospective Study on Cervical Cancer Screening Using Pap Smear and Related Factors Among Women Living in Tiaret, Algeria

To identify the abnormal pap smear cytology and its association with different socio-demographic characteristics in women attending the cervical cancer screening service at the Proximity Public Health Establishment (PPHE Zaaroura-Tiaret) in Algeria. This retrospective study was conducted on 1230 women attending the cervical cancer screening service mentioned above during the period from October 1st 2017 to March 31st 2018. Pap smears were made with the conventional method according to standard medical literature and classification as per Bethesda system 2014. Statistical analysis was performed using R Studio Software. The mean age of study participants was 42.24 years. The maximum number of study subjects (37.24%) was in the age group of 41 to 50 years. According to Bethesda Terminology, 356 (28.94%) were normal smears, 802 (65.20%) of women in the study group had inflammatory smear, 53 (4.31%) smears were reported as inadequate, Epithelial cell abnormality was seen in 19 (1.54%) of the smears which includes 3 (0.24%) ASCUS, 2 (0.16%) LSIL, 1 (0.08%) HSIL, 5 (0.41%) ASCH, and 8 (0.65%) AGC. Out of the 19 (1.54%) abnormal Pap smear, 0.54% were found in women in the age group of 41–50 years. The majority of the women with abnormal Pap smear were married before the age of 21 years (0.57%). The present study found that 0.98% women with abnormal Pap smear had more than 3 children. It was also found that women who did not breastfeed had the highest rate of abnormal Pap smear (0.57%). These various elements suggest that we could still significantly reduce the incidence of this cancer thanks to better information and awareness among women that are not currently screened.

Transgender and Nontrans Patients Do Not Receive Statistically Different Quality Primary Care at Whitman-Walker Health, 2008-2016.

Purpose: Washington, DC, has the highest prevalence of transgender persons in the United States at 2.8%. Transgender persons in DC have lower income, less stable housing, and more HIV infection than nontrans persons. Data are scarce regarding primary care quality among trans persons. We provide a detailed analysis of transgender patients at Whitman-Walker Health, an HIV- and LGBT-focused community health center.Methods: We performed a retrospective electronic medical record review of transgender patients ≥18 years of age from 2008 to 2016, evaluating demographic factors, HIV status, gender-affirming care, and primary care quality indicators.Results: Of 20,097 patients, 1822 (9.0%) self-identify as transgender (62.9% trans female and 37.2% trans male), and 18,275 were nontransgender. Transgender patients are more likely to be young, white, HIV negative, and reside outside Washington, DC, than nontrans patients. Transgender patients are more likely to engage in primary care and have a similar likelihood of mammogram and colonoscopy screening than nontrans patients. Trans males are more likely to be privately insured, have lower rates of HIV testing than nontrans patients, and have higher rates of cervical Pap smears than cis females. Trans females have a high prevalence of HIV infection (26.6%).Conclusion: This is the largest single-center U.S. transgender cohort to date. Over a quarter of trans females are HIV positive, consistent with a national prevalence of 27.7%. Transgender and nontrans patients do not receive statistically different quality of primary care. Trans patients' high engagement in primary care may result from providing hormone therapy and primary care within a single provider visit.

Searching for an ideal cervical cancer screening model to reduce false-negative errors in a country with high prevalence of cervical cancer

The purpose of this study was to develop an ideal cervical cancer screening model to reduce false-negative errors in Korea where there is a high prevalence of cervical cancer. We conducted a cross-sectional study including 33,531 women who underwent routine cervical cancer screening in Korea. Colposcopic examinations were performed after abnormal results on their screening tests. Diagnostic capacities including sensitivity, specificity, and false-negative rate of each screening scenario were analysed at the CIN1 or worse (CIN1+) threshold with colposcopic biopsy results considered the gold standard. A total of 4117 women had valid results for Papanicolaou (Pap) cytology, human papilloma virus (HPV) tests, cervicography, and colposcopically directed biopsy were included in this study. The disease prevalence of CIN1+ was 38.1%. Pap-alone resulted in the highest false-negative rate of 46.9%, followed by HPV-alone at 25.1%, cervicography-alone at 18.7%, Pap/HPV-combined at 15.0%, Pap/cervicography-combined at 6.9% and Pap/HPV/cervicography-combined at 2.9% in a sample of 1570 women with CIN1+ lesions. Therefore, cervicography demonstrated excellent performance for the detection of CIN or cervical cancer and markedly reduced false-negative errors when used in combination with Pap cytology and HPV tests.IMPACT STATEMENTWhat is already known on this subject? False-negative rate of Pap smears is as high as approximately 40–50%. Limitations of the Papanicolaou (Pap) test have led to the development of new screening programmes for cervical cancer, such as combination screenings with human papillomavirus (HPV) tests or cervicography.What do the results of this study add? Pap-alone resulted in the highest false-negative rate of 46.9%, followed by HPV-alone at 25.1%, cervicography-alone at 18.7%, Pap/HPV-combined at 15.0%, Pap/cervicography-combined at 6.9% and Pap/HPV/cervicography-combined at 2.9% in a sample of 1570 women with CIN1+ lesions.What are the implications of these findings for clinical practice and/or further research? Cervicography demonstrated excellent performance for the detection of CIN or cervical cancer and markedly reduced false negative errors when used in combination with Pap cytology and HPV tests.

