Pap Test Screening Research Articles

Clinical validation of REALQUALITY RQ-HPV Screen according to the international guidelines for human papillomavirus DNA test requirements for cervical screening

BackgroundAccording to international guidelines, HPV DNA tests represent a valid alternative to Pap Test for primary cervical cancer screening, provided that they guarantee balanced clinical sensitivity and specificity for cervical intraepithelial neoplasia grade 2 or more severe lesions. The aim of this study was to assess whether REALQUALITY RQ-HPV Screen, a new assay based on real time PCR that targets the E6-E7 region of 14 high-risk human papillomaviruses, meets the criteria for primary cervical cancer screening.MethodsAs required by guidelines, a non-inferiority test was conducted to compare the clinical performance of the test under evaluation with that of a clinically validated reference test (Hybrid Capture 2, HC2). The reproducibility of the device was assessed as well. The clinical samples used to test the hypothesis of non-inferiority and to asses reproducibility comprised 910 and 536 cervical specimens respectively. All specimens were originating from a population-based screening cohort.ResultsThe study demonstrates that both the clinical sensitivity and specificity of REALQUALITY RQ-HPV Screen are non-inferior to those of HC2. In addition, an adequate intra- and inter-laboratory reproducibility has been reached by the test.ConclusionsREALQUALITY RQ-HPV Screen fulfils all the requirements of the international guidelines and can be considered clinically validated for primary cervical cancer screening purposes.

Malignant lymphoma of the uterine cervix presumptively diagnosed by Pap smear: A case report.

Malignant lymphoma of the uterine cervix is exceedingly rare and is difficult to diagnose by cervical cytology. The current study presents a case of malignant lymphoma of the uterine cervix that was presumptively diagnosed by cervical cancer screening in which the patient had no clinical symptoms. The anterior lip of the uterine cervix was occupied by a macroscopic hemorrhagic tumor. The obtained tumor cells exhibited typical cytological features of malignant lymphoma and were positive for CD20. The final diagnosis was diffuse large B cell lymphoma of the uterine cervix, stage IIEA (Ann Arbor classification). The patient received 6 courses of R-CHOP chemotherapy and achieved complete remission. Despite its rarity, the possibility of malignant lymphoma should be considered while screening for cervical cancers using Pap smears. The Pap test screening may be useful for the early diagnosis of malignant lymphoma of the uterine cervix in certain cases. By reaching a rapid and accurate diagnosis, immediate treatment may be initiated and surgery may be avoided.

High frequency of HPV16 European variant E350G among Mexican women from Sinaloa.

Background & objectives:Human papillomavirus (HPV) infections play a crucial role in the aetiology of cervical cancer (CC), and HPV16 is the primary viral genotype associated with CC. A number of variants of the HPV16 E6 gene are involved in the progression of CC, differing in their prevalence and biological and biochemical properties. This study was designed to determine the frequency of HPV types 16/18 and to identify the presence of HPV16 E6-variants in asymptomatic Mexican women.Methods:A total of 189 cervical Pap smears were collected from women attending public health services in three different cities in Sinaloa, Mexico. Viral DNA was identified by amplification of E6 viral gene fragments using polymerase chain reaction (PCR). Identification of variants was done by sequencing a DNA fragment (321bp) of the HPV16 E6 gene.Results:More than half of the women tested were HPV-positive (52.38%), with HPV16 being the most frequent genotype (21.16%), followed by HPV18 (8.99%). Sequence analysis of the E6-HPV16 PCR products showed that in all cases, the viruses corresponded to European variants. It was further observed that the E350G intra-variant was the most common (>76%).Interpretation & conclusions:This study showed a predominance of European lineage variants of HPV16 among asymptomatic women from Sinaloa, Mexico, predominantly with of the E350G variant. This variant has been shown to be associated with an increased risk of early development of CC. The use of molecular identification of carcinogenic HPV and Pap test screening may be a good strategy for monitoring women to prevent CC.

