Cervical Cancer Screening Program Research Articles

Factors influencing cervical cancer screening uptake among the women in Maesot, Tak province, Thailand

Background: Cervical cancer is one of the most significant public health issues in Thailand. The number of women who have had cervical cancer screenings has increased over time; however, if major obstacles are not addressed, it will become challenging to maintain this success. Objectives: This study aimed to identify the magnitude and factors influencing cervical cancer screening uptake among women in Maesot, Tak Province, Thailand. Methods: This cross-sectional study was conducted in Maesot, Thailand. A structured questionnaire was used. Descriptive statistics and multiple logistic regression were used to determine the magnitude of the cervical cancer screening uptake and associated factors. The association was described with an Adjusted Odds Ratio (AOR) and 95% Confidence Interval (95% CI) at the statistically significant level of p-value < 0.05. Results: Of the total 422 women, the average age was 38.82 ±8.46 years. Nearly one-fourth of the respondents were Thai nationals. Almost 70% of respondents were married, and 80% were employed. About one-third of respondents had a high school level of education. The magnitude of Cervical Cancer Screening Uptake (CCSU) was 13.27% (95% CI: 10.34-16.86). Age ≥ 40 years (AOR=2.15, 95%CI: 1.05-4.40), Christian and having others religion (AOR=2.19,95% CI:1.08-4.44), married between 26 years to 43 years (AOR= 2.93, 95%CI: 1.45-5.93), having good knowledge of cervical cancer (AOR= 4.70, 95%CI: 2.22-9.72), and having good knowledge of cervical cancer screening program (AOR= 6.58, 95%CI: 2.82-17.77) were significant predictors of cervical cancer screening. Conclusion: Cervical cancer screening among women in Maesot is lower than that of national coverage of Thailand. Determining factors for the decision to undergo cervical cancer screening uptake include age, religion, age of marriage, knowledge of cervical cancer and knowledge of cervical cancer screening program. To improve uptake, structured screening programs need to be implemented in collaboration with national partners and institutions to decrease the incidence of cervical cancer in Thailand.

IJCM_229A: A Community-based screening programme for oral, breast, and cervical cancer in the rural area of Dakshin Kannada

Background: Karnataka recorded 87304 new cancer cases in the year 2021. Breast, lip and oral cavity, cervix were the top cancer sites amongst all sexes and are preventable. Despite the nation-wide launch of Population-based screening (PBS) in 2016, the reported coverage of individuals who were screened for these three cancers in Dakshin Kannada was 0.4% (NFHS-5). The study introduces on-site screening for oral and breast cancer in the community. Objectives: To estimate the proportion of pre-cancerous lesions of oral, breast, and cervical cancer, through community-based screening in adults aged 18 to 65 years, in the catchment area of a medical college in Dakshina Kannada Methodology: This observational study was conducted among all persons aged 18 to 65years, residing in the rural catchment area of a medical college in Mangalore taluk of Dakshina Kannada and consenting for the study. Pregnant women and persons with prior diagnosis of oral, breast or cervical cancer were excluded. Two-stage cluster sampling was used to enrol an estimated sample of 1120 beneficiaries. The study comprised of house-to-house survey, cancer awareness sessions, and community-based screening. Screening tests included Oral visual examination, clinical breast examination, iBreast examination (iBE; electronic palpation by ibreast device), and Pap smear tests. Participants who screened positive were referred for diagnostic tests and management. Results: The study was completed with survey of 556 households, 3 cancer awareness sessions, and screening of 525 beneficiaries (325 females and 200 males) for oral, breast, and cervical cancer. Three participants screened positive for oral cancer, and one participant for breast cancer, who were referred for management to tertiary care hospital attached to the medical college. 25% of female participants underwent cervical cancer screening, with no one detected with pre-cancerous lesions. Conclusion: A combination of house-to-house and camp-based approaches along with awareness sessions results in improved coverage of PBS in the community.

Factors Associated with Abnormal Mammogram Results Among Low-Income Uninsured Populations in Medically Underserved And Rural Texas Regions.

