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

This study was designed to test the effects of two message features (source and level of autonomy support) that are commonly found in short-form social media (e.g. TikTok) videos about Pap tests. The source is defined as who is communicating the message, and autonomy support refers to providing an individual with the independence, respect, and choice to make their own decision. In an online experiment, 636 females aged 21–29 viewed TikTok videos about Pap tests varying in source (doctor vs. peer) and level of autonomy support (either using controlling language to demand getting a Pap test or being supportive of one's choice of whether they receive a Pap test) and then responded to outcomes measures including perceived source credibility, perceived message effectiveness, attitude toward the message, attitude toward Pap tests, intention to engage with the videos, and intention to get a Pap test. Doctors were perceived as more credible than peers, and doctor videos were perceived to be more effective than peer videos. Autonomy support interacted with source, such that autonomy-supportive videos delivered by a doctor improved attitude toward the messaging and attitude toward Pap tests. Regardless of the source, autonomy-supportive videos increased intention to engage with the content on social media. As Pap test rates have recently declined among young women in the United States and viewing of Pap test-related videos has skyrocketed on the TikTok platform, short-form social media sites like TikTok may be an effective health communication tool for health professionals. [ABSTRACT FROM AUTHOR]

Objectives: This study compares the follow-up rates of non-normal cervical screening samples between Denmark and Flanders (Belgium) to illuminate whether organizational differences between the health systems might affect the follow-up rates, e.g. sending of reminders in Denmark since 2012 compared to Flanders with no such system in place. Methods: The study population included 48,082 Danish women and 22,271 Flemish women who received abnormal or inadequate primary screening results from 2014 to 2016. The participants were followed for 24 months, and the timeliness and appropriateness of the recommended follow-up, according to national guidelines, were evaluated. Results: After 18 months over 90% of the Danish women had received some form of follow-up, while in Flanders, this level is achieved only for those who test positive for human papillomavirus. The analysis also revealed that 10–28% of follow-ups were performed too early, with Danish women showing the highest proportions. In both regions, general practitioners (GPs) exhibited better follow-up rates compared to gynaecologists, with gynaecologists displaying a tendency towards earlier re-testing than recommended. Conclusions: An important factor influencing the follow-up rate may be the sending of reminders in Denmark since 2012, as the follow-up rates in general were higher in this period. It is noteworthy that a reminder system is currently being implemented in Flanders and further studies on the potential effects should be studied. Additionally, the organization of the health system might influence the follow-up rate, as engaging the GP for screening in Denmark may have had a positive effect. [ABSTRACT FROM AUTHOR]

This study aims to identify the experiences of visually impaired women regarding breast and cervical cancer screening and the barriers they encounter. A mixed-method approach was employed using surveys and semi-structured interviews. The survey questionnaire investigated the participation and knowledge of visually impaired women in breast and cervical cancer screenings, while the interviews supported the survey results and provided insights into women's experiences and barriers related to breast and cervical cancer screening. The quantitative part of the research was completed with 210 visually impaired women, while the qualitative part was completed with 15 participants. It was determined that 13.3% of the participants undergo breast self-examination (BSE) monthly, 4.7% undergo clinical breast examination (CBE) annually, and 33.3% of women aged 40 and above regularly undergo mammography. Additionally, 18.1% of the participants reported having regular gynecological examinations, and 31.3% reported having regular pap smears. The interview data revealed three main themes: personal factors, environmental factors, and barriers and facilitators. Participants face difficulties such as lack of knowledge about accessing healthcare facilities, screening, and preventive measures, limited mobility, economic challenges, negative attitudes of healthcare personnel, and inadequate environmental adjustments for disabled individuals. The study has revealed that visually impaired women in Turkey may not have sufficient participation in breast and cervical cancer screenings. [ABSTRACT FROM AUTHOR]

Background & Objective: The study explores human papillomavirus (HPV), a significant cause of cervical cancer, and its potential coinfections with other viruses like human herpes virus type 4 (HHV-4) or Epstein-Barr virus (EBV) and HIV. Nextgeneration sequencing (NGS) technology is used to analyze viral content in cervical samples from Iraqi women. Materials & Methods: Eight cervical samples were collected and processed using Illumina DNA Prep on the iSeq100 System. Viral genomic DNA was isolated and libraries prepared for sequencing. Results: MetaviralSPAdes assembled contigs from each sample, which were then blasted against the NT database. HPV16, HHV4, HIV, and bovine alpha herpesvirus 5 were among the viruses identified across samples. Conclusion: Viral coinfections identified through NGS underscore their potential impact on cervical health, emphasizing NGS's diagnostic sensitivity for viral infections not typically detected by standard gynecological methods. [ABSTRACT FROM AUTHOR]

Japan is lagging in cervical cancer prevention. The effectiveness of a self‐sampling human papillomavirus (HPV) test, a possible measure to overcome this situation, has not yet been evaluated. A randomized controlled trial was performed to evaluate the effectiveness of a self‐sampling HPV test on detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and screening uptake. Women between 30 and 58 years old who did not participate in the cervical cancer screening program for ≥3 years were eligible and assigned to the intervention group (cytology or self‐sampling HPV test) or control group (cytology). Participants assigned to the intervention group were sent a self‐sampling kit according to their ordering (opt‐in strategy). A total of 7337 and 7772 women were assigned to the intervention and control groups, respectively. Screening uptake in the intervention group was significantly higher than that in the control group (20.0% vs. 6.4%; risk ratio: 3.10; 95% confidence interval [CI]: 2.82, 3.42). The compliance rate with cytology triage for HPV‐positive women was 46.8% (95% CI: 35.5%, 58.4%). CIN2+ was detected in five and four participants in the intervention and control groups, respectively; there was no difference for intention‐to‐screen analysis (risk ratio: 1.32; 95% CI: 0.36, 4.93). Self‐sampling of HPV test increased screening uptake; however, no difference was observed in the detection of CIN2+, probably due to the low compliance rate for cytology triage in HPV‐positive women. Efforts to increase cytology triage are essential to maximize precancer detections. [ABSTRACT FROM AUTHOR]

Overexpression of HPV‐oncoproteins E6 and E7 is necessary for HPV‐driven cervical carcinogenesis. Hence, these oncoproteins are promising disease‐specific biomarkers. We assessed the technical and operational characteristics of the 8‐HPV‐type OncoE6/E7 Cervical Test in different laboratories using cervical samples from HPV‐positive women living with (WLWH) and without HIV. The 8‐HPV‐type OncoE6/E7 Test (for short: "OncoE6/E7 test") was performed in 2833 HIV‐negative women and 241 WLWH attending multicentric studies in Latin America (ESTAMPA study), and in Africa (CESTA study). Oncoprotein positivity were evaluated at each testing site, according to HIV status as well as type‐specific agreement with HPV‐DNA results. A feedback questionnaire was given to the operators performing the oncoprotein test to evaluate their impression and acceptability regarding the test. The OncoE6/E7 test revealed a high positivity rate heterogeneity across all testing sites (I2: 95.8%, p <.01) with significant lower positivity in WLWH compared to HIV‐negative women (12% vs 25%, p <.01). A similar HPV‐type distribution was found between HPV DNA genotyping and oncoprotein testing except for HPV31 and 33 (moderate agreement, k = 0.57). Twenty‐one laboratory technicians were trained on oncoprotein testing. Despite operators' concerns about the time‐consuming procedure and perceived need for moderate laboratory experience, they reported the OncoE6/E7 test as easy to perform and user‐friendly for deployment in resource‐limited settings. The high positivity rate variability found across studies and subjectivity in test outcome interpretation could potentially results in oncoprotein false positive/negative, and thus the need for further refinements before implementation of the oncoprotein testing in screen‐triage‐and‐treat approaches is warranted. [ABSTRACT FROM AUTHOR]

