Cervical Cancer Screening Methods Research Articles

Knowledge and Interests of Women of Childbearing Age (PUS) about Acetic Acid Visual Inspection (IVA)

Reproductive health is a complete physical, mental and social condition, not only free from disease or disability in all aspects related to the reproductive system, its functions and processes. Cervical cancer is a primary malignant tumor originating from squamous epithelial cells, cancer that occurs in the cervix or cervix which is located between the uterus and the vaginal opening. Overcoming this problem requires efforts to solve the problem with other screening methods that are more capable, cost-effective and possible to be carried out in Indonesia. One of the alternative methods of cervical cancer screening that can answer these requirements is IVA (Visual Inspection with Acetic Acid Overlay). Women of Childbearing Age (PUS) about Acetic Acid Visual Inspection (IVA) In RW 05, Campurejo Village, Mojo Subdistrict, Kediri The research design used in this research is correlation research. The approach in this study uses a Cross Sectional approach. This research was conducted to find a relationship between the knowledge of Women of Childbearing Age (PUS) about Acetic Acid Visual Inspection (IVA) with an interest in Acetic Acid Visual Inspection (IVA).Results: Based on the results of the Spearman Rank test, P value = 0.007 <0.05 from a significant level of 5%, then H0 is rejected and H1 is accepted, meaning that there is a relationship between women's knowledge of IVA about IVA with interest in doing IVA in RW 05 Kelurahan Campurejo District City of Kediri. From results can be concluded that H1 is accepted, meaning that there is a relationship between knowledge of women of childbearing age (IVA) about Visual Inspection of Acetic Acid (IVA) with an interest in conducting Visual Inspection of Acetic Acid (IVA).

Performance of screening tools for cervical neoplasia among women in low- and middle-income countries: A systematic review and meta-analysis.

To evaluate the performance of visual inspection with acetic acid (VIA) testing, visual inspection with Lugol's iodine (VILI), primary HPV testing, and conventional Pap smear in detecting CIN2+ among non-pregnant women aged 30-65 in LMICs between 1990 and 2020. Systematic review and meta-analysis. Low- and middle-income countries, non-pregnant women aged 30-65. CENTRAL (Cochrane Library), CINAHL, Embase, Global Health, PubMed, and Web of Science databases were systematically searched to identify studies evaluating the performance of cervical cancer screening methods in LMICs. A diagnostic test accuracy meta-analysis was conducted to evaluate the performance of 4 screening methods in detecting CIN2+ relative to biopsy or cytology reference standards. Pooled statistics for sensitivity, specificity, diagnostic odds ratios, and summary receiver operating characteristic curves were determined for each method. Subgroup analyses were performed to examine whether there was variation in performance based on different reference standards for defining CIN2+, specifically: colposcopy-directed biopsy, biopsy alone, colposcopy alone, or liquid-based cytology. Eighteen studies were identified through systematic review. Twelve studies were included in meta-analysis; 11 were cross-sectional and 1 was a randomized controlled clinical trial. The remaining six of the eighteen studies were inclided in a narrative syntehsis. Pooled estimates for sensitivity for VIA, VILI, primary HPV testing, and conventional Pap smear were 72.3%, 64.5%, 79.5%, and 60.2%, respectively; pooled estimates for specificity were 74.5%, 68.5%, 72.6%, and 97.4%, respectively; the diagnostic odds ratios were 7.31, 3.73, 10.42, 69.48, respectively; and the area under the summary receiver operating characteristic curves were 0.766, 0.647, 0.959, and 0.818, respectively. Performance of the screening method varied based on the reference standard used; pooled estimates using either colposcopy-directed biopsy or biopsy alone as the reference standard generally reported lower estimates; pooled estimates using either colposcopy alone or liquid-based cytology as references reported higher estimates. This meta-analysis found primary HPV testing to be the highest performing cervical cancer screening method in accurately identifying or excluding CIN2+. Further evaluation of performance at different CIN thresholds is warranted.