This study investigated the potential associations between neighborhood characteristics, rurality, ethnicity/race, and breast cancer screening outcomes in designated Health Professional Shortage Areas in Central Texas. Limited access to preventive medical care can impact screening rates and outcomes. Previous research on the effects of factors such as rurality, neighborhood socioeconomic status, and education level on cancer prevention behaviors has yielded inconsistent results. We analyzed data from a state-funded breast and cervical cancer screening programs for disadvantaged and medically underserved individuals. A mixed-effects logistic regression model was used to assess the impact of residency characteristics (rurality, educational attainment, unemployment, and poverty) on abnormal breast cancer screening outcomes, with individual level (age, ethnicity, race, and education) as control variables. During the studied time, there were 1,139 women screened and 134 abnormal mammograms found. Residency characteristics were not significantly associated with abnormal mammography outcomes at 0.05. However, individual factors are strongly associated with abnormal screening results. Non-Hispanic or Latino white women had increased odds of abnormal clinical outcomes compared with Hispanic or Latino women (OR = 2.03, CI 1.25-3.28; p = 0.004). Additionally, women residing in counties with more than 30% of the population completing college had increased odds of abnormal mammogram outcomes compared with counties with less than 15% college attainment (OR = 2.89, CI 0.99-8.38; p = 0.051). This study found a significant correlation between area-level educational characteristics and abnormal mammography outcomes. Future research should explore the contextual risk factors influencing breast cancer occurrence and develop targeted interventions for this population.

The Acceptability and Feasibility of Self-Collected HPV Testing for Cervical Cancer Screening Among Black and Latinx Women in Chicago: Perspectives from the Community.

Cervical cancer disproportionally affects Black and Latinx women in Chicago. Black and Latinx women have a higher incidence of cervical cancer diagnosis and lower rates of cervical cancer screening than non-Latinx White women. Self-collected high-risk human papillomavirus (HPV) testing has been proposed as a method to address these barriers to screening and prevent cervical cancer. This study aimed to understand the feasibility and acceptability of self-collected HPV testing as a novel approach to address barriers to cervical cancer screening for Black and Latinx women in Chicago. Semistructured interviews with 17 Black and Latinx community members of the greater Chicago area were conducted. Thematic analysis using inductive and deductive coding was completed. Findings from qualitative interviews indicate strong support for self-collected HPV testing among community members. They expressed a preference for self-collected HPV testing due to the comfort, control, and reduced anxiety it offers. Financial constraints, prioritization of other life demands, and past trauma were identified as substantial barriers to traditional cervical screening. Self-collected HPV testing could address barriers to cervical cancer screening by providing a less-invasive, patient-centered alternative to traditional methods. Self-collected HPV testing should be made accessible, be integrated into existing cervical cancer screening programs, and be covered by health insurance.

Optimizing the Role of Cadres in Increasing the Coverage of Early Detection of Cervical Cancer in the Working Area of Dasuk Health Center

Cancer is a public health problem in the world. Cancer can threaten health both physically and psychologically and can even cause death. One of the cancers that most often causes death in women is cervical cancer. Efforts to prevent cervical cancer with the cervical cancer screening program in 2018 found estimated data on the number of cervical cancer cases in East Java Province of 27,837 which has the largest number of cervical cancer sufferers compared to other provinces. Meanwhile, 2020 experienced obstacles due to the co-19 pandemic. The COVID-19 pandemic has had a major impact on cervical cancer screening. Based on the data results from the 2022 Dasuk Health Center Performance Assessment Report, the total target of WUS (Women of Reproductive Age) in the Dasuk Health Center Work Area is 6. 672 targets. While the number of WUS (Women of Reproductive Age) who carried out early detection of cervical cancer through the IVA method was 438 targets (0.06%). This shows that the awareness of women of childbearing age in conducting early screening for cervical cancer is still low. Identification of factors that influence the low coverage of early detection of cervical cancer in the Working Area of ​​the Dasuk Health Center with fishbone diagram analysis and identification of priority problems with ultrasound analysis shows that the problems that need to be prioritized for resolution are campaign discontinuity, people are afraid to check IVA tests, lack of public understanding of the importance IVA test examination.