Development of mobile technologies for the prevention of cervical cancer in Santiago, Chile study protocol: a randomized controlled trial

BackgroundIn Chile, more than 500 women die every year from cervical cancer, and a majority of Chilean women are not up-to-date with their Papanicolau (Pap) test. Mobile health has great potential in many health areas, particularly in health promotion and prevention. There are no randomized controlled trials in Latin America assessing its use in cervical cancer screening. The ‘Development of Mobile Technologies for the Prevention of Cervical Cancer in Santiago, Chile’ study aims to determine the efficacy of a text-message intervention on Pap test adherence among Chilean women in the metropolitan region of Santiago.Methods/designThis study is a parallel randomized-controlled trial of 400 Chilean women aged 25–64 who are non-adherent with current recommendations for Pap test screening. Participants will be randomly assigned to (1) a control arm (usual care) or (2) an intervention arm, where text and voice messages containing information and encouragement to undergo screening will be sent to the women. The primary endpoint is completion of a Pap test within 6 months of baseline assessment, as determined by medical record review at community-based clinics. Medical record reviewers will be blinded to randomization arms. The secondary endpoint is an evaluation of the implementation and usability of the text message intervention as a strategy to improve screening adherence.DiscussionThis intervention using mobile technology intends to raise cervical cancer screening adherence and compliance among a Chilean population of low and middle-low socioeconomic status. If successful, this strategy may reduce the incidence of cervical cancer.Trial registrationClinicaltrials.gov NCT02376023 Registered 2/17/2015.First participant enrolled Feb 22nd 2016.

Effect of Darvyadi Yoni Varti in the management of Garbhasaya Mukhagata Vrana (Cervical erosion) - An Open label clinical trial

Cervical erosion is a common condition seen in most women of all the age groups. About 85% women suffer from the cervical erosion i.e. benign condition of female genital tract during their lifetime. Cervical cancer is one of the most common cancers in women worldwide about 493 000 new cases each year resulting in 274 000 deaths globally. Cytology (Pap test) screening has been very successful in lowering cancer incidence and mortality in countries where good-quality screening is available. For the present study open label single arm clinical study was planned to evaluate the efficacy of Darvyadi Yoni Varti in the management of cervical erosion. Total 43 patients with cervical erosion diagnosed by Pap smear test were selected from out patient department of Prasutitantra and Streeroga, out of which two patients discontinued. The treatment protocol comprised of Darvyadi Yoni Varti of 3gm once at bed time for 21 days. The assessment was done with subjective criteria and Pap-smear after 45 days. The results were observed highly significant in clinical features of disease like in Yoni Srava (68.75%), Yoni Kandu (70.83%), Kati Shoola (56.94%), Udara Shoola (70%), Mutra Daha (74.07%), Daurbalya (63.83%), area of erosion (85.96%), appearance of erosion (69.32%) and significant result was observed in Yoni Daha (76.92%). Darvyadi Yoni Varti was effective management of cervical erosion.

Abstract 4225: Disparities in cervical cancer screening participation: a comparison of Russian, Somali and Kurdish immigrants with the Finnish general population

Abstract Background: Cervical cancer screening through Pap test has been shown as an effective preventive measure for early detection of precancerous in the cervix. Finland offers mass Pap test screening to all eligible women. Knowledge about disparities in the screening participation among immigrants compared with the Finnish general population is limited. Objectives: (1) To compare Pap test screening participation in the past five years among Russian, Somali and Kurdish immigrants living in Finland with the Finnish general female population; (2) to examine if the observed disparities remain similar when adjusted for socio- demographic and health-related confounding factors. Methods: Data from the Finnish Migrant Health and Well-being Study and Finnish Health 2011 Survey were used. Random samples of persons living in six cities in Finland were drawn from the national population registry. Data of self-reported cervical screening participation (Pap test) among women aged 29-60 were available from the women of Russian (n=257), Somali (n=113), Kurdish (n=167) origin and the general population (n= 436). Logistic regression was used for statistical analysis. Results: The age-adjusted Pap test participation rates were 79% among the Russian, 41% among the Kurdish, and 64% among the Somali, compared to 94% among the Finnish general population. After adjusting for age, socio - demographic, and health-related confounders, the immigrants had significantly lower likelihood for screening compared with the Finnish reference group (Russian Odds Ratio[OR] 0.33, 95% confidence interval [CI] 0.19-0.58; Somali [OR]0.08, [CI] 0.03-0.19; Kurdish [OR] 0.17 [CI]0.08-0.34). Conclusions: Initial results demonstrate significantly lower likelihood for Pap test screening among the immigrant groups compared with the Finnish general population. Note: This abstract was not presented at the meeting. Citation Format: Esther E. Idehen, Päivikki Koponen, Tommi Harkanen, Tellervo Korhonen. Disparities in cervical cancer screening participation: a comparison of Russian, Somali and Kurdish immigrants with the Finnish general population [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4225. doi:10.1158/1538-7445.AM2017-4225