Background: Cervical Cancer (CC) is the fourth most frequent malignancy worldwide among females with significant death rates. It ranks as the 8th most frequent cancer in Saudi female. CC is preventable, with likelihood of full treatment by early detection, because of its long pre-invasive period. Lack of awareness and practice on CC prevention and screening increase the risk of disease. Objective: to examine knowledge, attitude, and practice on CC prevention among Saudi female university students. Methods: A facility-based cross-sectional study with a convenience sample included 594 female university students studying at health and non-health colleges of Prince Sattam bin Abdulaziz University in Al-Kharj City, Saudi Arabia. All female students were asked to complete an online questionnaire on knowledge, attitude, and practice on CC prevention. Results: A total of 594 respondents to the questionnaire, 88.7% of them had unsatisfactory knowledge about CC. Out of a total of 27 points, students' knowledge mean score was 9.3 ± 6.4. Conversely the majority of students (94.4%) had positive attitude toward CC; the mean attitude score was 34.52 ± 5.04 out of 45. Regarding students practice, less than 7% of students were vaccinated against HPV and only 3.7% were screened for cancer cervix. Married females, health colleges students, and high attitude score were significant predictors for the students' knowledge about cancer cervix (P < 0.05). Conclusion: Majority of the respondents displayed lack of knowledge; however, they had a positive attitude toward CC. Very alarmingly, almost all of students had inadequate practice regarding CC prevention. So, the study recommends developing and implementing educational programs and strategies for female university students to improve their knowledge and practice related to cervix cancer. Results of this study provide evidence that can help in formulating effective awareness strategies and educational programs for women that would help in CC prevention. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Oral cancer screening requires analysis capable of detecting changes preceding the clinical manifestation. Oral cytopathology studies as an oral cancer screening have shown promising results. This study aims to evaluate the use of cytopathology in a quali‐quantitative analysis using Papanicoloau staining.Four experimental groups were evaluated: control (CG), exposed to carcinogens (EG), potentially malignant disorder with and without epithelial dysplasia (D‐OPMDG and ND‐OPMDG) and oral squamous cell carcinoma (OSCCG). Oral smears were collected using a Cytobrush® and conventional exfoliative cytology.Oral Papanicolaou smears from 143 individuals were analysed in 8100 images. Qualitatively, non‐lesional groups exhibited minimal suspected cases (20% in CG and 5% in EG), in the OPMD groups the ability to identify altered cells was low (40% in D‐OPMDG and 0% in ND‐OPMDG). Conversely, a notable 100% accuracy was achieved in the OSCCG. Quantitatively, a higher percentage of anucleated and a lower percentage of intermediate cells were observed in the OPMDG; a higher proportion of parabasal/suspicious cells was observed in OSCCG. The optimal threshold for improved accuracy in detecting suspected malignancies occurs when the count of parabasal/suspicious cells exceeds 8/100 cells examined. Cytomorphometric analysis revealed a higher nucleus/cytoplasm ratio (N/C) in OSCCG, with a best cutoff point indicating enhanced accuracy in discerning suspected malignancies when exceeding 17% of cells exhibiting this elevated ratio.It is possible to suggest updates in cytomorphometric and quantitative analysis in the modified Bethesda system for the oral cavity including objective criteria in the risk classification, therefore improving oral cancer screening. [ABSTRACT FROM AUTHOR]

Objective: To describe the prevalence of cervical intraepithelial neoplasia (CIN), high-risk human papillomavirus (hrHPV) infection, and cervical cancer in a high-risk, underscreened incarcerated population and to evaluate the performance of current cervical cancer screening options to detect cervical precancer (CIN 2/3) in this population. Study Design: Deidentified data were obtained from all cytological, hrHPV DNA, and histopathological testing of cervical biopsies performed on people incarcerated at the North Carolina Correctional Institute for Women between January 1, 2013, and December 31, 2020. These were linked to corresponding demographic data. The proportions of histopathological diagnoses of CIN2+ and CIN3+ immediately preceded by abnormal cytology testing or hrHPV testing were determined, and prevalence differences and 95% confidence intervals were calculated. Results: A total of 15,319 individuals incarcerated at the North Carolina Correctional Institute for Women had at least one cytology result during 2013–2020. Of these, 2,829 (18%) had abnormal cervical cytology, and 3,724 (24.3%) had positive hrHPV testing. The detection of CIN2+ was 95.9% by preceding abnormal cervical cytology, 89.9% by preceding positive hrHPV testing (p = 0.03), and 96.5% by preceding positive co-testing. The detection rate of CIN3+ was 96.6% by preceding abnormal cervical cytology, 90.8% by preceding positive hrHPV testing (p = 0.12), and 96.6% by positive co-testing. Conclusion: In our sample, primary cytology and co-testing detected CIN2+ at higher rates when compared with primary hrHPV testing. This reinforces that incarcerated populations do not fall into average-risk populations for which current cervical cancer screening options are designed, which should be considered when performing screening in this population. [ABSTRACT FROM AUTHOR]

Background: We assessed experiences of human papillomavirus (HPV) vaginal self‐sampling and future screening preferences in an ethnically and socio‐economically diverse group of women overdue for cervical screening. Setting and Participants: A postal questionnaire was embedded in the YouScreen self‐sampling trial in England: 32.5% (2712/8338) of kit completers returned the survey. Kit non‐completers were encouraged to return a questionnaire, but no responses were received. Participants were ethnically diverse (40.3% came from ethnic minority backgrounds), and 59.1% came from the two most deprived quintiles. Differences in confidence in kit completion, trust in the test results and intention to attend a follow‐up test if HPV‐positive were evaluated using Pearson's χ2 analyses. Binary logistic regression models explored predictors of a future screening choice and preferences for urine versus vaginal self‐sampling. Results: Most kit‐completers reported high confidence in self‐sampling (82.6%) and high trust in the results (79.9%), but experiences varied by ethnicity and screening status. Most free‐text comments were positive but some reported difficulties using the device, pain or discomfort. Most women would opt for self‐sampling in the future (71.3% vs. 10.4% for a clinician‐taken test) and it was more often preferred by ethnic minority groups, overdue screeners and never attenders. Urine self‐tests were preferred to vaginal tests (41.9% vs. 15.4%), especially among women from Asian, Black or Other Ethnic backgrounds. Conclusions: Kit‐completers were confident, found the test easy to complete, and trusted the self‐sample results. However, experiences varied by ethnic group and some women highlighted difficulties with the kit. Most women would prefer self‐sampling in the future, but it was not a universal preference, so offering a choice will be important. Patient or Public Contribution: We did not have direct patient and public involvement and engagement (PPIE) in the questionnaire design. However, patients and public representatives did input into the design of the YouScreen trial and reviewed the wider study materials (e.g. participant information sheet). Trial Registration: This questionnaire study was embedded in the YouScreen trial. The protocol for the YouScreen trial is available at https://www.isrctn.com/ISRCTN12759467. The National Institute for Health Research 43 Clinical Research Network (NIHR CRN) Central Portfolio Management System (CPMS) ID is 4441934. [ABSTRACT FROM AUTHOR]