Cervical Cancer Screening Barriers Among HIV Positive Women Attending ART Clinic at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia: A Qualitative Study

<i>Background</i>: Cervical cancer is the most common cause of morbidity and death among female cancer patients globally, particularly in poor nations like Ethiopia. It is a preventable, non-communicable disease of public health relevance. In Ethiopia, women's acceptance of the services for cervical cancer screening and treatment is low and poorly recorded. The goal of the current study is to investigate the obstacles that HIV-positive women face while trying to use cervical cancer screening. <i>Objective</i>: To investigate cervical cancer screening barriers among HIV positive women at Yekatit 12 Hospital Medical College, Ethiopia, 2021. <i>Methods</i>: Between April and June of 2021, a qualitative study was carried out with women who tested positive for HIV and were enrolled in the ART clinic at Yekatit 12 Hospital Medical College. At the time of the study, HIV-positive women and medical professionals were purposefully chosen from an ART clinic. In all, 14 patients and 9 healthcare professionals participated in the study. A schedule for in-depth interviews were used to gather data. Analysis was done by using atlas ti computer software. <i>Result</i>: The risk factors and symptoms of cervical cancer were not well known to the respondents. Women have identified several factors that impact their use of cervical screening: inadequate knowledge of the significance of screenings, perceptions of the seriousness of cervical cancer, the separation of the screening location from ART, having conflicting concerns, and emotional barriers like anxiety about a positive result, embarrassment, and shame anticipation. These same problems were recognized by healthcare professionals as obstacles to cervical screening. <i>Conclusion</i>: This study offers extensive data on the various complex reasons why women do not participate in cervical cancer screening programs. Consequently, it is crucial to develop interventions that can address and reduce these barriers.

Vaginal dysbiosis seems associated with hrHPV infection in women attending the Dutch Cervical Cancer Screening Program.

Human papillomavirus (HPV) is a sexually transmitted virus, which infects approximately 80% of all men and women at some time in their lives. Usually, the infection is resolved successfully by the body's immune system. Persistent infection with high-risk HPV (hrHPV) is necessary but not sufficient for cervical cancer development, and additional factors, such as the vaginal microbiome (vaginome), are thought to be involved. The aim of this study is to investigate whether either vaginal dysbiosis (imbalance in vaginal bacterial composition) or sexually transmitted pathogens, e.g., Chlamydia trachomatis (CT), are possible cofactors for hrHPV infection and HPV-induced cervical dysplasia in asymptomatic women attending the Dutch Cervical Cancer Screening Program. In this study, 492 hrHPV-positive and 500 hrHPV-negative cervical smears from women attending the Screening Program were included. Age and cytology were known for the hrHPV-positive samples. All cervical smears were diluted in Aptima® specimen transfer medium and tested with Aptima® transcription-mediated amplification assays targeting CT, Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), Candida spp. (CS), C. glabrata (CG), Trichomonas vaginalis (TV), and bacterial vaginosis (BV). The prevalences of CT, NG, MG, CS, CG, TV, and BV in this cohort were found to be 1.9%, 0.0%, 1.7%, 5.4%, 1.4%, 0.1%, and 27.2%, respectively. When comparing HPV groups, it was found that CT, MG, and BV had a significantly higher prevalence in hrHPV-positive smears as compared with hrHPV-negative samples (for all p < 0.001). No significant differences were found when comparing different age groups and cytology outcomes. In conclusion, vaginal dysbiosis seems associated with hrHPV infection in women attending the Dutch Cervical Cancer Screening Program.

Evaluation of a novel vaginal cells self-sampling device for human papillomavirus testing in cervical cancer screening: A clinical trial assessing reliability and acceptability.

