Pap Smear Research Articles

Enhancing cervical cancer diagnosis with graph convolution network: AI-powered segmentation, feature analysis, and classification for early detection

Cervical cancer is a prevalent disease affecting the cervix cells in women and is one of the leading causes of mortality for women globally. The Pap smear test determines the risk of cervical cancer by detecting abnormal cervix cells. Early detection and diagnosis of this cancer can effectively increase the patient’s survival rate. The advent of artificial intelligence facilitates the development of automated computer-assisted cervical cancer diagnostic systems, which are widely used to enhance cancer screening. This study emphasizes the segmentation and classification of various cervical cancer cell types. An intuitive but effective segmentation technique is used to segment the nucleus and cytoplasm from histopathological cell images. Additionally, handcrafted features include different properties of the cells generated from the distinct cervical cytoplasm and nucleus area. Two feature rankings techniques are conducted to evaluate this study’s significant feature set. Feature analysis identifies the critical pathological properties of cervical cells and then divides them into 30, 40, and 50 sets of diagnostic features. Furthermore, a graph dataset is constructed using the strongest correlated features, prioritizes the relationship between the features, and a robust graph convolution network (GCN) is introduced to efficiently predict the cervical cell types. The proposed model obtains a sublime accuracy of 99.11% for the 40-feature set of the SipakMed dataset. This study outperforms the existing study, performing both segmentation and classification simultaneously, conducting an in-depth feature analysis, attaining maximum accuracy efficiently, and ensuring the interpretability of the proposed model. To validate the model’s outcome, we tested it on the Herlev dataset and highlighted its robustness by attaining an accuracy of 98.18%. The results of this proposed methodology demonstrate the dependability of this study effectively, detecting cervical cancer in its early stages and upholding the significance of the lives of women.

Knowledge, Attitudes, and Prevalence of Cervical Cancer Screening Among Women in Garissa County

Background: Globally, cancer is a leading cause of death, with cervical cancer being particularlyprevalent in sub-Saharan Africa, including Kenya. Despite being preventable, cervical cancer remains asignificant health burden due to low screening awareness and socioeconomic disparities. In Kenya, it isthe second most frequent cancer among women. This is exacerbated by high HPV infection rates,underscoring the critical need for effective screening strategies. This study assessed the knowledge,attitudes, and prevalence of cervical cancer screening among women in Garissa County.Methods: A descriptive cross-sectional study involving 480 women was conducted in Savannah RoyalHospital, Garissa from January 31st to February 4th, 2023. The study employed questionnaires toassess the knowledge and attitudes of women toward cervical cancer screening, alongside visualinspection with acetic acid (VIA) to determine the prevalence of cervical cancer. Participants wereselected through convenience sampling after a public awareness drive, and informed consent wasobtained from all participants.Results: Of 480 women screened, 96% (462) and 4% (18) tested negative and positive for cervicalcancer, respectively. Notably, 66% (315) were unaware of cervical cancer screening prior to the study,with 82.1% citing lack of awareness as the reason for not being previously screened. Regardingattitudes, 65.1% reported no discomfort during screening, 71.9% rated the experience positively, and50% felt no embarrassment in seeking a repeat VIA or Papanicolaou smear. Most women (72%)preferred receiving the results in person, and 97% were willing to undergo follow-up tests if the screeningresults were positive.Conclusion: The study highlights a significant lack of awareness of cervical cancer screening amongwomen in Garissa County, yet reveals positive attitudes toward screening. This suggests that enhancingawareness could lead to higher screening participation. The 4% positivity rate emphasizes the necessityof ongoing screening initiatives.

