DOCSLIB.ORG

The Use of Self-Sampling for HPV Testing to Improve Cervical Cancer Screening Participation Among Under- Screened Women Living in Rural Ontario

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Use of Self-Sampling for HPV Testing to Improve Cervical Cancer Screening Participation Among Under- Screened Women Living in Rural Ontario The Use of Self-sampling for HPV Testing to Improve Cervical Cancer Screening Participation among Under- screened Women Living in Rural Ontario by Catherine Sarai Racey A thesis submitted in conformity with the requirements for the degree of Doctorate of Philosophy Graduate Department of Public Health Sciences University of Toronto © Copyright by Catherine Sarai Racey 2017 The Use of Self-sampling for HPV Testing to Improve Cervical Cancer Screening Participation among Under-screened Women Living in Rural Ontario Catherine Sarai Racey Doctorate of Philosophy Graduate Department of Public Health Sciences University of Toronto 2017 Abstract Papanicolaou (Pap) testing has greatly reduced the incidence of and mortality due to cervical cancer. However, human papillomavirus (HPV) testing is being increasingly recommended for primary cervical cancer screening. One benefit of HPV testing is the opportunity for self- sampled specimen collection. The purpose of this dissertation was to determine if HPV self- sampling can improve participation in cervical cancer screening in under-screened rural communities. A systematic literature review and mixed methods study design addressed three objectives. A systematic literature review and meta-analysis calculated a pooled estimate of HPV self-sampling uptake in under-screened women (objective 1). Qualitative thematic analysis of community focus groups explored barriers to cervical cancer screening in an under- screened rural population and described women’s initial attitude towards HPV self-sampling (objective 2). These findings supported the design and implementation of a pragmatic randomized HPV self-sampling pilot study that determined the feasibility and acceptability of at- home HPV self-sampling to increase uptake of cervical cancer screening in an under- screened rural community (objective 3). Meta-analysis of the literature found under-screened ii women were 2.1 (95%CI 1.3 – 3.5) times more likely to participate in screening when HPV self- sampling was offered compared to re-call letters for Pap testing. Thematic analysis found logistical, procedural, and knowledge barriers to cervical cancer screening. HPV self-sampling addressed logistical barriers, such as inconvenient clinic hours, and procedural barriers, such as embarrassment and lack of privacy. However, self-sampling does not address knowledge barriers, specifically a women’s fear of cancer or lack of awareness of the benefits of screening. The HPV self-sampling pilot study included 818 eligible women. Women who received a HPV self-sampling kit were RR=3.7 (95%CI 2.2 – 6.4) times more likely to be screened (HPV self-sampling or Pap testing) compared to women with no intervention, and RR=2.1 (95%CI 1.5 – 2.8) times more likely to be screened compared to women who received a Pap test reminder letter. The absolute participation with HPV self-sampling was moderate at 20.9% (95% CI 16.7–25.7%), indicating that barriers to screening remain. Together these results contribute further evidence for the use of HPV self-sampling to increase uptake of cervical cancer screening in under-screened rural women. iii Acknowledgements To my supervisor, Dr. Dionne Gesink, thank you so much for your continuous support in both academic and life pursuits. Your mentorship and encouragement will always be remembered. A sincere thank you to my committee members Dr. Ann Burchell and Dr. Tom Wong for their mentorship, guidance, and thorough review at every stage of this dissertation. Many thanks to Drs. Katherine brain, Shelley Deeks, Aisha Lofters, and Michelle Cotterchio for donating their time in review and thoughtful recommendations to strengthen this dissertation. I would like to acknowledge the funding support provided by the University of Toronto’s Open Graduate Scholarship, the Ontario Graduate Scholarship, and School of Graduate Studies travel awards, and Cancer Care Ontario. Thank you to numerous individuals who contributed to the success of this project: Suzanne Trivers and the entire staff at the Mount Forest Family Health Team and Claire Stewart Medical Clinic, Dr. Anu Rebbapragada and the Ontario Public Health Laboratory, and to the entire Provincial Under-Never Screened Research Team. I have greatly benefited from the contributions and advise from fellow PhD students, with special thanks to Dr. Diana Withrow and Dr. Jessica Dennis. To my parents, and brother, thank you for your continuous love and support, and for nurturing my curiosity and instilling in me that a little education is not hard to carry around. To Glenn, thank you for all that you have helped me achieve, I am forever grateful for your