The 2012 Consensus Pap Test Guidelines: A Failure of Patient Education [24J

INTRODUCTION: The 2012 consensus cervical cancer screening guidelines recommend longer intervals between Papanicolaou (Pap) tests. We evaluated the knowledge and attitudes of women regarding the purpose and frequency of Pap test screening. METHODS: A 13-question survey was available to patients 18 years and older presenting to three clinical sites for obstetrical or gynecological care. Survey topics included familiarity with the 2012 consensus screening guidelines, cervical cancer knowledge, and attitudes towards screening. RESULTS: Updated data from 752 patients was included for analysis. Participants were primarily age 20-29 (45%) or 30-39 (33%), African American (53%), and had completed at least a high school degree or equivalent (87%). Pap tests were correctly identified as a screening test for cervical cancer by 75% of participants and 72% named Human Papillomavirus as the cause of cervical cancer. However, only 9% of women selected the correct screening intervals for patients age 21-29 and only 3% selected the appropriate screening interval for patients age 30 and above. Overall, 52% were uncomfortable with lengthening screening intervals and 60% would prefer a yearly pap test. However, 62% of women believed that additional education would increase their comfort with less frequent screening. CONCLUSION: Across diverse clinical populations, women are knowledgeable about the purpose of Pap tests and about cervical cancer. However, consistent with our previous data analysis, most women are unaware of the updated screening guidelines and many feel uncomfortable with increased screening intervals. Further education regarding the timing of pap tests is necessary to improve women’s comfort with the consensus guidelines.

Impact of a student-led community education program to promote Pap test screening among Asian-American women

Among ethnic groups, Asian-American women have the highest incidence of cervical cancer, low cervical cancer screening rates, and are more likely to state they have "never thought about" and/or "do not need" Pap testing. Through a Patient Advocacy grant awarded by the American Society of Cytopathology Foundation, we developed a culturally sensitive educational outreach program to encourage Pap screening among Asian-Americans in our community. Educational materials, translated into three languages, were shared at nine community events by undergraduate and medical student volunteers. Pre- and post-education surveys on awareness, knowledge, and attitudes towards screening were administered. Results were tallied and reported as raw percentages. A total of 328 surveys were completed; 80% were Asian respondents. Twenty percent of respondents were not up to date (NUTD) with Pap screening. Knowledge of Pap tests reported as "excellent"/"good" rose from 46% before to 85% after education. Those reporting "very likely"/"likely" to schedule a Pap test increased from 72% to 92% in the NUTD group and from 84% to 97% in the 21-29 age group. Those reporting "very likely"/"likely" to recommend a Pap test to others increased from 68% to 98% in the NUTD group and 77% to 97% in those aged 21-29. A student-led community-based culturally sensitive outreach approach improved Pap test knowledge and awareness among Asian-Americans. The largest increase in likelihood to obtain a Pap test and recommend the test to others was the NUTD and 21-29 age groups, suggesting influence on those in need of screening.