Genotype heterogeneity of high-risk human papillomavirus infection in Ethiopia.

Cervical cancer is a vaccine-preventable sexually transmitted disease. In the year 2020, there were an estimated 604,000 new cases and 342,000 deaths worldwide. Although its incidence is global, it is much higher in sub-Saharan African countries. In Ethiopia, there is a scarcity of data about the prevalence of high-risk HPV infection and its association with cytological profiles. Therefore, this study was conducted to fill this information gap. A hospital-based cross-sectional study was conducted from April 26 to August 28, 2021, and enrolled 901 sexually active women. Socio-demographic and other relevant bio-behavioral and clinical data were collected using a standardized questionnaire. Visual inspection with acetic acid [VIA] was done as an initial screening method for cervical cancer. The cervical swab was then collected using L-Shaped FLOQSwabs in eNAT nucleic acid preservation and transportation medium. A Pap test was done to determine the cytological profile. Nucleic acid was extracted using STARMag 96 ProPrep Kit on SEEPREP32. A Real-time multiplex assay was performed to amplify and detect the HPV L1 gene used for genotyping. The data were entered into Epi data version 3.1 software and exported to STATA version 14 for analysis. A total of 901 (age range from 30 to 60 years, mean age = 34.8 years, and SD± 5.8) women were screened for cervical cancer using VIA and 832 women had a valid co-testing (Pap test and HPV DNA testing) results for further process. The overall prevalence of hr HPV infection was 13.1%. Out of 832 women, 88% of them had normal and 12% had abnormal Pap test results. The proportion of high risk HPV was significantly higher among women with abnormal cytology (X 2 = 688.446, p < 0.001) and younger age (X 2 = 15.3408, p = 0.018). Among 110 women with hr HPV, 14 genotypes (HPV-16, -18, -31, -33, -35, -39, -45, -51, -52, -56, -58, -59, -66, and -68) were identified while HPV-16, -31, -52, -58, and -35 genotypes were highly prevalent. The high risk HPV infection continues to be a significant public health problem among women 30-35 years old. The presence of high-risk HPV irrespective of genotypes is highly correlated with cervical cell abnormalities. Genotype heterogeneity is observed suggesting the importance of periodic geospatial genotyping surveillance for vaccine effectiveness.

A cross sectional study on awareness about cancer screening methods for breast and cervical cancer in women of reproductive age from Jhansi, Uttar Pradesh

Background: Non-communicable diseases (NCDs) are responsible for 63% of all deaths in India of which 9% are due to cancers according to the World Health Organization (WHO) global profile 2018. One in eight men and one in eleven women die from the disease globally (Globocan 2020). To reduce the morbidity and mortality due to the disease early diagnosis of disease and risk factors by regular screening of asymptomatic people is recommended. Objectives of the study were: to assess the awareness about methods for breast and cervical cancer screening among women of reproductive age, and to assess their readiness to go for screening. Methods: In a health awareness session on cancer screening among women of reproductive age the participants (104 women) were given a self-designed questionnaire which was administered before the session. The questionnaire covered general awareness about cancer, the symptoms and the methods of screening for breast and cervical cancer. The results were expressed in frequency and percentages. Results: The mean age of participants was 29.8 years (range 21 years-45 years). 88% felt that early diagnosis would improve outcome. Only 11% had heard of Pap test and only 3 had gotten it done. Around 21% had heard about mammography and only 4% had heard about breast self-examination. 86% and 90% were ready to get themselves screened for cervical cancer and breast cancer respectively, if given the opportunity. Conclusions: This study highlights both the lack of knowledge and the high acceptance of cancer screening among women. Awareness campaigns at regular intervals backed by immediate access to screening facilities are required to address the problem.

Using focus groups to plan culturally acceptable primary cervical cancer screening in Grenada, West Indies.