Cervical cancer is a significant public health concern, particularly in low- and middle-income countries where resources for prevention and treatment are limited. Routine screening, such as the Papanicolaou test (Pap smears) and human papillomavirus (HPV) testing, plays a crucial role in the early detection and prevention of cervical cancer. However, the participation rate in cervical cancer screening programs remains below optimal levels due to various factors. This study aimed to evaluate the reliability and acceptability of the HygeiaTouch Self Sampling Kit for Women in collecting vaginal samples for HPV typing, comparing the results with samples collected by physicians. The study included 1210 women aged 21-65 from three medical centers in Taiwan. The findings indicated that the self-sampling kit was as effective as physician-collected specimens in terms of obtaining valid samples and identifying HPV. The agreement between the two methods was 88%, with a κ value of 0.75. Furthermore, the study assessed the mechanical characteristics of the self-sampling applicator through tensile, bending, and torque tests, and determined that it was safe for intravaginal use. Additionally, the study evaluated the safety and satisfaction of self-sampling and found a low rate of adverse events (0.7%) and high levels of satisfaction (over 90%) among participants. Overall, we demonstrated that the HygeiaTouch Self Sampling Kit for Women is a reliable and acceptable device for HPV testing and cervical screening, providing a convenient, safe, and effective alternative for women.

Pap smear in Early Detection of Cervical Precancerous Lesions in Erbil

Background and objectives: Cervical cancer remains common. This may be because Iraq has no cervical cancer screening or human papilloma virus vaccination program. The goal of the study is to figure out how well the Pap smear works as a way to find cervical precancerous lesions also identify the prevalence of cervical cancer among women and to identify the potential risk factors for cervical cancer. Methods: A prospective cross-sectional study conducted using closed end questionnaire tool for the purpose of data collection which started from 1st of October 2021 until 1st of September 2022. Convenient type of sampling was used in collecting data which include 470 women attending to cervical screening unit in Maternity Teaching Hospital, Erbil, Kurdistan Region /Iraq. The questionnaire composed of two main parts including the socio-demographic data of the patients such as age, gender, occupation, education level, religion, income status, age at the marriage, duration of marriage…etc. The result of pap smear and cone biopsy performed during colposcopy procedure to match the accuracy of pap smear. Results: The findings revealed that 36% of the women aged between 40-49 years, the majority (80%) of them were married at the age of 15-24 years, 30% of their marriage lasted from 4-14 years, and most (72.6%) of them were housewives. The result of sensitivity, accuracy, positive and negative predicted value was equal to 45.6%, 97.7%, 80%, 89.9% respectively. The kappa test was 0.52 which indicate agreement between screening and gold standard test is a diagnosis of cervical cancer is still colposcopy-guided biopsy, which is then staged on the basis of the clinical examination and the outcome of imaging procedures, most obtained results were statistically significant. Conclusion: Pap smear had a lower sensitivity, but a higher specificity in the current study. The most common complaint of the women was post-coital bleeding. Severe acute cervicitis was the most common finding for the Pap smear.

Evaluating Opt-In Vaginal Human Papillomavirus Self-Sampling: Participation Rates and Detection of High-Grade Lesions (CIN2+) among Unscreened Japanese Women Aged 30-39.

Cervical cancer incidence is increasing among Japanese women, which is partly attributed to low screening rates. This study examined the implementation of opt-in human papillomavirus (HPV) self-sampling among Japanese women aged 30-39 years who had not undergone cervical cancer screening, focusing on those requiring preconception care. The responses to the opt-in approach and effectiveness in detecting cervical squamous intraepithelial neoplasia 2 or worse (CIN2+) were evaluated. Participants used the Evalyn® Brush for self-sampling, with HPV testing conducted using the Cobas 4800 system (version 2.2.0). Out of 3489 eligible, unscreened women from four municipalities in Fukui Prefecture, only 10.6% (370/3489) requested the self-sampling kit. Of these, 77.3% (286/370) returned the kit (HPV testing rate: 8.2% (286/3489)). The HPV positivity rate was 13.7% (39/285), yet only 61.5% (24/39) of those with positive HPV results proceeded to cytology testing. Subsequently, three cases of CIN2+ were detected (10.5/1000). While this study demonstrated a reasonable kit return rate and indicated the capability of opt-in HPV self-sampling to detect CIN2+ cases in unscreened women, the low ordering rate of kits and suboptimal compliance for follow-up cytology testing highlight significant challenges. The findings suggest the need for more effective strategies to enhance participation in cervical cancer screening programs.

The impact of loss to follow-up in the Dutch organised HPV-based cervical cancer screening programme.