love, support and sacrifice. Rowan, thank you for putting life into perspective everyday. iv Table of Contents ABSTRACT ............................................................................................................................................ ii ACKNOWLEDGEMENTS ....................................................................................................................... iv TABLE OF CONTENTS ............................................................................................................................ v LIST OF TABLES .................................................................................................................................. vii LIST OF FIGURES .................................................................................................................................. ix LIST OF APPENDICES ........................................................................................................................... xi LIST OF ABBREVIATIONS ..................................................................................................................... xii CHAPTER 1: INTRODUCTION AND OBJECTIVES ..................................................................................... 1 1.1 INTRODUCTION ..................................................................................................................................... 1 1.2 STUDY OBJECTIVES ................................................................................................................................. 1 1.3 READERS NOTE ..................................................................................................................................... 2 CHAPTER 2: BACKGROUND AND LITERATURE REVIEW ......................................................................... 3 2.1 EPIDEMIOLOGY AND ETIOLOGY OF CERVICAL CANCER .................................................................................. 3 2.1.1 Human papillomavirus (HPV) ..................................................................................................... 4 2.1.2 Cervical Cancer Development .................................................................................................... 5 2.1.3 Cervical Cancer Progression ....................................................................................................... 6 2.1.4 HPV Prevalence in the Population .............................................................................................. 7 2.1.5 Risk factors for HPV infection anD Cervical Cancer .................................................................. 10 2.1.6 HPV Vaccination ...................................................................................................................... 12 2.2 CERVICAL CANCER SCREENING ............................................................................................................... 15 2.2.1 Papanicolaou (Pap) Testing ..................................................................................................... 15 2.2.2 HPV Testing .............................................................................................................................. 16 2.2.3 HPV Testing for Cervical Cancer Screening .............................................................................. 18 2.2.4 Cost-effectiveness of HPV testing ............................................................................................ 18 2.2.5 Screening GuiDelines anD ProposeD Algorithms ...................................................................... 19 2.2.6 Implementing HPV Testing: ..................................................................................................... 20 2.2.7 Participation in Cervical Cancer Screening ............................................................................... 23 2.2.8 Barriers to Cervical Cancer Screening ...................................................................................... 25 2.2.9 HPV Self-Sampled Testing ........................................................................................................ 25 2.3 SUMMARY: ......................................................................................................................................... 26 CHAPTER 3: METHODS ....................................................................................................................... 28 3.1 CONCEPTUAL MODEL ........................................................................................................................... 28 3.2 SUMMARY OF STUDY DESIGN ................................................................................................................ 29 3.3 OBJECTIVE 1: SYSTEMATIC REVIEW AND META-ANALYSIS ........................................................................... 32 3.3.1 StuDy Design: ..........................................................................................................................