To document Grenadian women's knowledge about cervical cancer and human papillomavirus (HPV) infection, as well as their attitudes towards primary cervical cancer screening methods. In this qualitative study, we used focus groups in Grenada to gather information concerning women's knowledge about, attitudes towards and perceptions of screening for cervical cancer and general knowledge about HPV. Ten focus groups comprising 73 participants representing 5 of the 6 parishes in Grenada were conducted with women aged 19-59. Participants were asked about pelvic exams, Pap smears, HPV, reasons for seeking or avoiding cervical cancer screening and how different modalities of testing might affect their decision-making. Responses were then coded and organized into common themes. While many respondents had heard of HPV, far fewer knew about its causative role in cervical cancer, how to prevent HPV infection or testing for the high-risk HPV types that cause almost all cases of cervical cancer. Many participants were aware that cervical cancer screening was beneficial, but numerous barriers to obtaining that screening were noted, including concerns about privacy and stigma, potential discomfort, and the cost and inconvenience involved. Our findings have implications for future cervical cancer screening efforts in Grenada. Central to these efforts should be a focus on educating Grenadians about the role of HPV infection in cervical cancer and the importance of early detection through screening. In addition, addressing issues of stigma and privacy are key to eliminating cervical cancer in Grenada.

Cervical Cancer Diagnostics Using Machine Learning Algorithms and Class Balancing Techniques

Objectives: Cervical cancer is present in most cases of squamous cell carcinoma. In most cases, it is the result of an infection with human papillomavirus or adenocarcinoma. This type of cancer is the third most common cancer of the female reproductive organs. The risk groups for cervical cancer are mostly younger women who frequently change partners, have early sexual intercourse, are infected with human papillomavirus (HPV), and who are nicotine addicts. In most cases, the cancer is asymptomatic until it has progressed to the later stages. Cervical cancer screening rates are low, especially in developing countries and in some minority groups. Due to these facts, the introduction of a tentative cervical cancer screening based on a questionnaire can enable more diagnoses of cervical cancer in the initial stages of the disease. Methods: In this research, publicly available cervical cancer data collected on 859 female patients are used. Each sample consists of 36 input attributes and four different outputs Hinselmann, Schiller, cytology, and biopsy. Due to the significant unbalance of the data set, class balancing techniques were used, and these are the Synthetic Minority Oversampling Technique, the ADAptive SYNthetic algorithm (ADASYN), SMOTEEN, random oversampling, and SMOTETOMEK. To obtain the mentioned target outputs, multiple artificial intelligence (AI) and machine learning (ML) methods are proposed. In this research, multiple classification algorithms such as logistic regression, multilayer perceptron (MLP), support vector machine (SVM), K-nearest neighbors (KNN), and several naive Bayes methods were used. Results: From the achieved results, it can be seen that the highest performances were achieved if MLP and KNN are used in combination with Random oversampling, SMOTEEN, and SMOTETOMEK. Such an approach has resulted in mean area under the receiver operating characteristic curve (AUC¯) and mean Matthew’s correlation coefficient (MCC¯) scores of higher than 0.95, regardless of which diagnostic method was used for output vector construction. Conclusions: According to the presented results, it can be concluded that there is a possibility for the utilization of artificial intelligence (AI) and machine learning (ML) techniques for the development of a tentative cervical cancer screening method, which is based on a questionnaire and an AI-based algorithm. Furthermore, it can be concluded that by using class balancing techniques, a certain performance boost can be achieved.

Digital cervicography for cervical cancer screening in low-resource settings: A scoping review