Interstitial cystitis – a diagnostic dilemma: A case report

Background: Interstitial cystitis is a debilitating condition with a rising prevalence due to increasedresearch and diagnostic criteria. Interstitial cystitis falls under the category of urologic chronic pelvic painsyndrome and is a diagnosis of exclusion. Interstitial cystitis or bladder pain syndrome (BPS) ischaracterized by chronic inflammation. Common symptoms include chronic pelvic pain, pressure, ordiscomfort perceived to be related to the urinary bladder accompanied by other urinary symptoms, suchas persistent urge to void or urinary frequency in the absence of confusable diseases (hypersensitivebladder symptoms). The true burden of interstitial cystitis is underestimated, and the economic burden ofthe disease is due to multiple office visits and an increase in direct medical costs.Case presentation: A 59-year-old para 2+0 (2 previous scars) postmenopausal with a 1-year history offrequency (up to eight episodes) nocturia with low abdominal pain. Her urinalysis profile, urea,electrolytes and creatinine, and ultrasound and computed tomography of the kidneys, ureters andbladder, pap smear, and random blood sugar tests were unremarkable. Cystoscopy was hemorrhagicwith biopsy histology showing ulcerated bladder mucosa with numerous plasma cells, eosinophils, andneutrophils in the lamina propria no atypia, with fibrosis and dilated capillaries in the lamina propria. Onfollow-up she had a recurrence of pain symptoms with a cystoscopy biopsy, seven months later showingplasma cell infiltrate with ulceration of the overlying urothelium, and congestion of the blood vessels. Shewas not neoplastic and was put on antihistamine, nonsteroidal antiinflammatory drugs, and solifen.Conclusion: Prompt diagnosis and treatment of interstitial cystitis will reduce the burden of diseaseassociated with multiple outpatient visits and unnecessary use of antibiotics. The mainstay ofmanagement is oral and intravesical treatment with surgery in refractory cases.

Should Liquid-Based Cytology (LBC) be Preferred than Conventional Pap Smear (CPS): A Comparative Analysis.

To study the cytomorphological differences of both techniques and to study the relative advantages and limitations of both techniques. A total of five hundred cases were collected. The conventional Pap smears (CPS) were prepared with cytobrush, and the same brush head was suspended in LBC vial and processed by SurePath. Of the 500 cases studied, the age ranged from 21 to 80years with a mean of 40.02. The number of satisfactory smears in CPS and LBC was 490 and 496 cases, respectively. In conventional method, 417 cases (83.4%) and LBC 430 cases (86.0%) were inflammatory smears. The number of LSIL was 18 in conventional method and 15 in LBC. HSIL was 11 in CPS and 10 in LBC, and 8 squamous cell carcinoma cases were seen in LBC. Histopathological correlation was observed in 19 cases of which LBC showed sensitivity and specificity of 100%. LBC may be considered better than conventional Pap smear due to better adequacy, clarity of background, detection of infections and increased sensitivity and specificity in detecting LSIL and HSIL.

Deep Neural Network for the Detection and Classification of Spontaneous Abortion Associated with Cervical Cancer

Cervical cancer is the most prevalent cancer and serious condition that currently poses a threat to the health of women. Automated cervical cancer diagnosis and classification from pap smear images has become essential due to the precision, dependency, and timely analysis of the cancer progression. The chance of occurrence of Spontaneous Abortion (SA) associated with cervical carcinoma can be identified from the pap smear image analysis. Advancements in Deep Neural Network (DNN) paved path to the efficient analysis of pap smear images for the detection of SA. The DNN must be optimized to obtain better accuracy in multiclass Herlev dataset pap smear image classification problem. The class carcinoma-in-situ is associated with SA and this class need to be identified without any error. For quantitative analysis of cell images, accurate localization of cell nuclei as well as the extraction of textural features are accomplished. Classification and decision-making are carried out as part of high-level processing to categorise the cancer phases into six classes. The domain aspects of cervical cancer are used to explore and present appropriate methods and techniques. This work focuses on the development of optimized DNN that can differentiate cancer classes in an efficient way. For Herlev images the proposed system provided multiclass average accuracy of 96.49%. Proposed EL-CNN architecture provided better outcomes than state-of-the-art systems.

Hsa-miR-194-5p and hsa-miR-195-5p are down-regulated expressed in high dysplasia HPV-positive Pap smear samples compared to normal cytology HPV-positive Pap smear samples