Abstract C53: Human papillomavirus (HPV) and cervical cancer: Exploring knowledge, attitudes, and cultural taboos among Mexican American families along the Texas-Mexico border

Abstract Background: Hispanic women living along the Texas-Mexico border have higher cervical cancer mortality and incidence rates compared to other Hispanic women in the U.S. The human papillomavirus (HPV) causes the majority of cervical cancers. Although cervical cancer can be prevented through HPV vaccination and prevented or detected early through Pap test screening and follow-up treatment, they are all underutilized by Hispanic females. Research indicates that beliefs, misconceptions, and taboos regarding sexuality may contribute to the low perceived risk for HPV and cervical cancer, thus contributing to the underutilization of vaccination and Pap test screening. Since beliefs are often transmitted through parents, it is critical to elucidate parents' and young women's (aged 18-26 years) beliefs about HPV and cervical cancer. In this study, we explored knowledge, attitudes, and perceptions about HPV and cervical cancer among Hispanic parents and young women living along the Texas-Mexico border. Methods: We conducted eight focus groups in two counties along the Texas-Mexico border. Research staff recruited family members - fathers, mothers, and young women (aged 18-26 years) who were eligible for HPV catch-up vaccination - from local community centers, health centers, and colleges. Research staff audio-recorded focus groups for accuracy, transcribed recordings word-for-word, and uploaded transcripts into Atlas(ti) 5.0 for analysis. After open and axial coding, the research team analyzed the data for content, meaning, patterns, frequency, and themes by applying the constant comparison method to guide analysis and generation of themes. Results: Although misconceptions existed across all participant groups, the type of misconception varied. Mothers, fathers, and young women held different beliefs. Misconceptions among parents centered heavily on sexual risk with fathers linking HPV risk to promiscuity. On the other hand, mothers linked HPV risk to adultery and indiscretion of male partners. Young women's beliefs were about transmission of the virus via unclean surfaces and beliefs that medications can cure HPV. Conclusions: Results uncovered important differences in knowledge and risk beliefs concerning HPV and cervical cancer among Hispanic parents and young women living along the Texas Mexico border. Our findings highlight critical knowledge areas that can be addressed through interventions to overcome barriers to HPV prevention in Hispanic women, as well as to create culturally appropriate prevention messages that may ultimately help reduce disparities in HPV and cervical cancer among Hispanic women along the Texas-Mexico border. Citation Format: Daisy Y. Morales-Campos, Shedra Amy Snipes, Maria E. Fernandez. Human papillomavirus (HPV) and cervical cancer: Exploring knowledge, attitudes, and cultural taboos among Mexican American families along the Texas-Mexico border. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C53.

Screening History in 313 Cases of Invasive Cancer: A Retrospective Review of Cervical Cancer Screening in Alberta, Canada.

To examine the screening history of invasive cervical cancer (ICC) cases in Alberta, Canada to identify areas for improvement of the population-based cervical cancer screening program. Retrospective review of ICC cases diagnosed in 2 cities in Alberta between 2007 and 2012. Cancer morphology and staging were elicited from the Alberta Cancer Registry; cancer screening history and Pap test results were extracted from the Provincial Cervical Cancer Screening database. Women were classified as adequately screened, underscreened, and unscreened depending on time from last screening Pap test to diagnosis. Of the 280 cases that occurred in women eligible for screening, 125 (44.6%) were adequately screened, 18 (6.4%) were underscreened, and 137 (49%) were unscreened. Among the adequately screened, 71 (56.8%) had normal Pap test results, but 48 (38%) had less than 3 previous Pap tests (p = .003). Cancer stages I to II were diagnosed in 48.8% and 44.1% of adequately screened and unscreened women and cancer stages III to IV in 30.6% and 66.1% in each group, respectively (p = .0058). Squamous cell carcinoma (SCC) was diagnosed in 189 women (67.5%). The proportion of SCCs was similar in adequately screened and unscreened women. The proportion of SCCs and advanced stages of ICC seems to be decreased. The results of quality improvement initiatives such as enhanced surveillance of high-grade Pap test results and histology-cytology correlation will be monitored and are expected to result in better outcomes for adequately screened women.