Loss to follow-up (LTFU) within cervical screening programmes can result in missed clinically relevant lesions, potentially reducing programme effectiveness. To examine the health impact of losing women during the screening process, we determined the proportion of women LTFU per step of the Dutch hrHPV-based screening programme. We then determined the probability of being LTFU by age, screening history and sampling method (self- or clinician-sampled) using logistic regression analysis. Finally, we estimated the number of missed CIN2+/3+ lesions per LTFU moment by using the CIN-risk in women compliant with follow-up. Data from the Dutch nationwide pathology databank (Palga) was used. Women eligible for screening in 2017 and 2018 were included (N = 840,428). For clinician collected (CC) samples, the highest proportion LTFU was found following 'referral advice for colposcopy' (5.5% after indirect referral; 3.8% after direct referral). For self-sampling, the highest proportions LTFU were found following the advice for repeat cytology (13.6%) and after referral advice for colposcopy (8.2% after indirect referral; 4.3% after direct referral). Self-sampling users and women with no screening history had a higher LTFU-risk (OR: 3.87, CI: 3.55-4.23; OR: 1.39, CI: 1.20-1.61) compared to women that used CC sampling and women that have been screened before, respectively. Of all women LTFU in 2017/18, the total number of potentially missed CIN2+ was 844 (21% of women LTFU). Most lesions were missed after 'direct referral for colposcopy' (N = 462, 11.5% of women LTFU). So, this indicates a gap between the screening programme and clinical care which requires further attention, by improving monitoring of patients after referral.

Real-world effectiveness of cytology and HPV-based screening strategy in cervical cancer screening: A cross-sectional population-based study in Chengdu, China.

Cervical cancer poses a significant health challenge in developing countries, emphasizing the need for appropriate screening strategies to accelerate the elimination of this disease. This study summarized the results of a large-scale community-based cervical cancer screening program conducted in Chengdu, China, to understand the prevalence of HPV infection and cervical lesions in the population, and to compare the real-world effectiveness of two different screening methods implemented in the program. From January 2021 to December 2022, a total of 363,376 women aged 35-64 years in Chengdu received free screenings. Among these participants, 70.1% received cytology screening and 29.9% received HPV testing combined with 16/18 genotyping and cytology triage. Ultimately, 824 cases of high-grade lesions and cervical cancer were detected, with a total detection rate of cervical cancer and precancerous lesions of 226.8 per 100,000. The follow-up rate of patients with high-grade lesions and above was 98.9%, and the treatment rate was 86.6%. The overall high-risk HPV infection rate was 11.7%, with the HPV 16/18 infection rate of 1.4%. The rate of abnormal cytology results was 2.8%. The attendance rates for colposcopy and histopathology were 71.6% and 86.1%, respectively. By calculating the age-standardized rates to eliminate the different age composition between the two group, the HPV-based screening strategy had a higher rate of primary screening abnormalities (3.4% vs. 2.8%, P<0.001), higher attendance rates of colposcopy (76.5% vs. 68.9%, P<0.001) and histopathological diagnosis (94.1% vs. 78.0%, P<0.001), higher percentage of abnormal colposcopy results (76.0% vs. 44.0%, P<0.001), and higher detection rate of cervical precancerous lesions and cancer (393.1 per 100,000 vs. 156.4 per 100,000, P<0.001) compared to cytology screening. Our study indicates that the combination of HPV testing with 16/18 genotyping and cytology triage has demonstrated superior performance in cervical cancer screening compared to cytology alone in large-scale population.

Perceived barriers to self-collected HPV testing for cervical cancer screening, and knowledge of HPV: a survey of primary healthcare smear-takers across Aotearoa New Zealand.

Cervical cancer remains a burden within Aotearoa New Zealand, with 2022 screening rates sitting 12.7% below target. The National Cervical Screening Programme has changed to primary human papillomavirus (HPV) testing for all screen-eligible people, with the aim for home self-testing. Little is known about the readiness of primary care for the change to self-testing and its associated challenges. A pilot HPV cervical cancer screening programme is being conducted in 17 practice centres. The aim of this study is to explore smear-taker knowledge at these centres about the use of primary HPV testing for cervical cancer screening. This is an ethically approved questionnaire study, with data from a structured web-based questionnaire sent to all smear-takers at the pilot centres. We achieved a total completion rate of 57.8%. The average score for "Knowledge of HPV" was 56.5% (range=20-100%). The challenges to patient home HPV self-testing were felt to be overall "not at all" to "mildly challenging". Up to 73.3% of participants identified ongoing needs for further education. The findings indicate knowledge deficits regarding HPV testing for cervical cancer screening and a desire for the provision of further education. Overall, respondents felt that no major barriers to implementing HPV self-testing would occur.