Recent advances in molecular analyses of ovarian cancer have revealed a wealth of promising tumour‐specific biomarkers, including protein, DNA mutations and methylation; however, reliably detecting such alterations at satisfactorily high sensitivity and specificity through low‐cost methods remains challenging, especially in early‐stage diseases. Here we present PapDREAM, a new approach that enables detection of rare, ovarian‐cancer‐specific aberrations of DNA methylation from routinely‐collected cervical Pap specimens. The PapDREAM approach employs a microfluidic platform that performs highly parallelized digital high‐resolution melt to analyze locus‐specific DNA methylation patterns on a molecule‐by‐molecule basis at or near single CpG‐site resolution at a fraction (< 1/10th) of the cost of next‐generation sequencing techniques. We demonstrate the feasibility of the platform by assessing intermolecular heterogeneity of DNA methylation in a panel of methylation biomarker loci using DNA derived from Pap specimens obtained from a cohort of 43 women, including 18 cases with ovarian cancer and 25 cancer‐free controls. PapDREAM leverages systematic multidimensional bioinformatic analyses of locus‐specific methylation heterogeneity to improve upon Pap‐specimen‐based detection of ovarian cancer, demonstrating a clinical sensitivity of 50% at 99% specificity in detecting ovarian cancer cases with an area under the receiver operator curve of 0.90. We then establish a logistic regression model that could be used to identify high‐risk patients for subsequent clinical follow‐up and monitoring. The results of this study support the utility of PapDREAM as a simple, low‐cost screening method with the potential to integrate with existing clinical workflows for early detection of ovarian cancer. Key points: We present a microfluidic platform for detection and analysis of rare, heterogeneously methylated DNA within Pap specimens towards detection of ovarian cancer.The platform achieves high sensitivity (fractions <0.00005%) at a suitably low cost (∼$25) for routine screening applications.Furthermore, it provides molecule‐by‐molecule quantitative analysis to facilitate further study on the effect of heterogeneous methylation on cancer development. [ABSTRACT FROM AUTHOR]

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Background: The United States (U.S.) has a growing population of Brazilian immigrant women. However, limited research has explored Pap tests and human papillomavirus (HPV) vaccination among this population. Methods: Participants completed an online survey between July—August 2020. Bivariate analyses examined associations between healthcare-related variables (e.g., insurance, having a primary care provider) and demographics (e.g., age, education, income, marital status, years living in the U.S., primary language spoken at home) with 1) Pap test recency (within the past 3 years) and 2) HPV vaccination (0 doses vs. 1 + doses). Variables significant at p < 0.10 in bivariate analyses were included in multivariable logistic regression models examining Pap test recency and HPV vaccination. Results: The study found that 83.7% of the sample had a Pap test in the past three years. Women who did not know their household income were less likely to be than women who reported a household income of < $25,000 (adjusted OR [aOR] = 0.34, 95% CI: 0.12, 0.95). Women who had seen a healthcare provider in the past year were more likely to have had a Pap test within the last three years than those who had not seen a provider in the past year ([aOR] = 2.43, 95% CI: 1.32, 4.47). Regarding HPV vaccination, 30.3% of respondents reported receiving one or more doses of the HPV vaccine. The multivariable logic regression models determined that women aged 27 -45 (aOR = 0.35, 95% CI: 0.18, 0.67) were less likely than women aged 18–26 to have been vaccinated against HPV). and that women with a PCP were more likely to be vaccinated than those without a PCP (aOR = 2.47. 95% CI:1.30, 4.59). Conclusion: This study found that Brazilian immigrant women in the youngest age groups (21 – 29) for Pap test, 18- 26 for HPV vaccination) had somewhat better rates of Pap screening and HPV vaccination than the general U.S. population. This study adds new information about cervical cancer prevention and control behaviors among Brazilian immigrant women. [ABSTRACT FROM AUTHOR]

Machine learning-based systems have become instrumental in augmenting global efforts to combat cervical cancer. A burgeoning area of research focuses on leveraging artificial intelligence to enhance the cervical screening process, primarily through the exhaustive examination of Pap smears, traditionally reliant on the meticulous and labor-intensive analysis conducted by specialized experts. Despite the existence of some comprehensive and readily accessible datasets, the field is presently constrained by the limited volume of publicly available images and smears. As a remedy, our work unveils APACC (Annotated PAp cell images and smear slices for Cell Classification), a comprehensive dataset designed to bridge this gap. The APACC dataset features a remarkable array of images crucial for advancing research in this field. It comprises 103,675 annotated cell images, carefully extracted from 107 whole smears, which are further divided into 21,371 sub-regions for a more refined analysis. This dataset includes a vast number of cell images from conventional Pap smears and their specific locations on each smear, offering a valuable resource for in-depth investigation and study. [ABSTRACT FROM AUTHOR]

Cervical cancer (CC) is one of the deadliest gynecological cancers worldwide. Human papillomavirus is the main etiological agent responsible for the initiation and development of most CC cases. The standard method utilized for CC screening in the global population is the cytological Pap smear test. Despite its effective validity in detecting precancerous lesions and its response to layer stages of this disease, greater screening and diagnostic reliability are needed, as well as an improvement in specificity and sensitivity. In this context, the use of liquid biopsies, like blood, for the isolation of circulating tumor DNA (ctDNA) in CC screening, diagnosis, prognosis, and surveillance could fill the gaps that still exist. In the present review, we aim to study the literature in order to collect knowledge on blood-based liquid biopsy based on descriptions of its precious molecular content and its utilization as a potential tool for CC patients' management. We will mainly focus on the important role of the novel ctDNA and the unique possibilities to additionally use HPV-ctDNA in CC at various stages of clinical application. [ABSTRACT FROM AUTHOR]

Biomedical imaging devices, in general, have been made and used a lot lately to examine the insides of the body during diagnostic and analytic procedures. Biomedical imaging gives accurate information about metabolites, which can be used to find and classify diseases because it is not invasive. For the study of cervical cancer (CC), the pap smear is a crucial type of biological imaging. CC is a crucial reason to enhance the rate of women's mortalities. Proper screening of pap smear images is critical for assisting in the early detection and analysis of CC. Computer‐aided systems for cancerous cell recognition need well established artificial intelligence (AI) methods. In this study, we introduce an automated Cervical Precancerous Lesion Classification using Quantum Invasive Weed Optimization with Deep Learning (CPLC‐QIWODL) on biomedical pap smear images. The presented CPLC‐QIWODL technique examines the pap smear images for cervical cancer classification. To do so, the presented CPLC‐QIWODL technique pre‐processes the biomedical images using a Gabor filtering (GF) approach. Moreover, the CPLC‐QIWODL technique uses a deep convolutional neural network‐based SqueezeNet system for feature extraction. Furthermore, the hyperparameter tuning of the SqueezeNet methodology takes place using the QIWO technique, showing the novelty of the work. Finally, to classify CC, the deep variational autoencoder (DVAE) model is applied. The experimental result analysis of the CPLC‐QIWODL technique is tested using a benchmark medical image database. Extensive comparative results demonstrated the enhanced outcomes of the CPLC‐QIWODL technique over other existing algorithms, with a maximum accuracy of 99.07%. [ABSTRACT FROM AUTHOR]