300O Assessment of the effectiveness of cervical cancer screening

Background According to the US Center for Disease Control (CDC 2013), a reliable statistical tendency of decreasing cervical cancer incidence and mortality caused by this disease has beenrecorded in the United States over the recent 40 years that isrelated tohigh rate coverage of the female population by Pap-test screening. This tendency is proved by American Cancer Society (ACS, 2012).According to Gold M.A. (2006), 7080% decrease of cervical cancer incidence has been achieved by Pap test screening in developed countries. According to the Norwegian Cervical Cancer Screening Program (NCCSP, 2014), screening has contributed to 25% decrease of cervical cancer incidence and 50% decrease of mortality caused by this disease in Norway.According to Nanda K. et al. (2000) data, in case of cervical cancer CIN 2/3, Pap test sensitivity and specificity vary within the range 47% - 62% and 60% - 85% correspondingly. Methods We have studied the cost-effectiveness of cervical cancer screening program, based on5 yearperiod data (2010 -2014): 66,324 women received gynecological examination and Pap test and 12,147 received colposcopy, targeted biopsy and morphologicalanalysis.In2013, 13 584womenreceivedcervicalcancerscreening, amongthem7,416womenattheNationalScreeningCenter(NCC).Theindicatorsof diagnostic effectiveness of gynecological examination, Pap test, colposcopy and combination of a Pap test and colposcopy have been studied based on NCC data with a purpose of assessment. Results In 2013, the prevalence of cervical severe dysplasia(CIN3) and intraepithelial carcinoma(CIS) per1,000 female population eligible forscreeningconstituted 9,8% and cancer prevalence was 6,1%. The study has found that making of alterations in a screening guideline and re-adjusting of a target group from 25-59 to 30-64 age group will increase the number of detected cervical cancer cases and decrease needed expenditures: in case of 50% coverage of a target group by ~93,000 GEL and by ~ 130,000 GEL in case of 70% coverage. Conclusions >Makingofalterationstothescreeningguidelineandreadjustingofa targetgroupto3064agegroupwillsignificantlyenhancethecosteffectivenessofcervical cancer screening. Legal entity responsible for the study National Screening Center Funding National Screening Center Disclosure All authors have declared no conflicts ofinterest.

Why Do Chilean Women Choose to Have or Not Have Pap Tests?

ObjectiveTo describe the perceptions of Chilean women about why women choose to have or not have Pap test screening. DesignQualitative research using content analysis according to Krippendorf. SettingFour urban health clinics in Santiago, Chile. ParticipantsFifty-seven Chilean women. MethodsAudiotaped focus groups. ResultsSix themes emerged: Reasons that make it difficult for women to schedule appointments, Characteristics of health professionals that make it difficult to have a Pap test, Characteristics of the test that are barriers to having a Pap test, The relationship of the test with cancer, Family context, and Each woman's personal characteristics. ConclusionPrimary health care providers play an important role in promoting adherence to cervical cancer screening. Nurses should proactively address women's perceptions and knowledge about screening and openly and uniformly discuss the importance and benefits of Pap test screening.

Racial/ethnic disparities, body weight, and psychosocial antecedents that predict women’s failure to meet Pap test screening national recommendations

Background: The economic burden associated with cervical cancer in the U.S. is estimated 300–400 million dollars in direct costs. Healthy People 2020 Objective C-15 points the nation’s aim to increase the proportion of adult women who receive a cervical cancer screening to 93%. To identify the associated factors that can help increase Pap test, this study examined the predictors of failure to meet USPSTF Pap test recommendation among adult women. Methods: We analyzed the 2014 National Cancer Institute’s nationally representative Health Information National Trends Survey (HINTS) 4 Cycle 4 data (N=3,677). Adult women who were 21 to 65 years of age and not diagnosed with cervical cancer were included in this analysis. Stepwise multiple logistic regression was conducted to predict the behavioral and demographic factors associated with failure to meet USPSTF Pap test recommendation. Results: Women with the following characteristics tend to fail to meet the Pap test national recommendation with statistical significance: (I) being Asian or White ( vs . Hispanic); (II) being underweight or of normal weight ( vs . overweight/obese); (III) having more symptoms of depression and anxiety within the past two years; (IV) never being diagnosed with cancer; (V) fail to meet USPSTF mammography recommendation ( vs . met); (VI) having last routine check-up by a doctor more than 2 years ( vs . within 2 years); (VII) being older than 35 ( vs . aged 21–35); (VIII) being single, divorced/separated, or widowed ( vs . married/living as married); and (IX) having less education ( vs . college graduate or more). Conclusions: This study identified racial/ethnic disparities in women who failed to meet the Pap test screening national recommendation. Additionally, symptoms of depression and anxiety and being underweight or of normal weight ( vs . overweight) were identified as significant predictors to failing to meet Pap test screening national recommendations. These findings may be used to identify future cervical cancer screening priority populations and direction for further intervention.