BackgroundThe human papillomavirus (HPV) infection may affect the miRNA expression pattern during cervical cancer (CC) development. To demonstrate the association between high-risk HPVs and the development of cervix dysplasia, we examined the expression patterns of hsa-miR-194-5p and hsa-miR-195-5p in Pap smear samples from southeast Iranian women. We compared samples that were HPV-positive but showed no abnormality in the cytological examination to samples that were HPV-positive and had severe dysplasia.MethodsPap smear samples were obtained from 60 HPV-positive (HPV-16/18) patients with histologically confirmed severe dysplasia (cervical intra-epithelial neoplasia (CIN 3) or carcinoma in situ) and the normal cytology group. The expression of hsa-miR-194-5p and hsa-miR-195-5p was analyzed by real-time quantitative PCR, using specific stem-loop primers and U6 snRNA as the internal reference gene. Clinicopathological features were associated with miRNA expression levels. Furthermore, functional enrichment analysis was conducted using in silico tools. The Kaplan–Meier survival method was also obtained to discriminate survival-significant candidate miRNAs in CC, and receiver operating characteristic (ROC) curves were constructed to assess the diagnostic value.ResultsCompared to HPV-positive cytologically normal Pap smear samples, hsa-miR-194-5p and hsa-miR-195-5p relative expression decreased significantly in HPV-positive patients with a severe dysplasia Pap smear. Kaplan–Meier analysis indicated a significant association between the miR-194 decrease and poor CC survival. In essence, ROC curve analysis showed that miR-194-5p and miR-195-5p could serve as valuable markers for the development of cervix dysplasia in individuals who are positive for high-risk HPVs.ConclusionsThis study revealed that hsa-miR-194-5p and hsa-miR-195-5p may possess tumor suppressor capabilities in the context of cervical dysplasia progression. However, it remains uncertain whether these microRNAs are implicated in the transition of patients with high dysplasia to cervical cancer. We also showed the potential capability of candidate miRNAs as novel diagnostic biomarkers related to cervical dysplasia progression.

Experience of Establishment of a Community PAP Smear Lab at Rural Community Health Center in North India

Experience of Establishment of a Community PAP Smear Lab at Rural Community Health Center in North India

Deep Learning-based Ensemble Approach for Conventional Pap Smear Image Classification

Cervical cancer screening allows the early signs of precancerous abnormalities in the cervix before they develop into invasive cancer. The Pap Smear is a widely used screening for early detection and prevention of cervical cancer. In many remote areas, the number of cytologists available to interpret pap smear screening tests is insufficient. This lack of personnel makes the test interpretation very time-consuming. To address this, deep learning techniques have been employed to detect cervical cancer cells and support cytologists. Therefore, an integrative approach with deep learning models and the ensemble techniques such as the maximum occurrence and the maximum probability score of cervical cells was proposed. The multi-cell assessment of the Pap smear slide allowed aggregate predictions of single cervical cell images using the proposed method. The classification results between pre-trained deep learning models and the proposed method were compared. In the experimental results, the proposed method can achieve an accuracy score of more than 97%, while the best pre-trained deep learning model can attain an accuracy score of more than 85%. Hence, the proposed method may have the potential to assist physicians or cytologists in the classification of cervical cell types for Pap Smear images.

An audit of 1632 routinely collected cervical cancer screening smears from 398 women in Germany: Results from the TeQaZ Study

ObjectiveThere is evidence in Germany that half of the cervical cancer (CC) cases had undergone screening frequently in the decade preceding their diagnosis, signaling cytology quality issues. This study investigates routine smear assessment accuracy in Germany. MethodsWithin a population-based case-control study in 9 German states, we recruited cases (women with a histologically confirmed diagnosis of CC) and population controls (women with no history of CC or hysterectomy). Two independent expert cytologists audited Pap smears taken within the 10 years preceding CC diagnosis (cases)/study entry (controls). We report the prevalence of positive results, as well as routine assessment’s accuracy, as sensitivity, specificity, false-positive and false-negative rates along with 95% confidence intervals (95% CI). We also examined cases’ smear history, to investigate possible false-positive recurrence. ResultsWe audited 1632 smears of 392 women (18.9% cases, 81.1% controls). In the routine assessment, the overall prevalence of positive results was 4.5% (29.0% among cases). According to the expert audit, the overall prevalence of positive results was 7.7% (40.8% among cases). When restricting analyses to the 3 years preceding diagnosis/study entry, this prevalence increased to 11.9% overall (61.4% among cases). The overall sensitivity of the routine assessment was 54.9% (66.8% for cases). ConclusionAs cytology remains an important part of CC screening, quality issues must be urgently addressed in Germany. Shifting to objective methods such as primary high-risk HPV screening followed by triaging may help CC elimination in Germany.