IntroductionDigital cervicography (DC) is a method of capturing images for analysis during visual inspection with acetic acid (VIA) for cervical cancer screening. Cervical cancer is the 3rd leading cause of female cancer in the world with approximately 90 % of deaths due to cervical cancer occurring in low and middle income countries (LMICs). The need for cost-effective and sustainable methods for screening is vital in these settings. This scoping review systematically synthesizes published data illustrating the use of DC in screening programs. We aim to understand how digital cervicography is used, implemented, and impacted on programs. MethodsSearch of eight online databases identified 53 studies published between 1993 and 2021. Inclusion of articles were English language, cervical cancer screening program located in an LMIC, and DC as an intervention. ResultsAll studies were cross-sectional studies (n = 53), with variation in terminology, uses, and device methods. Devices were grouped as either smartphones (n = 14), commercially available digital cameras (n = 17), or other (EVA®, n = 4; Cerviscope, n = 12; custom device, n = 4; or not specified, n = 2). Nineteen studies found acceptability and feasibility for DC in their screening programs. Various programs using DC found benefits such as task sharing, healthcare worker training, patient education and using images for review from a remote specialist or mentor. ConclusionThe use of DC in LMICs is beneficial for support of healthcare workers, enhances quality improvement and demonstrates overall acceptability in screening programs. Advancing technologies for human papillomavirus (HPV) testing and cytology are common methods for cervical cancer screening, although are limited in LMICs. This scoping review demonstrates the different methods, uses, and benefit of digital cervicography in cervical cancer screening programs.

"I am not a Good Woman?" Exploring the Views and Challenges of Nurses When Discussing HPV Testing and Associated Cervical Screening with Women in Iraq.

Cervical cancer is mostly caused by high-risk Human papillomavirus HPV, with an estimation prevalence of HPV of 99.7% worldwide. The US Food and Drug Administration (FDA) approved an HPV test for primary cervical screening in 2014. An HPV-DNA test, which provides higher protection against invasive cervical carcinomas, is replacing the long-standing Pap smear as the primary method of cervical cancer screening. To explore nurses' experience and knowledge of HPV DNA testing and how screening impacts on women's health through increasing awareness and proposing actions for health education strategies. A qualitative exploratory study was conducted on a purposeful sample of 25 qualified nurses, who were all employed in regional hospitals within a gynecological department in Kirkuk, Iraq. The nurses were interviewed with a semi-structured topic guide between November 2021 and February 2022. Responses were transcribed verbatim, translated into English and analysed using a content thematic analysis approach. Four themes with associated sub-themes emerged following coding and peer review. Participants had lack of experience and fragmented knowledge of HPV DNA testing/screening. Culturally sensitive resources for patients and training for nurses was identified key requirements. Currently, there are no facilities for a HPV testing/screening services available in Iraq. The role of nurses undertaking HPV screening is not established and yet nurses represent the largest sector of health professionals. The dissemination of a collaborative HPV screening training programme to include clinical competence and knowledge for nurses and gynaecologists may improve knowledge, and could also be effective in improving patient awareness and engagement with cervical health.

A Critical Analysis of Machine Learning and Deep Learning Methods for Cervical Cancer Screening

A Critical Analysis of Machine Learning and Deep Learning Methods for Cervical Cancer Screening

CONVENTIONAL CYTOLOGY VERSUS LIQUID BASED CYTOLOGY FOR EVALUATION OF CERVICAL SMEARS – A STUDY OF 300 CASES

BACKGROUND: Over the years, different studies conducted have established the advantages of liquid based cytology(LBC) over conventional preparations(CP) in cervical smears screening. However, the high cost of machinery required for the preparations still limits its usage in low-resource countries. This study aims to evaluate the performance of a low cost LBC method, EziPREP™ technique against conventional preparations for cervical screening. MATERIALS &amp; METHOD: This was a cross sectional study comprising of 300 consequtive cervical samples over a period of 2 year. CP smears were prepared as per the standard technique using ayre’s spatula while for LBC sample was obtained on endocervical brush followed by detaching the head of brush into the fixative vials of LBC. The LBC samples were processed as per the manufacturer's protocol. Both CP and LBC smears were stained using standard Papanicolaou stain &amp; H &amp; E stain protocol. Slides were analysed by two pathologists independently. RESULTS: The unsatisfactory rate for CP was 5%, main cause being obscuring haemorrhage and inflammation, whereas on LBC samples it was 1.4%, owing to inadequate cellular material. Uniform distribution was more in LBC smears, with minimal overlapping. The morphological details were comparable in both sets of smears. The pathogenic organisms, like Gardenella(31%) &amp; Candida(20%) were detected in more CP smears, Trichomonas was seen equally in both smears(3%). There was a 98% concordance in cytologic diagnosis between CP and LBC smears. Screening time was notably reduced in LBC smears (3±1minutes vs 5±1 minutes for CP) CONCLUSION: This low-cost LBC method holds promise in providing monolayered cervical smears with a clear background. It might carve the way for inclusion of liquid based cytology methods for cervical cancer screening on a larger scale in the low resourse countries.