This narrative review delves into cervical health during pregnancy, specifically focusing on the frequency and associated risk factors of abnormal Pap smears conducted in the 1st trimester. Pregnancy is a transformative journey for women, characterized by profound physiological changes, yet the performance and implications of Pap smears during this crucial period remain underexplored in the literature. In pursuit of comprehensive and reliable insights, this review strictly adheres to ethical guidelines, drawing exclusively from published, peer-reviewed sources while upholding the privacy and confidentiality of human subjects involved in the studies. Employing a qualitative data analysis and interpretation approach, the review presents results descriptively and thematically. Through this systematic approach, our review offers a holistic overview of abnormal Pap smears in the 1st trimester of pregnancy while identifying the factors associated with their occurrence. This synthesis of existing knowledge ensures the relevance and reliability of our findings, effectively addressing the research question. Understanding the implications of abnormal Pap smear results during the initial stages of pregnancy is paramount for maternal and fetal wellbeing. As such, this review contributes to bridging the gap in the literature by shedding light on this relatively understudied intersection of cervical health and pregnancy. Doing so provides valuable insights that can guide healthcare professionals in offering informed and appropriate care to pregnant women, ultimately promoting the health and safety of both mothers and their unborn children. [ABSTRACT FROM AUTHOR]

Objectives: The main risk factor involved in CIN2+ recurrence after treatment is the HPV persistent infection. The dysregulation of the immune system permits only HR-HPVs to become persistent infections, to promote cancer development, and to increase the risk of recurrence after treatment. Therefore, there is a shift to a Th2-type cytokine pattern during the carcinogenesis pathway; for this reason, the neutrophil-lymphocytes ratio (NLR) could be a marker of this immunological change. The study aimed to analyse the predictive role of NLR in the recurrence of high-grade CIN (CIN2+) after excisional treatment in a real-world life setting of patients treated for CIN2+. Design: This study wascross-sectional study. Participants/Materials, Setting, Methods: We examined a retrospective database of 444 patients, who attended the colposcopy service of our department from 2011 to 2020 due to an abnormal screening Pap smear, and we compared the clinical characteristics to NLR performed at the time of diagnosis. All analysed patients were treated according to an established protocol (colposcopy every 6 months for the first 2 years and every year for over 3 years) and HPV-DNA test and cervical biopsy were performed at entry and the end of follow-up. All patients underwent a blood sample examination, including complete white blood cell counts and collecting neutrophil and lymphocyte values expressed as 103/mL. Results: The sensitivity (SE) and specificity (SP) of the NLR cut-off point of 1.34 for the diagnosis of CIN2+ recurrence were 0.76 and 0.67, respectively. We found that CIN2+ recurrences were significantly higher in patients with NLR <1.34 (3.7% vs. 0.6%, p = 0.033) and the 5-year recurrence-free survival was higher in patients with NLR ≥1.34 (97% vs. 93%, p = 0.030). Limitations: Firstly, the retrospective analysis and low incidence of recurrence may limit the conclusions. Second, for the retrospective design of the study, we did not take into consideration the patient's comorbidities and habits (smoking) that may influence the NLR. On the other hand, the median duration of follow-up in our study was 26 months (IQR: 22–31), which fully reflects the incidence of recurrences. Conclusions: It is well known that CIN2+ lesions are sustained by deregulation of the immune system caused by persistent HPV infection, which may lead to cervical cancer. Among the actors underlying dysregulation of immunity, lymphocytes are involved in the permission of persistent infection and for this reason, NRL could be a reliable and cost-effective biomarker in predicting the risk of recurrence, especially for high-grade cervical lesions. [ABSTRACT FROM AUTHOR]

Cervical cancer ranks among the leading causes of mortality in women worldwide, underscoring the critical need for early detection to ensure patient survival. While the Pap smear test is widely used, its effectiveness is hampered by the inherent subjectivity of cytological analysis, impacting its sensitivity and specificity. This study introduces an innovative methodology for detecting and tracking precursor cervical cancer cells using SIFT descriptors in video sequences captured with mobile devices. More than one hundred digital images were analyzed from Papanicolaou smears provided by the State Public Health Laboratory of Michoacán, Mexico, along with over 1800 unique examples of cervical cancer precursor cells. SIFT descriptors enabled real-time correspondence of precursor cells, yielding results demonstrating 98.34% accuracy, 98.3% precision, 98.2% recovery rate, and an F-measure of 98.05%. These methods were meticulously optimized for real-time analysis, showcasing significant potential to enhance the accuracy and efficiency of the Pap smear test in early cervical cancer detection. [ABSTRACT FROM AUTHOR]

Introduction: Increasing family planning xutilization in low-income countries to improve health outcomes of women and children is a global priority. The Federated States of Micronesia (FSM) has poor maternal child health outcomes; therefore, this study aimed to examine family planning utilization in Pohnpei State, FSM. Methods: This cross-sectional study sought to characterize family planning utilization in adult women of reproductive age and high school age adolescents in Pohnpei using representative survey data collected in 2019 (N = 570 and N = 1726, respectively). Chi-square tests were used to determine significant factors associated with family planning utilization. Results: Among adult women of reproductive age (18–49 years old) not trying to get pregnant, 31.6% reported using contraception during last intercourse. Contraceptive use was significantly lower among younger women (18–24 years old) (21.7%, p = 0.021), unmarried women (18.6%, p < 0.001), those without health insurance (28.7%, p = 0.030), those who have never had a pap smear (20.5%, p < 0.001), and those who have never been pregnant (14.5%, p < 0.002). Among adolescents who reported being sexually active, 28.5% reported using any contraception at last intercourse and 22.6% reported using a condom at last intercourse. Condom use among sexually active adolescents was lowest among 12th graders (13.5%, p < 0.001) and girls (16.8%, p = 0.004). Conclusions: Our findings suggest that young, unmarried, never pregnant women face an unmet need for family planning. Additionally, women with lower access to and use of healthcare services have lower use of family planning. Significance: Data published on reproductive health in FSM have been limited. This study points to several possible interventions to increase family planning utilization in Pohnpei, including the development of a comprehensive school-based health education curriculum, increasing access to and promotion of well-woman visits, and increasing use of long-acting reversible contraception. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objective: The introduction of cytological screening with the Papanicolau smear significantly reduced cervical cancer mortality. However, Pap smear examination can be challenging, being based on the observer ability to decode different cytological and architectural features. This study aims to evaluate the malignancy rate of AGC (atypical glandular cells) category, investigating the relationships between cytological and histological diagnosis. Methods: Eighty‐nine patients, diagnosed as AGC at cytological evaluation and followed up with biopsy or surgical procedure at Policlinico Gemelli Hospital, Rome, Italy, were included in the study. The cytopathological architectural (feathering, rosette formation, overlapping, loss of polarity, papillary formation, three‐dimensional formation) and nuclear (N/C ratio, nuclear enlargement and hyperchromasia, mitoses, nuclei irregularity, evident nucleoli) features of AGC were evaluated. Statistical analyses were performed to assess cyto‐histological correlation and determine the relevance of architectural and nuclear features in the diagnosis of malignancy. Results: Of the 89 AGC patients, 48 cases (53.93%) were diagnosed as AGC‐NOS and 41 (46.07%) were diagnosed as AGC‐FN, according to the Bethesda classification system. The follow‐up biopsies or surgical resections revealed malignancy in 46 patients (51.69%). The rates of malignancy for AGC‐NOS and AGC‐FN were 35.41% and 70.73% respectively. Furthermore, analysing cytopathological features, we found that both architectural and nuclear criteria were statistically significant (p < 0.05). Only overlapping, nuclear irregularity and increased N/C ratio were not found to be statistically significant for detecting malignancy. Conclusions: Cytological diagnosis of glandular lesions remains a valid tool, when appropriate clinical correlation and expert evaluation are available. [ABSTRACT FROM AUTHOR]