Pemberdayaan Wanita Usia Subur Dalam Deteksi Dini Kanker Cerviks Melalui Pemeriksaan IVA

Cervical cancer is a disease that can be detected early in various ways, one of which is screening. Based on its effectiveness, detection that can be done is by means of pap smears and IVA tests. The IVA test is an initial action to detect changes in abnormal cervical cells and can be carried out in all types of health services, including community health centers. Here partners are not yet motivated to carry out screening. So it is necessary to provide education about early detection screening for cervical cancer.

A Narrative Review of Cervical Cancer Screening Utilization Among Haitian Immigrant Women in the U.S.: Health Beliefs, Perceptions, and Societal Barriers and Facilitators.

Haitian immigrant women living in the U.S. have a higher rate of cervical cancer mortality than any other ethnic group, primarily due to lower rates of screening test utilization. Therefore, it is important to understand the issues affecting their pap smear screening behaviors. We conducted a narrative review of articles from PubMed, SCOPUS, Embase, CINAHL/Nursing, and Psych Info. Inclusion criteria: U.S. Haitian immigrant, screening, cervical cancer, health beliefs/perceptions. Exclusion criteria: HPV-vaccine. Primary barriers: (1) lack of knowledge of cervical cancer, HPV, and pap smears; (2) lack of culturally appropriate dissemination of information; and (3) difficulty obtaining the test. Primary facilitators: (1) provider recommendations, (2) Haitian media to disseminate health information, and (3) having health insurance. This review highlights the points for intervention by health professionals and policy makers to address this group's low pap smear utilization.

PRIMARY PREVENTION OF CERVICAL CANCER WITH VIDEO MEDIA FOR POSYANDU CADRES

Cervical cancer is one of the malignancies of the female reproductive organs with a long pathophysiology. Early detection with Visual Acetate Inspection (VIA) and Pap Smear can prevent poor prognosis. However, the evaluation of the coverage of the achievement of the program is still low. The study aimed to analyze the effectiveness of primary prevention education on cervical cancer using video media to increase the knowledge of posyandu cadres. Type of experimental research categorical paired. The sample was 56 posyandu cadres who were selected by purposive sampling. Knowledge data collection was done with pretest and posttest questionnaires. Data analysis was performed with Wilcoxon (ρ=0.005). The results showed an increase in the median value of knowledge pretest 65.00 to the posttest median of 85.00. Video media effectively increases the knowledge of posyandu cadres about the early detection of cervical cancer (ρ=0.000). Health education with video media proved effective in increasing the knowledge of posyandu cadres about the primary prevention of cervical cancer. It is hoped that this study can contribute to improving the ability of human resources in promotive efforts through interactive media-based health promotion.

Lactobacillus spp in vaginal and cervical smears in patients with endometrial cancer

Lactobacillus spp in vaginal and cervical smears in patients with endometrial cancer

Comparative analysis of different cervical screening methods with special reference to the WHO recommended human papillomavirus detection at a rural tertiary care center - A pilot study

Background: Cervical cancer (Ca Cx) the 4th common cancer has a high mortality rate. Human Papilloma Virus (HPV) is chiefly responsible for a long latent period to progress from preinvasive to invasive Ca Cx. So it can be prevented by screening procedures such as visual inspection with acetic acid (VIA), conventional cervical PAP smear (CP), liquid-based cytology (LBC), and high-risk (HPV-hr) detection along with vaccination. Aims and Objectives: The study aims to determine the socio-demographic profile of Ca Cx and the most appropriate cost-effective community screening method. Materials and Methods: A prospective observational study with 80 symptomatic women of reproductive and peri/postmenopausal age groups attending the Gynecology Department who underwent VIA, CP, and LBC and thereby detected positive along with screened negative but clinically suspicious women were tested for HPV-hr detection. Results were tabulated into an Excel sheet and screening methods were compared using Chi-square test, gold standard being cervical histopathology (P<0.5 significant). Statistical software used - Graphpad Prism 9 (San Diego, CA). Results: The mean age was 43.3 years. Multiparity and early marriage were seen in 80% and 45% respectively. Inflammatory lesions were best diagnosed by CP but epithelial cell abnormality and more satisfactory smears by LBC (P<0.05). Sensitivity was highest (93.75%) in VIA, positive predictive value, and specificity in CP (91.66%, 75%). negative predictive value was highest in VIA and HPV-hr DNA (50%). Conclusion: VIA with CP/LBC is an economically viable and effective screening method for Ca Cx in developing countries along with HPV vaccination.