Comparison of the diagnostic value of the visual inspection with acetic acid (VIA) and Pap smear in cervical cancer screening

ObjectiveThis study aimed to compare the diagnostic value of VIA with Pap smear in screening for cervical cancer. Materials and methodsIn this cross-sectional study, 440 women who had eligibility criteria, in Kashan city were assessed. All women underwent Pap smear test and then a visual inspection with acetic acid and colposcopy-biopsy (Gold Standard). Then, the diagnostic value indices including the specificity, sensitivity, positive and negative predictive values for the results of VIA and Pap smear were analyzed by SPSS V16 software. ResultsFinding showed that 29.9% of women had abnormal Pap smear. The false positive rate of Pap smear was 40.2%, and its false negative rate was 37.4%. For VIA, the false positive and false negative rates were 21.2% and 4.6%. The sensitivity, specificity, NPV and PPV of Pap smear was 29.7%, 85.5%, 59.8%, 62.6%, and these values for VIA was 94.6%, 81.6%, 78.8%, 95.4% respectively. Combination of Pap smear and VIA showed the sensitivity of 97.3% and 100% in low grade and high grade cervical lesions. ConclusionVIA has a higher sensitivity than Pap smear in detection of low and high grade cervical lesions, however, its specificity is less than Pap smears. Therefore it is recommended to use of VIA along with Pap smear to reach a higher sensitivity.

The Trend of Abnormal Cervical Cytology Among Iranian Women During Recent Years from 2013 to 2016

BackgroundCervical cancer is one of the common cancers in developing countries, which has a high rate of mortality. This study aimed to evaluate the prevalence of abnormal cervical cytology among Iranian women.MethodsIn this cross-sectional study, cervical cytological results of 137,484 Iranian women, who were screened for cervical cancer in Tehran and 12 other provinces of Iran from 2013 to 2016, were investigated. The Pap smear was prepared by a liquid-based method and evaluated by a pathologist.ResultsThe overall prevalence of abnormal cervical cytology in the studied population was 3%. The mean age of the population was 35.77 ± 9.6. In this study, the prevalence of abnormal cytology in 2013, 2014, 2015, and 2016 was 2.10%, 2.68%, 3.47%, and 3.60%, respectively. The rate of the abnormal Pap smear has increased over the years, and this trend has been statistically significant (P<0.001). In this population, atypical squamous cells of undetermined significance (ASCUS) cytology was the most common abnormal Pap smear (1.96%).ConclusionIn this study, the prevalence of abnormal cervical cytology has been significantly increased in Iran in recent years. This increase requires careful monitoring of general education programs, strict cervical cancer screening, and routine vaccination against HPV infection.

Colorectal, cervical and prostate cancer screening in Australians with severe mental illness: Retrospective nation-wide cohort study.

People with severe mental illness have similar cancer incidence, but higher mortality than the general population. Participation in cancer screening may be a contributing factor but existing studies are conflicting. The aim of this study was to investigate the frequency of colorectal, prostate and cervical cancer screening among people with and without severe mental illness in Australia, who have access to universal health care. We followed three cohorts using de-identified data from a random 10% sample of people registered for Australia's universal health care system: those aged 50-69 years ( n = 760,058) for colorectal cancer screening; women aged 18-69 years ( n = 918,140) for cervical cancer screening and men aged 50-69 years ( n = 380,238) for prostate cancer screening. We used Poisson regression to estimate incidence rate ratios and 95% confidence intervals for the association between severe mental illness and rates of faecal occult blood testing, pap smears and prostate-specific antigen testing. Having severe mental illness was associated with a 17% reduction in rates of pap smear (incidence rate ratio = 0.83, 95% confidence interval: 0.82-0.84) and prostate-specific antigen testing (incidence rate ratio = 0.83, 95% confidence interval: 0.81-0.85), compared to the general population. By contrast, incidence rates of faecal occult blood testing were only lower in people with severe mental illness among the participants who visited their general practitioner less than an average of five times per year (incidence rate ratio = 0.83, 95% confidence interval = [0.73, 0.94]). Our results suggest that differences in screening frequency may explain some of the mismatch between cancer incidence and mortality in people with severe mental illness and indicate that action is required to improve preventive screening in this very disadvantaged group.