This article discusses the detection of primary peritoneal low-grade serous carcinoma in cervical smears. The study reports three cases of asymptomatic women who had abnormal glandular cells in routine Pap smears. Further investigations revealed raised serum CA125 levels and mild ascitic fluid collection in the pelvis. The patients underwent exploratory laparotomy, which confirmed the presence of low-grade serous carcinoma. The article emphasizes the diagnostic value of cellblock immunocytochemistry in confirming the diagnosis. The document also discusses the presence of low-grade serous papillary cell clusters with psammoma bodies in the tubal lumen, which are characteristic of primary peritoneal serous tumors. The document highlights the importance of considering various factors to distinguish primary peritoneal serous carcinomas from other types of serous tumors. The shedding of peritoneal tumor cells into the uterine cavity is proposed as a possible explanation for abnormal Pap tests. [Extracted from the article]

Background: Human papillomavirus (HPV) is a well-established causal agent of cervical cancer, and the first group of viruses to have been acknowledged to prompt carcinogenesis. They are linked with cancers of the uterine cervix, anogenital tumours, and head and neck malignancies. Cervical cancer is by far the most common HPV-related disease, with about 99% of cervical cancer cases caused by persistent genital high-risk (HR) HPVs, especially types 16 and 18. Methodology: A hospital-based descriptive analytical study of 300 consenting HIV-infected women on antiretroviral therapy (ART), selected from the three senatorial districts of Plateau State, Nigeria, was conducted over a period of 24 months (November 2018 to November 2020). Blood and cervical specimens were collected from each participant. HIV status was confirmed by standard rapid test on serum sample, CD4+ cell count was determined by flow cytometry and HIV viral load estimation was done by GeneXpert nucleic acid amplification technique. Cervical cytology was performed by Papanicolaou (Pap smear) on the cervical specimen and reported according to the 2004 Bethesda system classification. HPV antigen was first detected on the cervical specimen using ELISA, and samples positive for HPV antigen were then subjected to multiplex PCR amplification of E6 and E7 genes to detect HR-HPV (16 and 18) and other HPV types. Standard questionnaires were administered to obtain information on biodata, risk factors and clinical presentations. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 26.0, and significance level was determined at p<0.05. Results: Of the 300 participants, 84 were positive for HPV of any type, giving an overall prevalence of HPV infection of 28.0%. The prevalence of HPV-16 and HPV-18 types were 5.0% (15/300) and 5.3% (16/300) respectively. Cytological analysis showed that 36.3% (109/300) of the participants had cervical abnormalities ranging from low-grade to high grade squamous intraepithelial lesions and cervical intraepithelial neoplasia. HPV prevalence of 46.8% (51/109) in women with cervical abnormalities was significantly higher than 17.3% (33/191) in women with normal cervical cytology (OR 4.2, p<0.0001). HPV prevalence was higher in women with AG-US (100.0%), ASC-US (78.8%), AC-US (66.7%), ASC-H (33.3%), HSIL (33.3%), HSIL (23.8%), and LSIL (41.2%) compared with women with normal cervical cytology (p<0.001). Aside educational level (p=0.03), none of the analyzed sociodemographic characteristics or risk factors for cervical cancer was significantly associated with HPV infection in the study (p>0.05). Conclusion: This study showed high prevalence of HPV infections among HIV-infected patients on ART in Plateau State, north-central Nigeria including detection of high-risk HPV types 16 and 18, which are major risk factors for progression of cervical intraepithelial neoplasia to cervical cancer. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer is the fourth most common cancer in women worldwide and the most common cancer affecting females in many developing countries. Conventional Pap smear is the most widely used method with sensitivity of 51% and specificity of 98%. Other screening methods are liquid based cytology, pap net, auto pap, auto screen, visual inspection with acetic acid and Lugols Iodine, HPV DNA testing Colposcopy, Cervicography, Speculoscopy, and polar probes. Portable colposcope is an instrument which overcomes the disadvantages of standard colposcope. The advantages of portable colposcope are low cost, portability and can be used in rural setting for mass screening because of its portability . The aim of the present study is to assess the efficacy of portable colposcope in assessing women with unhealthy cervix .Methodology: Prospective interventional study conducted for 1 year .250 patients who presented with unhealthy cervix and consented for the study are randomly selected. Results: Sensitivity and specificity of pap smear in the present study were 72% and 95% respectively. Sensitivity and specificity of colposcopy were 84.4% and 92.48% respectively. Diagnostic accuracy of pap smear was 88.4%. Diagnostic accuracy of colposcopy was 91.2% in the present study. Conclusion: The diagnostic accuracy of pap smear and colposcopy were good in the present study. The present study finds that colposcopy is safe and effective and reasonably accepted method of investigation for evaluating unhealthy cervices. [ABSTRACT FROM AUTHOR]

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

Why you should read this article: • To understand that women with mobility impairments have lower rates of uptake of cervical screening and a higher incidence of cervical cancer than those without mobility impairments • To recognise the challenges of accessing cervical screening attendance for women with mobility impairments • To acknowledge the important role of the nurse in improving uptake of cervical screening for women with mobility impairments. Cervical cancer, the fourth most frequently diagnosed malignancy worldwide, is largely preventable through cervical screening and human papillomavirus vaccination programmes. Despite this, there is a higher incidence of cervical cancer in women with lower limb mobility impairments, and lower rates of cervical screening uptake, compared with those without such impairments. This article reports the findings of an integrative literature review that explored the challenges experienced by women with lower limb mobility impairments in accessing cervical screening services and identified strategies used to overcome these challenges. Challenges included environmental barriers, time constraints, inadequate education of healthcare professionals and lack of awareness of the need for cervical screening for this patient population. Nurses, as the healthcare professionals who most often carry out cervical screening, must take the lead in addressing these challenges. The word ‘women’ is used in this article to reflect the cohorts in the studies reviewed and the terminology used in the literature search. [ABSTRACT FROM AUTHOR]