Knowledge, attitudes, and practices about HPV and the Pap Smear screening method

· Recibido: 10 de agosto de 2023 · Arbitrado: 30 de agosto de 2023 · Aceptado: 18 de octubre de 2023 · Publicado: 1 de febrero de 2024 The objective of this research was to determine knowledge, attitudes and practices about the Human Papillomavirus and the Papanicolaou screening method, in women between 15 and 49 years old who attend the Palca Health Center, in the Department of La Paz in Bolivia. . It is a descriptive epidemiological study, with a field, cross-sectional design for the collection of qualitative and quantitative data. The main results showed that 83% of the sample does not have knowledge about HPV. 95% of women have a favorable opinion about the Pap test. However, 75% do not take the correct actions to make that diagnosis. 75% do not have knowledge about the Pap test. It is concluded that the level of knowledge about the Human Papillomavirus and the Papanicolaou test in the women in the study is low. They do not know the form of transmission, the risk of contagion, and the ways to prevent it.

Knowledge, Attitude and Practice Concerning Cervical Cancer Screening Among Reproductive Age Group Women in Low-Resource Settings Yenagoa Bayelsa State.

Nigeria has one of the highest rates of cervical cancer morbidity and mortality in Sub-Saharan Africa. Both the human papillomavirus vaccine (HPV) and cervical screening are effective prevention strategies against both HPV infection and cervical cancer. Lack of awareness, limited knowledge, limited decision-making agency, lack of spousal support and stigma are barriers to uptake of these preventive measures. Cervical cancer is the second most diagnosed cancer and the third leading cause of cancer death in women worldwide. Eighty three percent (83%) of the world's new cases and 85% of all cervical cancer-related deaths occur in developing countries. It is primarily caused by human papilloma virus (HPV); a sexually transmitted pathogen that could be prevented with safe sexual practice and using vaccines, among others. The aim of the study was to assess the knowledge and attitude of reproductive age group women in low resource setting in towards cervical cancer and its prevention in Yenagoa, Bayelsa State Nigeria. This study employed the use of a descriptive study design to examine the knowledge and assessment of cervical cancer among women of reproductive age (19-54), about cervical cancer, its prevention, and their utilization of Pap smear screening; using a convenience sample of 406 women in two communities (Okaka and Agudama) in Yenagoa Local Government Area of Bayelsa State, Nigeria. Women voluntarily completed a structured questionnaire. Results showed that women who participated in the study were aware of cervical cancer (78.3%; n=318) but many (70.4%; n= 286) were unaware of Pap smears as the screening tests for cervical cancer. Although few of them (45.6%; n =185) knew about a screening center, out of which 17.6% (n= 32) reported that the screening center was less than 2km away from their residences. There is need for health care professionals, to intensify efforts to increase awareness about cervical cancer screening and encourage women through the different clinics to use these services. The benefits of screening and early diagnosis of cervical cancer should be emphasized to enhance the utilization of cervical cancer screening services.

Knowledge of Pap smear test among reproductive age group women of Kathmandu, Nepal

Cervical cancer is a malignant tumor of the lowermost part of the uterus and a major cause of morbidity and mortality among women in the world. Globally, it is the fifth leading cause of cancer-related deaths among women after cancers of the breast, lungs, stomach and colorectal in developing countries. About 80% of new incidences of cervical cancer occur in developing countries, usually, with less comprehensive cervical cancer prevention programs. The objective of the study is to assess the level of knowledge on cervical cancer and Pap smear tests among Reproductive age group women. A descriptive study was conducted in Gokarneshwor-8, Kathmandu community on 105 respondents through non-probability purposive sampling techniques and data was collected using interviewers administered questionnaires. Out of 105 respondents, a majority (64%) respondents had adequate knowledge of cervical cancer and Pap smear tests, while 36% had inadequate knowledge. This study concluded that the majority of respondents had adequate knowledge of Pap smear tests while only thirty-six percent had inadequate knowledge. Though there is adequate knowledge, only a few respondents had ever done a Pap smear test. Still, there are existing gaps that need more education to connect knowledge with attitudes as well as to uplift the regular practice of cervical cancer screening for eligible women.