Status and awareness of cervical, breast, and colon cancer screening in a Turkish city.

Mortality and morbidity rates of cervical, breast, and colorectal cancers (CRC) can be decreased via effective screening strategies. Developing countries are to be expected to establish and implement their own programs. To evaluate regional awareness and status of cervical, breast, and CRC screening, a questionnaire-based study was conducted in 500 volunteers from a Turkish community hospital. Awareness rates were 57.4% for Pap smear, 61.2% for mammography, and 25.4% for CRC. Implementation rates were 19.2%, 23.9%, and 12%, respectively. Positive family history for gynecologic cancer and past cervical ablative procedure parameters were related to higher Pap smear rates. Educational level, breast self-exam, and positive Pap smear history parameters were related to higher mammography rates. Factors related to higher colorectal cancer screening rates were nulliparity and positive Pap smear history. Cancer screening rates for this Turkish city are still below the expected levels despite recently revitalized national screening program. For success, it is essential not only to educate rural populations but also to train negligent healthcare providers regularly.

Timely reminder interventions to improve annual Papanicolaou (Pap) smear rates among HIV-infected women in an outpatient center of southern Nevada: a short report

ABSTRACTCurrent guidelines recommend annual Papanicolaou (Pap) smears for human immunodeficiency virus (HIV)-infected women for cervical cancer screening. Rates for such screening in Nevada are below the national rate. Our cohort includes 485 eligible HIV-infected adult women from an outpatient center in Southern Nevada of which only 12 women had obtained a Pap smear in the past year. An intervention was conducted from June 2015 to September 2015, in which reminders to schedule a Pap smear were sent to the remaining cohort of 473 women via sequential text messaging, followed by phone call attempts. Of all subjects, 94% contacted by text messages and 41% contacted by phone calls were successfully reached. There was an increase in the rate of completed Pap smears from 2.5% (12/485) at baseline to 11.8% (56/473) after interventions (p < 0.0001) in a period of three months. Out of the 68 Pap smear results, 20 (29.4%) were abnormal. Our intervention, utilizing methods of communication such as text messaging and phone calls, markedly increased the rate of completed Pap smear screening in our population.

Occupational Stress, Job Satisfaction and Cervical Screening Intention of Maternity Oncology Nurses

&lt;em&gt;Background: Cervical Cancer could be a preventable disease, and a key aspect of its interference is &lt;/em&gt;&lt;em&gt;that the detection of the premalignant form by cervical screening. Nursing could be a skilled job &lt;/em&gt;&lt;em&gt;characterized by high stress. Stress could be associated with less practice of health promoting &lt;/em&gt;&lt;em&gt;behaviors; however, no study has investigated the relationship between job stress and health screening&lt;/em&gt;&lt;br /&gt;&lt;em&gt;behaviors among nurses in Egypt. Aim: describe the rate of Pap smears in hospital nurses and assess &lt;/em&gt;&lt;em&gt;the effects of job stress on receiving cervical cancer screening. Subject and Methods: Purposive &lt;/em&gt;&lt;em&gt;sampling included 30 nurses who worked in gynecological inpatient and outpatient department in all &lt;/em&gt;&lt;em&gt;general hospitals in Beni-Suef city. Data collection was carried out by self-administered structured &lt;/em&gt;&lt;em&gt;questionnaire, Job stressors &amp;amp; Job Satisfaction Scales for Nurses. Results: 86.7% of staff nurses &lt;/em&gt;&lt;em&gt;working in maternity oncology units never Performed cervical screening pap smear Previously. 90% &amp;amp; &lt;/em&gt;&lt;em&gt;93.4% of the nurses, respectively, were unsatisfied with their salary and job. 70% of them had an&lt;/em&gt;&lt;br /&gt;&lt;em&gt;occupational stress and 100% Perceived occupational health risks. Conclusion: The great majority of &lt;/em&gt;&lt;em&gt;nurses has unsatisfied and job stress. Most of them never Performed pap smear Previously and &lt;/em&gt;&lt;em&gt;absolutely refuse to do in future. The main cause for refusing cervical screening as mentioned by nurses &lt;/em&gt;&lt;em&gt;was a high flow rate of positive cases.&lt;/em&gt;

Accuracy of screening tools for Pap smears in general practice

BackgroundData extraction tools (DETs) are increasingly being used for research and audit of general practice, despite their limitations.ObjectiveThis study explores the accuracy of Pap smear rates obtained with a DET...