Prevalence of genital high-risk human papillomavirus infections and associated factors among women living with human immunodeficiency virus in Uganda

BackgroundWomen living with HIV are at risk for cervical dysplasia and cancer worldwide. In 2015, the World Health Organization (WHO) recommended that testing for high-risk HPV (hrHPV) infection be incorporated into cervical cancer screening programs using molecular nucleic acid tests (NATs) but this has not previously been done in Uganda. The country’s coverage for Human Papilloma Virus (HPV) screening remains low at less than 10% for women aged 25–49 years. This study determined the genital prevalence of hrHPV infection and the associated factors among women living with HIV in Uganda.MethodsA descriptive cross-sectional study was conducted in 15 selected health facilities among participants who were on Antiretroviral therapy (ART). Participants who consented to participate were instructed on how to collect their own high vaginal swabs using a cervical brush for HPV molecular testing (HPV DNA or HPV RNA) and their demographics data was collected using a standard questionnaire. Laboratory diagnosis for HPV molecular testing was done using Gene xpert machines and Hologic Aptima Machine. Modified Poisson regression analysis was conducted to determine the associated factors.ResultsThis study involved 5856 HIV positive participants on ART. A total of 2006 out of 5856 (34.3%) participants had high risk HPV infections. HPV infections by genotypes were: HPV16 317(15.8%), HPV 18/45 308 (15.4%) and other high-risk HPV 1381 (68.8%). The independent factors associated with all hrHPV were parity, education level, having more than one partner, and engaging in early sex. Smoking was associated with HPV 16, HPV 18/45 and other hrHPV. Age was associated with all hrHPV, marital status with HPV 16, and occupation with HPV 16.ConclusionsThe prevalence of genital high-risk HPV infections among HIV positive women attending ART clinics in public facilities in Uganda was high. Other hrHPV genotype was the commonest compared to 18/45 and HPV 16. The integration of cervical cancer screening in ART programmes remains paramount to support the early detection of cervical cancer and Non-invasive self-collected urine and vaginal sampling for cervical cancer screening present an opportunity.

Knowledge regarding human papillomavirus and cervical cancer prevention among medical students from Chulalongkorn University in Thailand

BackgroundCervical cancer is one of the leading causes of death among women in Thailand. General practitioners, within their primary healthcare role, play a vital role in the cervical cancer screening program, as they are the healthcare professionals most easily accessible to the general population. This study aims to determine the level of knowledge of cervical cancer and human papillomavirus (HPV) infection, HPV vaccination, and cervical cancer screening among last-year medical students.MethodsA cross-sectional study was conducted among sixth-year medical students using an electronic self-administered questionnaire. The two-part questionnaire comprised demographic data and 12 true/false questions that assessed knowledge regarding HPV infection, HPV vaccination, and cervical cancer screening recommendations. Pilot testing revealed a high Cronbach’s alpha and test–retest reliability coefficient.ResultsA 67% response rate was achieved. Among the 198 respondents, only one (0.5%) student correctly answered over 80% of the questions while most respondents (172, 71.7%) correctly answered less than 60% of the questions. Less than half of the respondents correctly identified crucial aspects such as the primary cause of cervical cancer, recommended vaccination age, cytology sensitivity compared to HPV testing, and the recommended screening frequency for average-risk women.ConclusionsThis study highlights a significant lack of comprehension among Thai medical students concerning HPV infection, vaccination, and cervical cancer screening guidelines. Encouraging educational enhancement, effective communication, and heightened awareness of these crucial topics within the medical school curriculum are imperative.

Performance of urine samples compared to cervical samples for detection of precancer lesions among HPV-positive women attending colposcopy clinic in Mexico City.