Load more

Recommended publications
  • Update on HPV Testing
    Update on HPV Testing Robert Schlaberg, M.D., Dr. med., M.P.H. Assistant Professor, University of Utah Medical Director, ARUP Laboratories Disclosures In accordance with ACCME guidelines, any individual in a position to influence and/or control the content of this ASCP CME activity has disclosed all relevant financial relationships within the past 12 months with commercial interests that provide products and/or services related to the content of this CME activity. Robert Schlaberg, MD, MPH has disclosed the following financial relationships with commercial interests: Commercial Interest What was Received For What Role Roche Diagnostics Honorarium Advisor Roche Diagnostics Research Grants PI Hologic Contract Research PI Hologic Honorarium Advisor Epoch Biosciences Contract Research PI Sanofi Pasteur Contract Research Co-PI IDbyDNA Stock Co-Founder, CMO Objectives 1. Understanding the biology and epidemiology of HR HPV 2. Understanding the performance of available cervical cancer screening tests 3. Reviewing recent changes to screening guidelines Background Eva and Juan Perón See: Lancet 2000; 355: 1988–91 Cervical Cancer • Incidence – Most frequent cancer death in women… now 14th – 12,000 cases, 4,200 deaths, 50% unscreened • Persistent HR HPV infection – Almost 100% of cervical cancers HR HPV+ – HPV16 (55‐60%), HPV18 (10‐15%) • Cause all common/most rare histologic types – Squamous cell carcinoma (80‐90%) Am J Clin Pathol 2012;137:516‐542 Cervical Cancer Trends ‐ US 16 14 12 10 100,000 8 per 6 Rate 4 2 0 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 NCI, SEER 9, seer.cancer.gov Squamous Cervical Precursor Lesions Modified from: J Clin Invest 2006;116:1167‐1173 Natural History of Cervical Precancer Degree of Regression Persistence Progression Progression to Dysplasia (%) (%) to CIN3 (%) Invasive Cancer (%) CIN I5732111 CIN II 43 35 22 5 CIN III 32 56 N/A 12 to 50* * Untreated 100 80 Invasion 60 40 CIN3 20 Lancet Oncol.
    [Show full text]
  • International Journal of Medical and Biomedical Studies (IJMBS)
    || ISSN(online): 2589-8698 || ISSN(print): 2589-868X || International Journal of Medical and Biomedical Studies Available Online at www.ijmbs.info PubMed (National Library of Medicine ID: 101738825) Index Copernicus Value 2018: 75.71 Original Research Article Volume 4, Issue 2; February: 2020; Page No. 322-327 ASSESSMENT OF AWARENESS OF CERVICAL CANCER AND PAP SMEAR TESTING IN FEMALES UP TO 40 YEARS AGE FROM BIHAR REGION Dr. Aakarsh Sinha1, Dr. Kumar Amit2 1Senior Resident, Department of Obstetrics and Gynaecology, Madhubani Medical College and Hospital, Madhubani, Bihar, India. 2Senior Resident, Department of Paediatrics, Darbhanga Medical College and Hospital Laheriasarai, Darbhanga, Bihar, India. Article Info: Received 30 January 2020; Accepted 25 February 2020 DOI: https://doi.org/10.32553/ijmbs.v4i2.1148 Corresponding author: Dr. Aakarsh Sinha Conflict of interest: No conflict of interest. Abstract Cervical cancer remain leading cause of cancer in women in India, accounting for nearly 25.9 % of new cancer cases and 23.3% of all cancer-related deaths in the country. [11] In 2008 in India, the annual incidence and mortality from cervical cancer was 134,420 cases and 72,825 deaths, respectively. In view of the huge population burden and limited healthcare resources, we have to look for the various ways of cost effective preventive and treatment modalities. Cervical cancer screening is an important tool in prevention and early treatment because of window of opportunity during the longstanding pathogenesis of the cervical cancer. [12] Cervical cancer results from a persistent infection by a high-risk subset of human papillomavirus (HPV). [13] Most women’s immune systems will eliminate HPV infection spontaneously, however, for a very small proportion of women, the infection will persist and can cause pre-cancerous changes in cells.
    [Show full text]
  • Human Papillomavirus Infection
    © National STD Curriculum PDF created September 26, 2021, 4:43 pm Human Papillomavirus Infection This is a PDF version of the following document: Module 1: Pathogen-Based Diseases Lesson 10: Human Papillomavirus Infection You can always find the most up to date version of this document at https://www.std.uw.edu/go/pathogen-based/hpv/core-concept/all. Background and Epidemiology Background Human papillomavirus (HPV) is one of the most common sexually transmitted infections (STIs). More than 170 types of HPV have been classified and more than 40 types of HPV can infect the genital tract of humans.[1,2,3] Genital HPV types are divided into two groups based on whether they have an association with cancer. Infections with low-risk types (non-oncogenic) are not associated with cancer but can cause genital warts and benign or low-grade cervical cellular changes. Infections with high-risk types (oncogenic), most notably HPV types 16 and 18, can cause low-grade cervical cellular changes, high-grade cervical cellular changes (moderate to severe Pap test abnormalities), and cancer of the cervix; in addition, some high-risk HPV types have been associated with cancers of the vulva, vagina, anus, penis, and oropharynx.[4] Most HPV infections, whether caused by low-risk or high-risk types, are transient, asymptomatic, and have no clinical consequences. Estimates on the incidence and prevalence of HPV infection are limited because HPV infection is not a reportable infection in any state (genital warts are reportable in a select number of states). In addition, most HPV infections are asymptomatic or subclinical, and therefore not diagnosed.