Abstract A113: Insight into cervical cancer prevention awareness, experiences, and attitudes among Southern Vietnamese women

Abstract Background At least 80% of new cervical cancer cases and deaths occur in low- and middle-income countries. Vietnam is a middle-income country where cervical cancer is the second most common and the deadliest gynecologic cancer. Cervical cancer incidence in Southern Vietnam has been shown to be 1.5-4 times higher than that in Northern Vietnam. However, less than 10% of Southern Vietnamese women have received the Human papillomavirus (HPV) vaccine and only 50% have ever been screened for cervical cancer. No study has examined the perceptions toward cervical cancer prevention and screening in Southern Vietnamese women. Hence, this study aimed to explore cervical cancer awareness, barriers to screening, and acceptability of HPV self-sampling for cervical cancer screening among rural and urban women in Southern Vietnam. Methods In October-November 2021, three focus groups were conducted in the rural district of Can Gio (n=21 participants) and three were conducted in the urban District Four (n=23 participants) in Ho Chi Minh City, Southern Vietnam. All participants were cervical cancer-free women aged 30-65 years. Awareness of, attitudes toward, and experience with cervical cancer prevention and screening were explored using audio-recorded, semi-structured discussions in Vietnamese. During the focus groups, participants also watched four short videos with Vietnamese subtitles and voiceover about cervical cancer screening methods and discussed their views on each. The recordings were transcribed, translated into English, and coded and analyzed using Dedoose 9.0.46. Results Four main themes emerged. First, women showed low awareness, but high acceptance of cervical cancer screening and HPV vaccination. Second, screening barriers were related to logistics (e.g., cost, time, travel distance), psychology (e.g., fear of pain, embarrassment, fear of the test revealing they had cancer), and healthcare providers (e.g., doctors’ impolite manners, male doctors). Third, women were concerned about self-sampling incorrectly and pain, but believed HPV self-sampling to be a feasible screening tool in some circumstances (e.g., during the COVID-19 pandemic, those living in remote areas). Fourth, women related cervical cancer prevention to COVID-19 prevention; they believed strategies that have been successful for COVID-19 control in Vietnam could be applied to cervical cancer. No differences in themes emerged by rural/urban areas. Conclusions Southern Vietnamese women showed low awareness but high acceptance of cervical cancer screening despite barriers. Strategies for successful COVID-19 control in Vietnam, including campaigns to increase public awareness, advocacy from the government and doctors, and efforts to increase access to screening and vaccination, should be applied to cervical cancer control. Health education programs to address HPV self-sampling concerns and promote it as a cervical cancer screening tool are warranted given its potential to improve screening uptake in this low-resource setting. Citation Format: Minh Tung Phung, Pham Le An, Lilah Khoja, Pham Duong Uyen Binh, Hong H.T.C. Le, Karen McLean, Bhramar Mukherjee, Rafael Meza, Alice W. Lee, Celeste Leigh Pearce. Insight into cervical cancer prevention awareness, experiences, and attitudes among Southern Vietnamese women [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A113.