High-risk human papillomavirus (hrHPV) detection in self-collected urine samples (SeCUS) may be a promising alternative for cervical cancer screening because of its greater acceptability, as long as it can offer comparable sensitivity to clinician-collected cervical samples (CCoS) for detecting precancer lesions. To evaluate the performance of the SeCUS compared to that of the CCoS for cervical intraepithelial neoplasia grade 3 (CIN3) detection among hrHPV-positive women receiving colposcopy in Mexico City using different specific extended HPV typing procedures: HPV16/18, HPV16/18/35/39/68 or HPV16/18/35/39/68/31. From March 2017 to August 2018, 4,158 female users of the cervical cancer screening program at Tlalpan Sanitary Jurisdiction in Mexico City were invited to participate in the FRIDA-Tlalpan study. All participants provided ≥ 30mL of SeCUS, and then a CCoS was obtained with Cervex-Brush®, which was used for hrHPV typing. Participants who tested positive for hrHPV in CCoS were referred for colposcopy for diagnostic confirmation, and all SeCUS of these women were also tested for hrHPV typing. In total, 561 hrHPV-positive women were identified by CCoS via colposcopy, and 82.2% of the SeCUS of these women were also hrHPV positive. From both CCoS and SeCUS, 7 cases of CIN3 were detected. Considering HPV16/18 typing, CCoS and SeCUS detected 4 cases of CIN3, but after HPV16/18/35/39/68/31 extension typing, both CCoS and SeCUS detected all 7 of the CIN3 cases among the hrHPV-positive women. Using extended hrHPV typing based on HPV16/18/35/39/68/31, our results suggest that the performance of SeCUS may be equivalent to that of CCoS for detecting CIN3 lesions. Although our results are inconclusive, they support the hypothesis that SeCUS may be an attractive alternative worthy of further research.

Cervical cancer screening program in Indonesia: is it time for HPV-DNA tests? Results of a qualitative study exploring the stakeholders’ perspectives

ObjectivesCervical cancer is a significant public health concern in Indonesia, and effective screening methods are necessary to improve the detection and reduce mortality. This study aimed to explore the perspectives of high-level stakeholders involved in cervical cancer screening in Indonesia and whether the use of human papillomavirus-deoxyribonucleic acid (HPV-DNA) methods for cervical cancer screening is acceptable in Indonesian settings.MethodsA qualitative research approach guided by realist evaluation was applied using focus group discussions (FGDs) between December 2021 and February 2022, conducted with stakeholders involved in cervical cancer screening in Indonesia. They were representatives of practitioners and policymakers involved in the screening, and were recruited through purposive recruitment. The data were analysed using inductive approach of thematic analysis.ResultsThe analysis of two FGDs with 29 participants identified four main themes: (i) Visual inspection with acetic acid (VIA) method as the most common modality used for cervical cancer screening, (ii) the applied screening programs in the community, (iii) the perceived challenges on the screening program, such as limitations of the National Health Insurance benefits package and a lack of regulations regarding screening procedures, and (iv) the possibilities of HPV-DNA testing as another modality for cervical cancer screening. Incorporating HPV-DNA testing also needs to ensure the capacity of the workers and the readiness of healthcare facilities.ConclusionAlthough HPV-DNA testing is a promising modality, challenges on the cervical cancer screening in Indonesia remain on the coverage, accessibility of the tools in practice and the women’s awareness towards the screening. Ultimately, the findings of this study would help inform policies to improve cervical cancer screening programs in Indonesia.

Clinical and economic rationale for cervicalcancer screening program. Literature review

Cervical cancer ranks among the first in morbidity and mortality in female population of working age not only in the Russian Federation, but also in many countries worldwide. Moreover, in recent years there has been a tendency towards a decrease in the average age of mortality from this pathology, which may be due to the imperfection of the ongoing cytological screening programs. An analysis of the literature data on the clinical and economic feasibility of cervical cancer screening programs allows evaluating the information about their necessary frequency, the age category of women, and the ef fectiveness of timely detection of the pathology.