    [Show full text]
  • Cervical Cancer Prevention: Get with the Times…
    HPV an evolving understanding of an ancient and established virus Disclosures-1 • Merck – Speaker Panel for Gardasil • Hologic – Speaker Panel for Cervista and Thin Prep Disclosures-2 Gynecologic Oncologist Parent Vaccine Enthusiast Objectives • HPV • Cervical cancer • The Cervix • Epidemiology • Screening tests • Breast Cancer Public Health • Under valued in the USA – Funding – PhD vs MPH • Under recognized – Public awareness – MD awareness • Really important – Flu – Gun safety Mortality over the years • Pneumonia • Cardiac disease • TB • Cancer • GI infections • Pulmonary causes • Cardiac disease • Cerebrovascular dz • Cerebrovascular dz • Accidents • Nephropathies • Accidents • Cancer • Senility Concept of Cancer • Largely dependent upon knowledge of normal • No concept of prodromal cancer • Early diagnosis: desired, though treatment options limited • Prevention: unclear Screening Test • Performed on asymptomatic people • Common disease • Plausible test – Cost, Access, Reliable • Sufficient “lead time” to intervene • Intervention that can prevent death or morbidity • (Public Health concept) SCREENING • Public Health mechanism • For the asymptomatic patient • Cost to patient and society • Balance benefit versus harm • Examples – Lead in the water? – Blood pressure – STI screening (GYT) Diagnostic Test • A test performed on someone who is symptomatic and needs DIAGNOSIS • Xray, blood, biopsy • Pap smear can be diagnostic – Vaginal bleeding • Mammogram can be diagnostic – Breast lump • Colonoscopy can be diagnostic – Rectal bleeding SCREENING
    [Show full text]
  • Pap Smears Where Are We Headed
    Pap Smears Where are we headed Ian H. Thorneycrroft PhD,MD,FACOG Where are we headed/ • Less frequent sampling. • More use of DNA technology. • ?Increase in cervical cancer. History • The test was invented by and named after the prominent Greek doctor Georgios Papanikolaou. • Aurel Babeş of Romania independently made similar discoveries in 1927.[33] However, it should be noted that Babeş method was radically different from Papanicolaou's.[34] • Papanicolaou's name was repeatedly submitted to the Nobel Committee and rejected every time. The Nobel Committee delegated the in-depth investigation of Papanicolaou's merits and demerits to the late Professor Santesson, who was at that time the head of pathology at the Stockholm Cancer Institute (the Radiumhemmet). The investigator discovered Babeş' contributions that had never been cited by Papanicolaou and duly reported this fact to the Committee, which then rejected Papanicolaou's Nobel award.[35] Pap Smears • The Pap test, when combined with a regular program of screening and appropriate follow- up, can reduce cervical cancer deaths by up to 80%.[8] • Failure of prevention of cancer by the Pap test can occur for many reasons, including – not getting regular screening, – lack of appropriate follow up of abnormal results, – sampling and interpretation errors.[26] Latest Guidelines http://www.uspreventiveservicesta skforce.org/uspstf/uspscerv.htm ACOG guidelines summary • Cervical cancer screening should begin at age 21 years. • Pap cytology screening is recommended every 3 years for women between the ages of 21 years and 29 years. • For women aged 30-65 years, co-testing with cervical cytology screening and HPV testing is preferred and should be performed every 5 years.