Differences in Cervical Cancer Screening Between African-American Versus African-Born Black Women in the United States.

Although the incidence of cervical cancer has been declining steadily since the Pap smear became standard of care in the U.S., many African immigrants are unfamiliar with this screening test and its potential benefits. Using data from the CDC's National Health Interview Surveys, we identified respondents who were black women living in the United States, distinguishing U.S.-born (n=620) and African-born (n=36). We constructed a measure of current Pap status and used multivariate logistic regression models to compare Pap status between the two groups. Controlling for income, age, education, health insurance, and marital status, African American women were over 3 times more likely to have reported a current Pap smear than African-born women [Adjusted OR=3.37, 95% CI=(1.89, 5.96)]. Being an African-born woman was the strongest predictor of current Pap status. Distinguishing immigrant status in an analysis of cervical cancer screening rates for black women indicated much lower Pap smear rates for African-born women, compared with African-American women. More research on the impact of education and culturally specific care is needed to address the disparity in Pap smear rates for African-born black women.

Association between Pap smear screening and job stress in Taiwanese nurses

PurposeNursing is a professional job characterized by high stress. Stress could be associated with less practice of health promoting behaviors; however, no study has investigated the relationship between job stress and health screening behaviors among nurses. This study aimed to describe the rate of Pap smears in hospital nurses and examine the effects of job stress on receiving a Pap smear. MethodsThis study was a cross-sectional survey. The study participants were 30,681 full-time female nurses who were at least 30 years of age working in 100 hospitals across Taiwan. The study participants filled out an anonymous structured questionnaire from May to July, 2011. The outcome variable was having a Pap test during the previous 3 years. The level of stress was measured by a 19-item scale, with higher scores indicating higher stress levels. ResultsAbout 62.4% of the nurses had a Pap smear during the previous three years. Each point increase in the stress score decreased the likelihood of Pap smears (OR = .997, 95% CI: .995–.999), after adjustment for participant characteristics, health status, health behaviors, and hospital characteristics. ConclusionDespite more knowledge and higher accessibility, nurses were less likely to have Pap smear screening than the general population. A higher level of job stress was associated with a lower likelihood of having a Pap smear. Hospital administrators could help decrease work-related stress and improve stress adaption among nurses in order to improve their health screening behaviors.

Colposcopy Requirement of Papanicolaou Smear after Atypical Squamous Cells of Undetermined Significance (ASC-US) by Follow-up Protocol in an Urban Gynaecology Clinic, a Retrospective Study in Thailand.

ASC-US cases are managed according to the current American Society for Colposcopy and Cervical Pathology (ASCCP) guideline in which a human papillomavirus (HPV) test and repeat Pap smear are performed in the next 1 year. Colposcopy in cases of positive high risk HPV and persistent ASC-US or more in subsequent Pap smear is recommended. The HPV test is more expensive and still not currently a routine practice in Thailand. To identify the risk factors of persisted abnormal Pap smear and the colposcopic requirement rate in women with ASC-US. During 2008-2013, this study was conducted in Prapokklao Hospital, Chanthaburi, Thailand. Participants were women who attended gynaecology clinic for cervical cancer screening. Women who had cytological reports with ASC-US were recruited. During the study period, 503 cases were enrolled. Colposcopic requirement was defined as those who were detected with an ASC-US or more in subsequent Pap smears up to 1 year follow-up. The colposcopic referral rate was 23.2 (85/365) percent at 12 months. Prevalence of cervical intraepithelial neoplasia (CIN) 2/3 was 3.3 (12/365) percent. Loss follow-up rate of subsequent Pap smear and colposcopic appointment were 27.4 (138/503) and 48.2 (41/85) percent, respectively. There was no invasive cancer. High risk factors for persisted abnormal Pap smears in subsequent test were premenopausal status, HIV infected patients and non-oral contraceptive pills (COC) users. Referral rate for colposcopy in women with ASC-US reports was rather high. Loss to follow-up rate was the major limitation. Immediate colposcopy should be offered for women who had high risk for silent CIN.