Background & Objective: Immunosuppression, HPV persistence, and smoking are the main-related risk factors of Cervical Intraepithelial Neoplasia (CIN) recurrence. However, age as a basic factor may be a main factor related to CIN recurrence. Therefore, our study aimed to detect the potential role of women's age in CIN recurrence. Materials & Methods: This cross-sectional study was conducted on 329 patients who underwent conization in the gynecology-oncology clinics of Arash and Imam Khomeini hospitals affiliated with Tehran University of Medical Sciences between March 2016 and March 2021. Results: Totally, 329 cases were enrolled in the study. Most women were in their thirties. CIN recurrence was about 10.0% (32 cases). The CIN recurrence rate was 8.9% in women younger than 30, 10.2% in 30-40, 11.3% in 40-50, and 5.6% in 50–60 decades. There was no significant (p-value=0.802) difference in recurrence rate among age groups. There was a significant (p-value=0.023) difference in the frequency of endocervical involvement regarding age category, women aged 40 to 50 had the most frequent marginal involvement with 26.8%, while there was no significant (p-value=0.802) difference in frequency of marginal involvement regards age category. Conclusion: CIN cases with age higher than 40 years need to have more caution and tight follow-up visit after conization. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer is associated with HPV infection. In India, it is 2nd leading cause of female cancer taking a huge toll on human life. This study explores the socio-demographic and clinical profile of cervical cancer patients at a tertiary care hospital in Kolkata. Methods: A cross-sectional study was undertaken for 2 months with 41 cervical cancer patients using a questionnaire for socio-demographic details, gynecological history, and details of the cancer and its treatment. Results: The mean age of the respondents was 54.80 ± 2.17 years, with majority belonging to lower socio-economic status. 69.44% presented with post-menopausal per vaginal bleeding and 45.45% of the patients were in stage IIB. 51.85% had symptoms for 2-6 months before visiting a doctor. Conclusions: Delay in seeking medical help has significant association with per capita monthly family income (p=0.004). Cervical cancer is a major public health problem in India majority of patients belonging to lower socioeconomic status. [ABSTRACT FROM AUTHOR]

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Abstract Background The United States (U.S.) has a growing population of Brazilian immigrant women. However, limited research has explored Pap tests and human papillomavirus (HPV) vaccination among this population. Methods Participants completed an online survey between July—August 2020. Bivariate analyses examined associations between healthcare-related variables (e.g., insurance, having a primary care provider) and demographics (e.g., age, education, income, marital status, years living in the U.S., primary language spoken at home) with 1) Pap test recency (within the past 3 years) and 2) HPV vaccination (0 doses vs. 1 + doses). Variables significant at p

Abstract Background Despite the availability of effective vaccines, human papillomavirus (HPV) vaccine uptake remains low in most resource-limited settings including Nigeria. Mobile health technology (mHealth) has the potential to empower patients to manage their health, reduce health disparities, and enhance the uptake of HPV vaccination. Aim The “mHealth-HPVac” study will assess the effects of mHealth using short text messages on the uptake of HPV vaccination among mothers of unvaccinated girls aged 9–14 years and also determine the factors influencing the uptake of HPV vaccination among these mothers. Methods This protocol highlights a randomised controlled trial involving women aged 25–65 years who will be enrolled on attendance for routine care at the General Outpatient clinics of Lagos University Teaching Hospital, Lagos, Nigeria between July and December 2024. At baseline, n = 123 women will be randomised to either a short text message or usual care (control) arm. The primary outcome is vaccination of the participant’s school-age girl(s) at any time during the 6 months of follow-up. The associations between any two groups of continuous variables will be assessed using the independent sample t-test for normally distributed data, or the Mann-Whitney U test for skewed data. For two groups of categorical variables, the Chi-square (X2) test or Fisher’s exact test will be used, as appropriate. Using the multivariable binary logistic regression model, we will examine the effects of all relevant sociodemographic and clinical variables on HPV vaccination uptake among mothers of unvaccinated but vaccine-eligible school-age girls. Statistical significance will be reported as P

Abstract Background Cervical cancer is the fourth most common cancer among women worldwide, both for incidence and mortality. Prevention relies on screening with a Pap test to detect precancerous lesions, which can then be treated. Access to this screening is currently both improvable and inequitable. Pregnancy may be an ideal moment for women to catch up on their overdue cervical cancer screening. In the general population, women's risk of not being screened is associated with their place of birth and other social factors; this may be true as well among pregnant women. Our objective was to study the association between women's place of birth and their failure to catch up with this screening during pregnancy. Methods The 2016 French National Perinatal Survey included 13,147 women who gave birth after 21 weeks of gestation. The association between their place of birth and failure to catch up on this screening (defined by the absence of a Pap test during pregnancy for women overdue for it) was adjusted for age, parity, education level, health insurance, and when they began prenatal care with logistic regression models. Results Among the women for whom screening was then recommended, 49% were not up to date at the start of pregnancy, and of these, 53% were not caught up before delivery. After adjustment for other risk factors, maternal place of birth was not associated with a higher risk of failure to catch up with this screening during pregnancy. However, factors identified as associated with this risk included a low education level and late start of prenatal care. Conclusion About half of women overdue for cervical cancer screening did not catch up with it during their pregnancy. Professionals should pay special attention to women with lower education levels and late initiation of prenatal care, who constitute a group at high risk of not catching up on this screening during pregnancy.

Background: Despite the availability of effective vaccines, human papillomavirus (HPV) vaccine uptake remains low in most resource-limited settings including Nigeria. Mobile health technology (mHealth) has the potential to empower patients to manage their health, reduce health disparities, and enhance the uptake of HPV vaccination. Aim: The "mHealth-HPVac" study will assess the effects of mHealth using short text messages on the uptake of HPV vaccination among mothers of unvaccinated girls aged 9–14 years and also determine the factors influencing the uptake of HPV vaccination among these mothers. Methods: This protocol highlights a randomised controlled trial involving women aged 25–65 years who will be enrolled on attendance for routine care at the General Outpatient clinics of Lagos University Teaching Hospital, Lagos, Nigeria between July and December 2024. At baseline, n = 123 women will be randomised to either a short text message or usual care (control) arm. The primary outcome is vaccination of the participant's school-age girl(s) at any time during the 6 months of follow-up. The associations between any two groups of continuous variables will be assessed using the independent sample t-test for normally distributed data, or the Mann-Whitney U test for skewed data. For two groups of categorical variables, the Chi-square (X2) test or Fisher's exact test will be used, as appropriate. Using the multivariable binary logistic regression model, we will examine the effects of all relevant sociodemographic and clinical variables on HPV vaccination uptake among mothers of unvaccinated but vaccine-eligible school-age girls. Statistical significance will be reported as P < 0.05. Discussion: The mHealth-Cervix study will evaluate the impact of mobile technologies on HPV vaccination uptake among mothers of unvaccinated but vaccine-eligible school-age girls in Lagos, Nigeria as a way of contributing to the reduction in the wide disparities in cervical cancer incidence through primary prevention facilitated using health promotion to improve HPV vaccination uptake. Registration: PACTR202406727470443 (6th June 2024). [ABSTRACT FROM AUTHOR]

Background: Cervical cancer (CxCa), although preventable, is still among the most prevalent cancers in women. Mortality from this cancer is high, especially in low-income countries where preventive strategies are often lacking. We studied the knowledge, attitudes, and practices regarding CxCa among Yemeni women. Methods: This cross-sectional study was conducted in 2019 among 399 women in five major hospitals in Sanaa, the capital city of Yemen. Data were collected through face-to-face interviews using structured questionnaires. We used logistic regression models to analyze the likelihood of hearing about CxCa, believing that CxCa is treatable and preventable, awareness of the Pap smear test, and ever having this test, in relation to participant's age, education level, working outside the household, and family history of CxCa. Results: Only 66.7% of the women had heard of CxCa. Women with higher education, working outside the household, and with a family history of CxCa were more likely to be aware of CxCa. Working outside the household was the only variable related to a higher likelihood of knowing that CxCa is a treatable and preventable. Furthermore, women with a family history of CxCa were more likely to have knowledge about Pap smear test and were more likely to have Pap smear test in the past. Conclusion: This study identified a low awareness of CxCa and its prevention among Yemeni women. In order to reduce the burden of CxCa in Yemen and save women's lives, it is necessary to raise women's awareness of this disease, especially among those with lower education and those not involved in work outside their homes. [ABSTRACT FROM AUTHOR]