    [Show full text]
  • February 2007
    The Hellenic Society Prometheas Newsletter 62 February 2007 Prometheas Celebrated Greek Letters Day On Friday, January 26, 2007, Prometheas celebrated the Greek Letters Day at the hall of St. George Greek Orthodox Church in Bethesda, Maryland, in the presence of more than 160 participants. There were two parts to the celebration: The first part included an appropriate welcoming offered by Father Dimitrios Antokas of St. George highlighting the religious significance of the celebration and the contribution of the Three Hierarchs to the promotion of the Greek Letters. The main speaker of the celebration, Mr. Yiorgos Chuliaras, the Director of the Press and Information Office of the Greek Embassy, delivered a lecture titled “The Significance of Modern Greek Studies in the USA”. Mr. Chouliaras, a writer and poet as well, presented very eloquently the breadth and evolution of Modern Greek Studies in the US, emphasized the ecumenical character of the Greek culture and expressed his thoughts as to the future and significance of these studies for Greece and USA. The second part was a ceremony presenting the “Prometheas Hellenic Culture Awards” to students of the Greek Schools in the Washington Metropolitan Area. Awards were given to three students of the Hellenic School of Potomac ( Anastasia Gerohristodoulos, Andrew Nicolaou and Constantinos Frantzis), while two more students (Kristina-Maria Paspalis of the St. Constantine and Helen School and Dimitrios Daskalakis of the St. Katherine’s School) who had received awards in the summer of 2006 and were present at the ceremony, were recognized in front of the audience. Five more awards were presented last summer to students of the other parochial schools in the area.
    [Show full text]
  • Pdf 272.14 K
    DOI:10.31557/APJCP.2019.20.9.2579 Colposcopic and Histological Outcome of Atypical Squamous Cells of Undetermined Short Communications Editorial Process: Submission:06/08/2019 Acceptance:09/07/2019 Colposcopic and Histological Outcome of Atypical Squamous Cells of Undetermined Significance and Atypical Squamous Cell of Undetermined Significance Cannot Exclude High-Grade in Women Screened for Cervical Cancer Osman Ortashi*, Dana Abdalla Abstract Objectives: The objectives of the study are to assess the prevalence of colposcopic and histological abnormalities in patients diagnosed with ASCUS and ASC-H and to compare the prevalence of CIN in each group. Methods: Population-based cross-sectional retrospective study was conducted in one of tertiary hospitals in UAE. All cervical smears reported as ASCUS or ASC-H in 2015 were included in this study. The local guideline in 2015 was to refer all cases of ASC for colposcopy assessment. Results: Overall 7,418 cervical smears were processed at our laboratory service, 5.6% (n=413) were reported as ASC. 95% of them (n=394) were ASCUS and 5% (n=19) were ASC-H. The overall prevalence of high grade CIN in patients with ASC-H is 26% compared with 0.8% for patients with ASCUS regardless the age. The relative risk of patients with ASC-H is 8 folds higher than patients with ASCUS to have low grade CIN but 29 fold higher risk of having High grade CIN and the P value =0.0001.Conclusion: ASC-H cytology confers a substantially higher risk for high grade CIN than ASCUS regardless of age. HPV test is an important triage test in patients with ASCUS to predict cellular changes and CIN.