Knowledge, Attitude and Practices on Breast and Cervical Cancer Screening Methods Among Female Employees at the Gujarat Cancer and Research Institute, Ahmedabad: Analytical Research: Cross-Sectional Study

Knowledge, Attitude and Practices on Breast and Cervical Cancer Screening Methods Among Female Employees at the Gujarat Cancer and Research Institute, Ahmedabad: Analytical Research: Cross-Sectional Study

Human papillomavirus testing using existing nucleic acid testing platforms to screen women for cervical cancer: implementation studies from five sub-Saharan African countries

ObjectivesTo demonstrate acceptability and operational feasibility of introducing human papillomavirus (HPV) testing as a principal cervical cancer screening method in public health programmes in sub-Saharan Africa.Setting45 primary and secondary health...

Abstract P026: Exploring factors associated with preferences for human papillomavirus (HPV) self-sampling among racially-and ethnically-diverse women: a cross-sectional study

Abstract Background: Cervical cancer rates have declined since the implementation of cervical cancer screening methods such as Pap tests. However, Pap tests are still underutilized by many minority women due to limited awareness about human papillomavirus (HPV) and cervical cancer, difficulties accessing health care services, and cultural or religious beliefs. HPV self-sampling has been proposed as an alternative to overcome some of these barriers. This study aimed to assess awareness, self-efficacy, and preferences of HPV self-sampling among racially- and ethnically-diverse women. Methods: From May – November 2021, women, ages 30-65 years old, were recruited in person and virtually to complete an online survey. The survey included 15 sociodemographic questions and five outcome measures related to HPV self-sampling: (1) awareness of test; (2) self-efficacy to conduct test; (3) location preference of test (clinic vs. home); 4) collector preference for screening strategy (self-collected vs. clinician-collected); and 5) preference of cervical cancer screening strategy (HPV self-sampling vs. Pap test). Modified Poisson regression was conducted to assess exploratory associations between sociodemographic variables and each outcome measure; relative risks were adjusted for age. Results: A total of 420 women completed the online survey, of which 32.4% identified as non-Hispanic white, 22.2% as Hispanic, 12.6% as Black/African American, 28.3% as Asian, 1.9% as American Indian/Alaskan Native, and 1.4% as more than two races. The majority of women had not heard of HPV self-sampling (93.5%) but reported high self-efficacy (75.3%). Women also reported higher preferences for completing an HPV test in the clinic (52.2%) and for performing a self-collected HPV test themselves (58.7%) yet would choose a traditional Pap test over HPV self-sampling (56.0%). Conclusion: The low level of HPV self-sampling awareness, across all racial and ethnic groups, suggests a strong opportunity to promote widespread educational efforts around this new tool. While many women, including those that are racially- and ethnically-diverse, still prefer the Pap test, the biggest barrier to their potential uptake of HPV self-sampling is a strong reliance on provider expertise. Future research should leverage the provider role in HPV self-sampling interventions as well as explore the feasibility of home-based or clinic-based HPV self-sampling approaches. Citation Format: Serena Xiong, Rahel Ghebre, Shalini Kulasingam, Susan M. Mason, Rebekah J. Pratt, DeAnn Lazovich. Exploring factors associated with preferences for human papillomavirus (HPV) self-sampling among racially-and ethnically-diverse women: a cross-sectional study. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P026.

Health care personnel’s perspectives on human papillomavirus (HPV) self-sampling for cervical cancer screening: a pre-implementation, qualitative study