Sitologi Berbasis Konvensional dibandingkan dengan Cairan sebagai Skrining Kanker Servik : Sebuah Sistematik Review

Worldwide, there are 2.784 million women aged 15 years and over who are at risk of cervical cancer, and about 527,624 new cases of cervical cancer are diagnosed each year. Cervical cancer ranks as the fourth leading cause of cancer in women worldwide, and is the second most common cancer in women between the ages of 15 and 44. Cervical cancer can have devastating effects with very high costs, socially, and economically, affecting women in their productive years. Screening with routine cytology, using Papanicolaou (Pap) staining, has a major impact on the incidence of cervical cancer in many countries. In developed countries, but not in any developing country although its use is widespread. The use of conventional cytology as the primary test method has been replaced by the use of liquid-based cytology in many countries that have organized cervical cancer screening programs, such as the United Kingdom, the Netherlands, and Denmark. The main advantages of using liquid-based cytology instead of primary conventional cytology are that it facilitates reflex testing (i.e., residual material can be tested for the presence of human papilloma virus if borderline/slightly dicariotic smears are present) and reduces the number of slides of unsatisfactory quality. This literature review study aims to further examine how conventional cytology compares to liquid-based cytology as a method used in conducting cervical cancer screening. The journal in this review literature uses 3 databases including Google Scholar, PubMed, and Science Direct using the keywords "liquid based cytology", "conventional cytology" and "cervical cancer screening". Literature searches are adjusted based on inclusion and exclusion criteria. The search results were obtained by 10 international journals. Results show that both conventional and liquid-based cytology are effective methods for cervical cancer screening. Although liquid-based cytology may have some advantages over conventional cytology, both methods have proven effective for detecting cervical pathologies.Worldwide, there are 2.784 million women aged 15 years and over who are at risk of cervical cancer, and about 527,624 new cases of cervical cancer are diagnosed each year. Cervical cancer ranks as the fourth leading cause of cancer in women worldwide, and is the second most common cancer in women between the ages of 15 and 44. Cervical cancer can have devastating effects with very high costs, socially, and economically, affecting women in their productive years. Screening with routine cytology, using Papanicolaou (Pap) staining, has a major impact on the incidence of cervical cancer in many countries. In developed countries, but not in any developing country although its use is widespread. The use of conventional cytology as the primary test method has been replaced by the use of liquid-based cytology in many countries that have organized cervical cancer screening programs, such as the United Kingdom, the Netherlands, and Denmark. The main advantages of using liquid-based cytology instead of primary conventional cytology are that it facilitates reflex testing (i.e., residual material can be tested for the presence of human papilloma virus if borderline/slightly dicariotic smears are present) and reduces the number of slides of unsatisfactory quality. This literature review study aims to further examine how conventional cytology compares to liquid-based cytology as a method used in conducting cervical cancer screening. The journal in this review literature uses 3 databases including Google Scholar, PubMed, and Science Direct using the keywords "liquid based cytology", "conventional cytology" and "cervical cancer screening". Literature searches are adjusted based on inclusion and exclusion criteria. The search results were obtained by 10 international journals. Results show that both conventional and liquid-based cytology are effective methods for cervical cancer screening. Although liquid-based cytology may have some advantages over conventional cytology, both methods have proven effective for detecting cervical pathologies.

Performance of BD Onclarity HPV assay on FLOQSwabs vaginal self-samples.

Human papillomavirus (HPV) testing on self-collected vaginal samples has been shown to improve women's participation to cervical cancer screening programs, particularly in regions with limited access to health care. Nevertheless, the introduction of self-sampling in cervical cancer screening programs requires prior clinical validation of the HPV assay in combination with a self-sample collection device, including also the laboratory workflow and automation required for high-throughput testing in screening. In this study, the performance of BD Onclarity HPV on FLOQSwab-collected vaginal self-samples has been compared to clinician-taken liquid-based cytology samples, to detect high-grade cervical intraepithelial neoplasia using two high-throughput platforms, BD Viper LT and BD COR. The study findings have shown a similar performance of BD Onclarity on testing self-collected samples, confirming the validation of the proposed pre-analytical and analytical protocols for their use in cervical cancer screening programs based on self-collected vaginal samples.