    [Show full text]
  • 70% 1940 2035 Welcome to the November Issue of Epathway
    NOVEMBER 2019 | PUBLISHED BY RCPA ISSUE #097 IN THIS ISSUE Welcome to the November issue of Severe labour shortage ePathWay predicted within pathology profession ePathway is an e-magazine designed for anyone interested in their health and wellbeing and the integral role pathology plays in the International Pathology Day diagnosis, treatment and management of diseases. (IPD) 2019 This month’s issue of ePathway looks at the following: Let’s talk about oral sex Severe labour shortage predicted within pathology profession Do you know which test is International Pathology Day (IPD) 2019 named after Georgios Papanikolaou Let’s talk about oral sex Do you know which test is named after Georgios Papanikolaou This month saw the announcement of a new President for the RCPA. Dr Michael Dray steps into the role, replacing A/Prof Bruce Latham who INTERESTING FACTS has completed his 2-year tenure in the role. Dr Dray has held the position of Vice President of the RCPA for the past 2 years and prior to 70% that, was Vice President New Zealand for 6 years. the percentage of Remember to follow us on Facebook oropharyngeal cancers which (@TheRoyalCollegeofPathologistsofAustralasia), Twitter are caused by HPV[1] (@PathologyRCPA) or on Instagram (@the_rcpa). CEO, Dr Debra Graves can be followed on Twitter too (@DebraJGraves). 1940 the decade the pap smear became the standard for cervical screening Severe labour shortage predicted within pathology profession 2035 Australia is on track to eliminate cervical cancer by 2035[2] Source: [1] https://www.cancer.org.au/content/pdf/ News/MediaReleases/2018/World_Head_and _Neck_Cancer_ Day_2018_FINAL_27J ul18.pdf [2] https://www.cancer.org.au/news/media- releases/australia-set-to-eliminate-cervical- cancer-by-2035.html IMPORTANT MESSAGE has an important message for you.
    [Show full text]
  • Dr. Dasharatha Murmu Dr. M. Deepthi* ABSTRACT KEYWORDS
    ORIGINAL RESEARCH PAPER Volume-8 | Issue-11 | November - 2019 | PRINT ISSN No. 2277 - 8179 | DOI : 10.36106/ijsr INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH ROLE OF PAP SMEAR AS A SCREENING TEST FOR CERVICAL CANCER Obstetrics & Gynaecology Dr. Dasharatha Professor, Department of Obstetrics and Gynaecology, Alluri Sitarama Raju Academy of Murmu Medical Sciences, Eluru, west Godavari district, Andhra Pradesh 534005, India. Post Graduate, Department of Obstetrics and Gynaecology, Alluri Sitarama Raju Dr. M. Deepthi* Academy of Medical Sciences, Eluru, west Godavari district, Andhra Pradesh 534005, India. *Corresponding Author ABSTRACT Introduction: Worldwide cervical cancer is the fourth most common malignancy and the second most common malignancy in India. The objective of this study is to identify and analyse abnormal pap smear cytology among women attending gynaecological OPD with various complaints. Material and method: This retrospective study was conducted in 850 women attending gynaecological OPD at Alluri Sitarama Raju Academy of Medical Sciences, Eluru from January 2019 to June 2019. Pap smear test was done in women aged 21 -65 years and reported according to Bethesda system 2014. Results: Out of 850 women, 295 had inflammatory smear, 40 had ASCUS, 33 had LSIL, 26 with nonspecific findings, 12 had HSIL, 7 had ASC-H, 4 had squamous cell carcinoma and 1 had glandular cell abnormality. Conclusion: Cervical cancer is the most common malignancy for which screening with pap smear is advised. Pap smear is easy and economical and if done every 3 years as per guidelines, reduces incidence of mortality due to cervical cancer. It aids in timely treatment by detecting the prem alignant and malignant lesions.
    [Show full text]
  • International Journal of Medical and Biomedical
    || ISSN(online): 2589-8698 || ISSN(print): 2589-868X || International Journal of Medical and Biomedical Studies Available Online at www.ijmbs.info PubMed (National Library of Medicine ID: 101738825) Index Copernicus Value 2018: 75.71 Original Research Article Volume 4, Issue 2; February: 2020; Page No. 310-315 CLINICAL EVALUATION OF CYTOLOGICAL FINDINGS OF CERVICAL PAP SMEARS IN ANMCH OF GAYA, BIHAR, INDIA Dr. Vivek Kumar1, Dr. Jaideo Prasad2 1Tutor, Department of Pathology, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India. 2Prof & HOD, Department of Pathology, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India. Article Info: Received 20 January 2020; Accepted 18 February 2020 DOI: https://doi.org/10.32553/ijmbs.v4i2.1098 Corresponding author: Dr. Jaideo Prasad Conflict of interest: No conflict of interest. Abstract Introduction: Some of the cancer control programmes and screening tests have checked the cervical cancer incidence and its related mortality. The incidence and death rate due to cervical cancer is reduced upto 80% in some of the developing countries. Pap smear cytology is useful to detect and evaluate the degree of cellular alterations seen among cervical abnormalities. As Pap smear screening test is simple, rapid and cost effective, it is an ideal tool for mass screening programmes and better reliable results are obtained compared to other tests. Hence based on above findings the present study was planned for Clinical Evaluation of Cytological Findings of Cervical PAP Smears in ANMCH Gaya, Bihar, India. The present study was planned in Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India. In the present study 25 cases of the females cervical smears of patients undergone Papanicolaou (Pap) smear testing were enrolled in the present study.