Background: Colposcopy has a key role to play in see-and-treat programs for premalignant cervical lesions. The aim of the study/was to observe cervical changes with a colposcope using the Swede scoring system in fertile age group women using various contraceptives: conventional methods (barrier methods, coitus interruptus), oral contraceptives (OCPs), copper-T and bilateral tubectomy. The aim of the study was to observe and evaluate the colposcopic findings using the Swede scoring system for the diagnosis of premalignant/malignant lesions in reproductive age group women using various contraceptives. Methods: This was a prospective observational study, conducted among 200 women of reproductive age group using various contraceptives in a tertiary care institute in North India. PAP smear, direct visual examination, VIA (Visual Inspection with Acetic Acid) examination, colposcopic examination, and (biopsy if indicated) were done. The data were collected, and analysis was done using Microsoft Excel Office Software 2019 version 19.11 and epi info (CDC Atlanta) 7.23.1. Statistical analysis was done using percentages, mean, mode, median, standard deviation, Chi-square, Fisher's Test, and Anova Test. Results: We found positive PAP (Papanicolaou test) smears in 61.50%, positive VIA examination in 9%, and positive findings in colposcopic examination in 28.50%, Swede score of 0–3 in 100% (0–91%, 1–2%, 2–6%, and 3–1%) and positive biopsy in 9% subjects. Malignant findings were observed in 1.00% of PAP smears. Colposcopic findings were CIN 1 (cervical intraepithelial neoplasia 1) in 8.5% and CIN 2 in 0.5% subjects. Swede score was zero in 91%, 1 in 2%, 2 in 6%, and 3 in 1% of subjects. HPE (histopathological examination) was chronic cervicitis in 8.50% and mild dysplasia/CIN 1 in 0.5%. No significant statistical associations between contraceptive choice and false-positive test results or disease prevalence was found in any group except Cu-T users p = 0.0184 (especially for CIN 2; p = 0.0109 and CIN 1 more in all groups than Cu-T users). Colposcopy had sensitivity 100%, specificity 91.46% (0/0 = 0%) PPV = 5.56%, NPV = 100%, Accuracy = 91.5% for detecting mild dysplasia/CIN-non-significant (p = 0.055). Our study had mainly low-grade lesions with 100% NPV. With increase in Swede Score, sensitivity increases but at the expense of specificity but it was statistically non-significant (p = 0.055). Conclusions: Our study may guide the rational use of colposcopy with Swede scoring for see-and-treat lesions, which is easy and with a low learning curve, as a tool for diagnosis but only in cases where indicated like unhealthy cervix because of the high rate of false-positive results. In low-grade lesions, it is highly useful to rule out the disease. [ABSTRACT FROM AUTHOR]

We have been encouraging practicing gynecologists to adopt molecular diagnostics tests, PCR, and cancer biomarkers, as alternatives enabled by these platforms, to traditional Papanicolaou and colposcopy tests, respectively. An aliquot of liquid-based cytology was used for the molecular test [high-risk HPV types, (HR HPV)], another for the PAP test, and one more for p16/Ki67 dual-stain cytology. A total of 4499 laboratory samples were evaluated, and we found that 25.1% of low-grade samples and 47.9% of high-grade samples after PAP testing had a negative HR HPV-PCR result. In those cases, reported as Pap-negative, 22.1% had a positive HR HPV-PCR result. Dual staining with p16/Ki67 biomarkers in samples was positive for HR HPV, and 31.7% were also positive for these markers. Out of the PCR results that were positive for any of these HR HPV subtypes, n 68.3%, we did not find evidence for the presence of cancerous cells, highlighting the importance of performing dual staining with p16/Ki67 after PCR to avoid unnecessary colposcopies. The encountered challenges are a deep-rooted social reluctance in Mexico to abandon traditional Pap smears and the opinion of many specialists. Therefore, we still believe that colposcopy continues to be a preferred procedure over the dual-staining protocol. [ABSTRACT FROM AUTHOR]

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

Purpose: The aim of this study is to reveal female university students' knowledge and perceptions about cervical cancer (CC) and human papillomavirus (HPV), and relationship with e-health literacy (e-HL). It also aims to determine the predictors affecting CC and HPV. Methods: A cross-sectional study was conducted with 589 female university students in Türkiye. Data were collected using a "Cervical Cancer and HPV Awareness Questionnaire" and an "E-health Literacy Scale (e-HLS)." Analysis involved Pearson correlation analysis, Independent Sample t-test, one-way analysis of variance, and Linear Regression analysis. Results: Results indicate that female students exhibited a low level of knowledge and perception about CC and HPV. Only 2.90% of students reported being vaccinated, while 39.90% had sexual experience. Higher knowledge levels were observed among married individuals, those familiar with HPV and the HPV vaccine, those who had undergone Pap smear tests, sexually active individuals, and consistent condom users. e-HL had a positive impact on knowledge and perceived threat about CC and HPV. The affecting predictors for knowledge about CC and HPV were found to be e-HLS (β = 0.911), having prior knowledge of HPV (β = 0.201), and being aware of the HPV vaccine (β = 0.172). In terms of perceived threat, the affecting predictors were e-HLS (β = 0.207), having heard of HPV (β = 0.101), and having knowledge of the HPV vaccine (β = 0.092). Conclusion: e-HL emerged as a crucial predictor positively influencing knowledge and perceptions about CC and HPV. This suggests the potential for organizing digital health campaigns to enhance awareness and understanding of CC and HPV. [ABSTRACT FROM AUTHOR]

Objective: This study examined the relationship between women's health literacy levels, their health belief levels concerning cervical cancer, and the Pap smear test. Methods: This descriptive and relationship-seeking study was conducted with 519 women who were selected using the purposive sampling method and met the inclusion criteria. Data were collected using a questionnaire by the researchers, the Turkey Health Literacy Survey (THLS-32) and the Health Belief Model Scale for Cervical Cancer and the Pap Smear Test (HBM-SCCPST). Results: The mean THLS-32 score of the women was 32.08±11.85 and 30.2% had an insufficient level of health literacy. Women's education, occupation, economic status, knowledge of the Pap smear, and willingness to be vaccinated against the human papillomavirus were found to be factors affecting their health literacy (p<0.05). The mean subscale scores in the HBM-SCCPST were determined to be 30.83±8.46 for Pap smear benefits, 32.70±11.41 for barriers, 22.16±6.06 for cervical cancer-seriousness, 7.83±2.40 for cervical cancer-susceptibility, 9.15±2.86 for cervical cancer health motivation. The women's health literacy levels had a weak positive correlation with their mean Pap smear benefits subscale score (r=0.275), weak negative relationship with their mean barriers subscale score (r=-0.212) (p=0.000). Conclusion: In this study, it was observed that as the health literacy levels of the women increased, there was a decrease in their barrier perception and an increase in their benefit perception concerning the Pap smear test. The results suggest that women's health literacy levels are moderate, and there is a need for interventions to increase their health literacy. [ABSTRACT FROM AUTHOR]