Knowledge of the HPV status biases cytotechnologists' interpretation of Pap tests originally diagnosed as negative for intraepithelial lesion or malignancy.

Because of cervical cancer screening recommendations and forthcoming first-line human papillomavirus (HPV) screening, many Papanicolaou (Pap) tests will be performed in patients with known concurrent HPV results. This study was designed to evaluate whether knowledge of the HPV status affects cytotechnologists' interpretation of Pap tests. A retrospective search of cervical screening Pap tests with known concurrent HPV results provided 250 ThinPrep Pap tests, which were chosen to reflect an atypical rate similar to the rate of the Cleveland Clinic's normal practice. Fifty percent of negative for intraepithelial lesion or malignancy (NILM) and atypical squamous cells of undetermined significance (ASCUS) cases were from patients with positive HPV results. Slides were re-evaluated twice by 8 cytotechnologists blinded to the diagnosis and study purpose. The HPV status was provided for 50% of the cases in the first phase; after a washout period, knowledge of the HPV status for each case was reversed in the second phase. Follow-up information was collected from the medical record. In both phases, there was a significant bias for HPV-positive NILM cases to be upgraded to ASCUS or worse when the HPV-positive status was provided (P < .001). When the HPV status was withheld, there was no difference in upgrading NILM cases (phase 1, P = .69; phase 2, P = .066). A combined analysis showed a significant bias in referral to the pathologist when the HPV-positive status was provided rather than withheld (P < .001). Follow-up data revealed no significant effect of bias when the HPV-positive status was provided between patient groups with benign, low-grade, or high-grade follow-up. A known HPV-positive status biases cytotechnologists' interpretation of Pap tests, and this results in a higher rate of upgrading to ASCUS or worse; however, it does not improve sensitivity for disease detection. Cancer Cytopathol 2017;125:60-69. © 2016 American Cancer Society.

Racial/ethnic disparities, body weight, and psychosocial antecedents that predict women’s failure to meet Pap test screening national recommendations

Background: The economic burden associated with cervical cancer in the U.S. is estimated 300–400 million dollars in direct costs. Healthy People 2020 Objective C-15 points the nation’s aim to increase the proportion of adult women who receive a cervical cancer screening to 93%. To identify the associated factors that can help increase Pap test, this study examined the predictors of failure to meet USPSTF Pap test recommendation among adult women.

Roles of Health Care Providers and Patients in Initiation of Unnecessary Papanicolaou Testing After Total Hysterectomy.

To assess Papanicolaou (Pap) testing use among US adult women with a history of a total hysterectomy for a benign condition and the roles of health care providers and patients in the initiation of screening Pap tests. We used 2000 to 2013 data from the National Health Interview Survey on women aged 20 years or older who had undergone a hysterectomy (n = 11 616) to estimate unnecessary Pap test use. The percentage of self-reported Pap testing in the preceding 3 years among women who had undergone a hysterectomy decreased from 72.2% in 2000 to 53.3% in 2013. In 2013, 42.4% of women who had undergone a hysterectomy reported receiving recommendations for screening from a health care provider in the past year (32% of which were unnecessary), and 32.1% reported undergoing Pap tests in the preceding year (22.1% of which were unnecessary). Although the majority of Pap tests were performed at a clinician's recommendation, approximately one fourth were initiated by patients without clinician recommendations. Health care providers should advise women who have had a total hysterectomy for a benign condition on appropriate use of screening services.