BackgroundPersistent infection with high-risk human papillomavirus (hrHPV) types is a well-documented cause of cervical cancer. Since the implementation of cervical cancer screening methods (e.g., Pap tests), cervical cancer rates have declined. However, Pap tests are still unacceptable to many women and require complex infrastructure and training. Self-sampling techniques for collecting HPV specimens (or “HPV self-sampling”) have been proposed as a possible alternative to overcome these barriers. The objective of this study was to capture perspectives from health care personnel (providers, leaders, and clinic staff) across primary care systems on the potential implementation of an HPV self-sampling practice.MethodsBetween May and July 2021, a study invitation was emailed to various health care professional networks across the Midwest, including a snowball sampling of these networks. Eligible participants were invited to a 45–60-min Zoom-recorded interview session and asked to complete a pre-interview survey. The survey collected sociodemographics on age, occupation, level of educational attainment, race/ethnicity, gender, and awareness of HPV self-sampling. The semi-structured interview was guided by the Consolidated Framework for Implementation Research and asked participants about their views on HPV self-sampling and its potential implementation. All interviews were audio-recorded, transcribed, and analyzed using NVivo 12.ResultsKey informant interviews were conducted with thirty health care personnel—13 health care providers, 6 clinic staff, and 11 health care leaders—from various health care systems. Most participants had not heard of HPV self-sampling but reported a general enthusiasm for wanting to implement it as an alternative cervical cancer screening tool. Possible barriers to implementation were knowledge of clinical evidence and ease of integration into existing clinic workflows. Potential facilitators included the previous adoption of similar self-sampling tools (e.g., stool-based testing kits) and key decision-makers.ConclusionAlthough support for HPV self-sampling is growing, its intervention’s characteristics (e.g., advantages, adaptability) and the evidence of its clinical efficacy and feasibility need to be better disseminated across US primary care settings and its potential adopters. Future research is also needed to support the integration of HPV self-sampling within various delivery modalities (mail-based vs. clinic-based).

Adaptive fuzzy‐region growing fusion and improved CNN‐ANFIS‐based automated segmentation and classification of cervical cancer

SummaryThe cervical cancer screening mechanisms help to classify cervical lesions into cancerous, precancerous, and normal. But, some of the classification approaches provide optimal outcomes based on the precise spotting and segmenting of cervical cancer. Moreover, still, challenges persist in the precise spotting of cervical cancer. The conventional screening methods for cervical cancer require more experienced pathologists, but it may also lead to poor efficiency and low accuracy. To overcome these issues, medical image processing introduces both machine learning and deep learning methods into cervical cell classification. The major scope of this task is to plan a new cervical cancer diagnosis method using intelligent approaches. Here, the segmentation of abnormality is done by the novel adaptive fuzzy‐region growing fusion model, which is improved by the hybridized optimization algorithm named gray wolf‐tunicate swarm algorithm (GW‐TSA). Then, the new ensemble classification termed Improved convolutional neural network with artificial neural network fuzzy inference system, which depends on the proposed GW‐TSA for performance enhancement through optimizing the hyperparameters. Finally, the simulation findings show that the designed approach is achievable and provides the highest accuracy rate in diagnosing cervical cancer.

Factors associated with utilization of visual inspection with acetic acid in Nepal

&lt;p&gt;Visual inspection with acetic acid (VIA) is an optional cervical cancer screening method. National guideline of Nepal has emphasized using the VIA and intended to achieve at least a 50% screening rate by 2015 but the overall coverage is only 2.4% in 2019. A cross-sectional study was conducted to identify the factors associated with the utilization of VIA screening in Bagmati Province, Nepal. A convenience sample of 400 women aged 30 to 60 years was included in the study. A semi-structured questionnaire was used to elicit information on VIA test and factors associated with it. Awareness, economic status, socio-psychological beliefs, service availability and accessibility, perception on service providers’ performance were associated with low VIA use in the province. VIA screening was associated with socio-demographic variables (χ&lt;sup&gt;2&lt;/sup&gt;=29.9; df=4; p=&amp;lt;0.001), knowledge factors (χ&lt;sup&gt;2&lt;/sup&gt;=69.29; df=3; p=&amp;lt;0.001) and with the perception on service providers’ performance (χ&lt;sup&gt;2&lt;/sup&gt;=433.82; df=6; p=&amp;lt;0.001). Service providers’ approach during the VIA screening mattered to the acceptance of this service. The disparity was observed in the knowledge of cervical cancer and screening by the women. Based on this, there is a need for massive improvement on the awareness of the community about cervical disease and screening services.&lt;/p&gt;

Clinician practices, knowledge, and attitudes regarding primary human papillomavirus testing for cervical cancer screening: A mixed-methods study in Indiana