Screening is critical for prevention and early detection of cervical cancer but it is time-consuming and laborious. Supervised deep convolutional neural networks have been developed to automate pap smear screening and the results are promising. However, the interest in using only normal samples to train deep neural networks has increased owing to the class imbalance problems and high-labeling costs that are both prevalent in healthcare. In this study, we introduce a method to learn explainable deep cervical cell representations for pap smear cytology images based on one-class classification using variational autoencoders. Findings demonstrate that a score can be calculated for cell abnormality without training models with abnormal samples, and we localize abnormality to interpret our results with a novel metric based on absolute difference in cross-entropy in agglomerative clustering. The best model that discriminates squamous cell carcinoma (SCC) from normals gives 0.908 ± 0.003 area under operating characteristic curve (AUC) and one that discriminates high-grade epithelial lesion (HSIL) 0.920 ± 0.002 AUC. Compared to other clustering methods, our method enhances the V-measure and yields higher homogeneity scores, which more effectively isolate different abnormality regions, aiding in the interpretation of our results. Evaluation using an external dataset shows that our model can discriminate abnormality without the need for additional training of deep models. [ABSTRACT FROM AUTHOR]

• Neoadjuvant chemotherapy (NACT) improves response rates, but not overall survival, in advanced cervical cancer. • Novel use of meta -analysis reveals the efficacy of preoperative NACT in young patients with cervical cancer. • NACT has limited impact on adverse effects; there is potential for individualized postoperative strategies. Neither improvements in surgical techniques and methods nor advances in radiotherapy equipment and techniques have significantly improved cervical cancer survival rates for quite some time. By comparing the effectiveness of neoadjuvant chemotherapy in the treatment of locally advanced cervical cancer, this study aimed to explore effective treatment methods for locally advanced cervical cancer, and provide a theoretical basis to guide clinical practice. A search of PubMed, Embase, Scopus, Web of Science and Cochrane databases was undertaken to identify randomized controlled trials on the efficacy of neoadjuvant chemotherapy for locally advanced cervical cancer, where the intervention in the experimental group was neoadjuvant chemotherapy. Based on the inclusion and exclusion criteria, the studies were evaluated for quality according to the Cochrane Quality Rating Scale. Baseline information, intervention information and outcome indicators of the included studies were extracted. Meta-analysis was performed using RevMan 5.4. Significant differences in overall survival [relative risk (RR) 1.63, 95 % confidence interval (CI) 0.69–2.57; p = 0.0007] and complete remission rate (RR 0.37, 95 % CI −0.49 to 1.23; p = 0.041) were found between the two groups. Heterogeneity of the objective response rate showed p < 0.0001 and I 2 = 99 % (I 2 = 99 > 50 % and p > 0.1 for the Q-test suggested strong heterogeneity). The fixed effects model was chosen for the integration statistic [standardized mean difference (SMD) 0.81, 95 % CI −0.21 to 1.83; p = 0.12]; the difference was not significant (p > 0.05). Heterogeneity of the adverse effects of neoadjuvant chemotherapy showed p < 0.0001 and I 2 = 98 % (I 2 = 98 %>50 % and p > 0.1 for the Q-test suggested strong heterogeneity). The fixed effects model was chosen for the integration statistic (SMD −0.023, 95 % CI −0.95 to 0.49; p = 0.53); the difference was not significant (p > 0.05). The use of neoadjuvant chemotherapy for the treatment of locally advanced cervical cancer improved the objective response rate and the complete remission rate of patients, but failed to improve overall survival and adverse effects. [ABSTRACT FROM AUTHOR]

To determine the usefulness of combining two methodologies (OSCE and escape room) in a scenario simulation to evaluate a subject, and determine the evaluation of the students of this experience. An observational cross-sectional study was carried out with students enrolled in a sexual and reproductive health-care course as a part of their nursing degree. The students had to solve four clinical cases based on the contents of the teaching practices of the subject by solving clues that led them to carry out procedures and techniques and provide care in scenario simulators. Students evaluated the experience using the GAMEX (Gameful Experience in Gamification) scale. Mean differences were estimated with their respective 95% confidence intervals. A total of 124 students participated. Of these, 63.7% (79) solved the clinical cases with their knowledge and skills. Most (80.6%, 100) students stated that they completely remembered and applied the knowledge of the topic during the game. Almost all (98.4%, 122) would recommend this experience. The dimensions with the best rating on the GAMEX scale were "fun", with an average score of 4.7 points (0.49), followed by "critical thinking", with 4.2 (0.59). Women presented statistically better scores than men (mean difference: 1.58; 95% CI: 0.55, 2.61). The OSCE combined with an escape room using scenario simulations may be a useful tool to evaluate the subject. In addition, the students were satisfied, had fun, and recommended the experience. This study was not registered. [ABSTRACT FROM AUTHOR]

Background and Objectives: Our aim was to perform a retrospective analysis of the volume of cervical screening tests, the number of patients treated with an excision method, and the incidence of invasive and non-invasive cervical during a pandemic and pre-pandemic period of 24 months. Materials and Methods: The study compared 404 patients who underwent cervical cone biopsy for cervical cancer. The study examined patients' specimens based on histopathological characteristics and categorized cervical lesions based on pap smear. Results: There was a statistically significant age difference between the two study periods. The mean difference was 32 years before the pandemic and 35 years during the pandemic (p-value > 0.05). The biggest patient loss ratio identified by age group was in the 50–59-year group, with a 14.53% loss in the pre-pandemic period and a 9.1% loss in the pandemic period. In the pandemic period, patients from rural areas presented in the clinical trial with a lower rate of 39.52% (83 patients) vs. 60.47% (127 patients) in urban areas. A higher percentage of patients experiencing cervicorrhagia as a clinical manifestation in the pandemic period vs. the pre-pandemic period, with an increase in more severe lesions in the pandemic period, had a statistical significance of 8% more newly diagnosed compared to the pre-pandemic period. Conclusions: The addressability of the patients during the COVID period was not affected in a drastic way in our study. We encountered a decrease in appointments in the age group of 50–59 years and a decrease in patients with rural residence. In our study, we found an increase in cervical bleeding as a reason for consultation in the pandemic period with a higher lesion degree, both on a pap smear and on a cervical biopsy. [ABSTRACT FROM AUTHOR]

Cervical carcinoma is the most prevalent gynecology malignant tumor and ranks as the fourth most common cancer worldwide, thus posing a significant threat to the lives and health of women. Advanced and early-stage cervical carcinoma patients with high-risk factors require adjuvant treatment following surgery, with radiotherapy being the primary approach. However, the tolerance of cervical cancer to radiotherapy has become a major obstacle in its treatment. Recent studies have demonstrated that radiation resistance in cervical cancer is closely associated with DNA damage repair pathways, the tumor microenvironment, tumor stem cells, hypoxia, cell cycle arrest, and epigenetic mechanisms, among other factors. The development of tumor radiation resistance involves complex interactions between multiple genes, pathways, and mechanisms, wherein each factor interacts through one or more signaling pathways. This paper provides an overview of research progress on an understanding of the mechanism underlying radiation resistance in cervical cancer. [ABSTRACT FROM AUTHOR]