Impact of a Community Education Program to Promote Pap Test Screening Among Asian-American Women: An ASC Advocacy Award Program

Impact of a Community Education Program to Promote Pap Test Screening Among Asian-American Women: An ASC Advocacy Award Program

The Annual Gynecologic Examination Updated for the 21st Century

The concept of an annual gynecologic screening visit to identify disease at an early stage has long been an established component of women’s health care. Women and their health care providers have historically accepted the schedule of an annual gynecologic examination with cervical cancer screening and a pelvic examination. Recently, researchers questioned the value of the annual breast and pelvic examinations in asymptomatic women and re-established the intervals for Pap test screening with the addition of human papillomavirus co-testing to establish cervical cancer risk. The updated well woman examination is now an opportunity to engage women in health education, screening for chronic disease risks, and health care concerns such as depression and violence.

Multidisciplinary approach to introducing new technologies and reconstructive surgeries in diagnosis and treatment of neoplastic diseases of the female reproductive organs

Multidisciplinary approach that comprises the passing the examination in the exam room with the Pap test, questionnaires, ultrasound or digital mammography screening (MS) according to the age is a promising way of solving the problems with the visual localization of cancer, in particular with the reproductive organs. A minimally invasive removal technology that helped to determine the nature of tumor pathologies and remove those potentially dangerous hotbeds at the same time, was an important component of this secondary prevention system. Organ preserving and reconstructive surgeries (to our knowledge to 38,8% of patients with breast cancer and 95% of patients with vulvar cancer and vulvar dysplasia) have a positive effect not only on women’s life quality, but also become a good motivation for regular women’s screening in the region. Nothing is more convincing than the vivid example and “word of mouth”. A multidisciplinary approach to solving problem with the help of different specialists helped to reduce mortality rates for breast cancer by 30,03 ± 2,1% compared with 2009 (after the introduction of reconstructive surgery) and vulvar cancer by 83,3 ± 5,7% in comparison with 2005 (after the introduction of reconstructive surgery) at the continuing trend of increasing incidence rate. Cytological screening for dysplasia and early forms of cervical cancer needs a serious adjustment in accordance with the WHO recommendations and per capita accounting used in Russia.

Persistent Disparities in Hispanics with Cervical Cancer in a Major City.

Despite an overall improvement in cervical cancer screening, incidence, and mortality rates for minorities in the USA, regional differences in screening and stage at presentation have been observed. This study evaluated cervical cancer disparities in a predominately Hispanic population treated in a major treatment center in San Antonio, Texas. Data on 446 patients with cervical cancer treated between 2000 and 2011 at the Cancer Therapy and Research Center in San Antonio, Texas, were reviewed. Sufficient information was obtained on 319 patients and was compared with the Surveillance, Epidemiology, and End Results (SEER) data. Of 319 patients treated for cervical cancer between 2000 and 2011, 209 were Hispanics and 110 were Whites (82), Blacks (20), Asians (7), and others (1). The median and mean ages at diagnosis were 47 and 49, respectively. Only 36% were known to have screening Pap tests prior to diagnosis, of which only 24 had yearly Pap tests. Forty-two patients (20%) of those with no known screening Pap tests presented with stage IV disease at diagnosis (vs. 3% of those with known Pap tests). Among the Hispanics, 68% presented with regional disease (vs. 37% SEER) and 46% were stage III or higher disease, with stage IIIB accounting for 30% of total. Although the overall age-adjusted death rates were higher in Hispanics due to a higher percentage of more advanced disease, survival rates appear similar, stage for stage, to the SEER data. Even in a major city, Hispanics often present with more advanced cervical cancer than the general population. In order to minimize the cervical cancer disparities, efforts and strategies are needed to study the cultural and locale effects and to implement preventive measures and adaptive health education.