    [Show full text]
  • Retrospective Study of out Come of Pap Smear
    Volume : 5 | Issue : 12 | December-2016 ISSN - 2250-1991 | IF : 5.215 | IC Value : 79.96 Original Research Paper Medicine Retrospective Study of out Come of Pap Smear DR. OMANA.E.K Asso.Professor. ACME DR. VIDYA Asso.Professor ACME .S.PRABHU DR. JITHIN SURENDRAN DR. ASHISH DR.ENID ELIZEBATH PG in Community Med Cervical cancer is the second most common cancer among women globally. Globally, 15% of all cancers in females are cervical cancers, while in Southeast Asia, cancer cervix accounts for 20%-30% of all cancers.More than 85% cases and 88% deaths from cervical cancer occur in developing countries, where women often lack access to cervical cancer screening and treatment.India alone accounts for one-fourth of the global cervical cancer burden.The Papanicolaou test (abbreviated as Pap test, known earlier as Pap smear, cervical smear, or smear test) is a method of cervical screening used to detect potentially pre-cancerous and cancerous processes in the cervix. Pap described the fern test & the cyclical changes in the cervical mucus under the influence of various hormone. The test was invented by and named for the prominent Greek doctor Georgios Papanikolaou.1 Aim and Objective of the Study To study the profile of Pap smears done in gynecology dept during the year of June 2014to June 2015 in Pariyaram Medical College. STUDY POPULATION: Females attending gynaecology opd who were sent to pathology dept. for pap smear.(willing women>21years/ with cervical symptoms.) SAMPLE SIZE: a total of 1548 pap smears were taken in OBG dept in 2015, out of which 348 were inadequate or scanty ABSTRACT smears.
    [Show full text]
  • Clinical Study – Confidence HPV 2013-2016
    Clinical Study – Confidence HPV 2013-2016 Cellcall’s Confidence HPV Test [1-3] for Primary HPV Screening Summary of Baseline Results – Ongoing Clinical Study (n>6000) INTRODUCTION Millions of women are screened for cervical cancer each year in the Western World and via such programs cervical cancer was reduced by fifty percent, but the system lacks efficiency, automation and objectivity [4]. Traditional cervical cancer screening (cytology or Pap smear or Pap test named after Doctor Georgios Papanikolaou who invented it) was introduced over 50 years ago and has not changed much since. Cells scraped from the cervix are fixed on a glass slide and checked for physical signs of dysplasia indicative of malignant transformations (precancer or cancer). The evaluation is ultimately performed by highly experienced professionals, and patients are managed according to very complex algorithms [5]. This system is subjective, very intricate, with many ramifications, not very sensitive for the disease and cannot identify "at-risk individuals"[4]. In the early 80s Professor Harald zur Hausen discovered that a virus, called the Human papillomavirus causes the large majority of cervical cancers [6-9]. Today we are preparing for the HPV test, which detects the presence of the virus in the cervical sample, to take over the place of the Pap smear in screening [10-12]. It is a major step forward being very sensitive (approx. 95% versus 50%), highly objective and finding almost all at risk women [13-15]. However it brings a new major problem to solve: specificity. Only about 10% of the women infected with the virus develop dysplasia which has to be treated [16, 17].
    [Show full text]