Primary human papillomavirus (HPV) testing, in which a high-risk HPV test is administered without cytology, was first included in 2018 US cervical cancer screening guidelines. Subsequent guidelines endorsed primary HPV testing as the preferred method for cervical cancer screening following evidence of its clinical and economic benefits, although many sources still indicate it as an option along with cytology and HPV/Pap co-testing. Primary HPV testing could be key to improving the declining cervical cancer screening rates in the US; however its adoption has been slow as clinicians are hesitant to make the change. Indiana ranks in the top ten states for cervical cancer mortality, with marked race-ethnic disparities in cervical cancer screening and low HPV vaccination rates. To examine clinician practices, knowledge, and attitudes regarding primary HPV testing, in 2021 we conducted an online cross-sectional survey (n = 224) and in-depth interviews (n = 20) with Indiana clinicians practicing cervical cancer screening. Only 3 % reported using primary HPV testing for eligible patients, and only 50 % were willing to adopt it as the preferred cervical cancer screening method for the recommended patient group. In a multivariable logistic regression model, knowledge of the effectiveness (aOR 2.58 [1.41–4.72]) and perceived benefit (aOR 7.35 [3.65–14.81]) of primary HPV testing predicted willingness to adopt. In-depth interviews revealed knowledge gaps, uncertainty, and perceived limitations of this method as the reasons for limited uptake of primary HPV testing. Targeted messages about the benefits and effectiveness may enhance clinician knowledge, acceptance, and adoption.

Effectiveness and feasibility of self-sampling for human papillomavirus testing for internet-based cervical cancer screening.

Worldwide, around 18.2% of cervical cancer occurred in China, mainly because of lower screening coverage and screening quality in regional disparities. To assess self-sampling for human papillomavirus (HPV) testing, combined with the internet, as a primary cervical cancer screening (CCS) method in low-resource settings, and to establish an internet-based self-sampling CCS-management model. The women who participated registered on a CCS website. We recruited 20,136 women, aged 30-59 years, from 13 provinces in China, to perform vaginal self-sampling for HPV testing as a primary CCS, based on the internet. A questionnaire was subsequently used to investigate the acceptability of self-sampling. Of the 20,103 women with qualified samples, 35.80% lived in remote areas, 37.69% had never undergone CCS, 59.96% were under-screened, and the overall prevalence of a high-risk of HPV was 13.86%. Of 8,136 respondents, 95.97% of women felt that self-sampling was easy to perform, 84.61% had no discomfort when using a self-sampling brush, 62.37% women were more likely to choose self-sampling for CCS in future, and 92.53% were willing to introduce the concept to others around them. The reliability and ease of self-sampling were independent factors influencing selection of self-sampling (p < 0.05). The Internet-facilitated self-sampling for HPV testing and management model for cervical cancer prevention is feasible and effective. It can be used as a supplement to the conventional screening, particularly in outlying areas with few medical resources, to improve the coverage of CCS. https://www.chictr.org.cn, identifier: ChiCTR2000032331.

Acceptance of cervical cancer screening among women: global and Indian scenario

Cervical cancer is the fourth most leading cause of cancer worldwide but most of the deaths have been reported from developing countries. The absence of HPV (Human papilloma virus) vaccination and cervical cancer screening program, two highly effective preventive interventions, may be to blame for this difference. Most of the countries have screening programs for cervical cancer but lack of education, Ignorance, lack of access or few other barriers have led to low acceptance of cervical cancer screening methods. One of the three components of WHO global elimination for cervical cancer strategy is to screen 70% of the women of the world by 2030 at the age of 35 and again at 45. In India cervical cancer screening prevalence is very low as of NFHS-5 (a nationally conducted family health survey). This study aims to review the cervical cancer screening acceptance across WHO regions with special focus on India. The literature search utilized PubMed, Google Scholar, and ResearchGate databases, with a period limit of January 2017 to July 2022.