Prediction Models Applying Convolutional Neural Network based Deep Learning to Cervical Cancer Outcomes

Early identification of Cervical Cancer (CC) helps in reducing the death rate of CC patients. A Pap smear/Pap test, which is also a widely used method, is used to detect CC in its early stages. The automatic detection and categorization of Pap smear images is a difficult task. So, it is important to design and implement a high-efficiency with low-cost screening system. Therefore, this paper compares the efficiency of two deep learning-based cervical cancer screening strategies. The first technique taken for comparison is the Mutation based Atom Search Optimization (MASO) optimized DenseNet 121 architecture. The MASO technique is used to adjust hyperparameters such as learning rate value, batch sizes, and the number of neurons in the dense layer in the DenseNet 121 architecture. The second technique taken is the Sooty Tern optimized CNN-based Long Short-Term Memory (ST-CNN-LSTM) classifier to identify the different types of cervical cancer stages. The areas affected by the cancer are identified using Kernel-Weighted Fuzzy Local Information C-Means clustering (KWFLICM) model. This model removes the nucleus and cytoplasm from the background area of the cell. Normal, mild dysplastic, severe dysplastic, and carcinoma are among the CC classifications offered by these two classifiers. The efficiency of these classifiers is compared in two datasets (Hervel and SIPaKMeD) via different performance metrics such as specificity, precisions, F-score, accuracy, confusion matrix, sensitivity, and recall. The ST-CNN-LSTM offers improved performance in terms of accuracy (99.80%), sensitivity (98.83%), and specificity (99%) when compared to other classifiers.

The importance of health education in relation to cytopathology testing

The uterine cervix, also known as the cervix, is the lower and narrower part of the uterus, establishing the connection between the vaginal canal and the internal organs of the female reproductive system. This type of cancer is mostly associated with persistent infection by the Human Papillomavirus (HPV) and is the third most common type of cancer among women. The role of the nursing professional is crucial in the process of detecting and diagnosing cervical neoplasia. Nursing actions include advising the population on the importance of regular preventive examinations. The aim of this study is to analyze the importance of health education in the context of the cytopathological examination, exploring the relationship between health education and the performance of this examination. Methodologically, this is an integrative literature review, using the following databases: PUBMED, SCIELO and BVS, using the following descriptors: "cytopathological examination", and "pap smear", "health education", and "patient adherence". A total of 120 articles were found and 11 were selected for analysis based on the inclusion and exclusion criteria. It was concluded that raising awareness about testing is essential and should be done with humanized care and proximity to the woman. Health education is a tool that should be used by the entire multi-professional team. Its benefits include the dissemination of quality information to more people, increased demand for health services, counseling, thus reducing the incidence of cervical cancer, early diagnosis and effective treatment of these patients.

Mediating Effect of White Blood Cells and Tobacco Exposure on Cervical Neoplasm Risk Among Taiwanese Women.

Background: Both the high-risk human papillomavirus (HR-HPV) infection and tobacco exposure are significantly associated with cervical neoplasm risk. Immune cells play important roles in carcinogenesis. However, it is still unclear whether immune cells have a mediating effect on the HR-HPV infection and tobacco exposure with cervical neoplasm development. Aim: The aim of this study was to determine how the increased white blood cell (WBC) count affects the relationship between HR-HPV DNA load and tobacco exposure in the development of cervical neoplasia. Methods: A hospital-based case-control study design was conducted with a total of 108 cases of Taiwanese women with ≥ cervical intraepithelial neoplasia (CIN) I confirmed by biopsy, and 222 healthy Taiwanese female subjects with negative findings on a Pap smear were assigned to the control group. The study evaluated HR-HPV status and immune cell counts (WBCs, natural killer (NK) cells) and tobacco exposure by a self-construct questionnaire. Results: Both HR-HPV DNA load and tobacco exposure significantly independently increased cervical neoplasm risk (AORs: 1.28 and 1.42, respectively). Similar significant results were found for WBCs and NK cells, with respective AORs of 1.20 and 1.00. Moreover, increased WBCs (β = 0.04, 95% CI corrected: 0.01-0.07) and tobacco exposure (β = 0.02, 95% CI corrected: 0.01-0.04) mediated the relationship between the high-risk HPV DNA load and cervical neoplasm risk. Conclusions: Elevated WBC count acts as both predictor and mediator in cervical neoplasm development linked to HR-HPV DNA load. Monitoring and maintaining WBC levels within the normal range could be a preventive strategy for cervical neoplasm development.