Radical Hysterectomy in Cervical Cancer: Patients’ Epidemiological and Clinical Profiles and Perioperative Outcome in Two Referral Hospitals in Cameroon

Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment modality when the disease is diagnosed at early stage. Radical hysterectomy in cervical cancer has not been evaluated in recent years in Cameroon. The purpose of this study is thus to evaluate the epidemiological and clinical features and short term outcomes of patients who underwent surgery. Patients and methods: This retrospective study was conducted at the Douala Gynaeco-obstetric and Pediatric Hospital and the Douala General Hospital. Cervical cancer patients who underwent Radical hysterectomy between January 2015 and December 2020 were included. A pre-established data collection tool was used to record socio-demographic, clinical and outcomes information from patients’ files;additional outcome information was obtained from phone calls. Descriptive analysis was done using the SPSS version 26. Bivariate analysis was used to determine associations between disease and patients characteristics and occurrence of adverse postoperative outcome. P value of 0.05 was considered. Results: Sixty one patients were enrolled. Their ages ranged from 33 to 74 years with a mean age of 51.95 ± 10.29 years. Over 85% of women were married, 65.57% were unemployed and 86.88% were multiparous. Only 28% had never done cervical cancer screening. Most patients had stage IB1 to IB2 stage disease (57.1%). Less than 9% underwent radical hysterectomy and 8 of those (13.11%) suffered intraoperative complications. Twenty-five patients (40.98%) presented immediate and short term complications. There was no significant association between the disease or patients’ characteristics and adverse outcomes. Conclusion: Cervical cancer patients are relatively young in our settings and only 9% of them reach the hospital at early stage. Postoperative adverse outcomes rate is higher than that reported in the literature. Sensitization on screening and awareness of early symptoms can reverse the situation.

Perceived Barriers to Cervical Cancer Screening Using Pap Smear Test among Women Attending Saad Abu Al Ella Hospital in Khartoum State, 2022

Background: Cervical cancer is the second common cancer among women worldwide. It is a preventable cancer, and early detection of precancerous conditions through the Papanicolaou cytology screening (Pap smear) is a key aspect of prevention;it is accepted worldwide as an efficient tool for secondary prevention. While the PS test is simple, inexpensive, and relatively reliable as a method of diagnosing cervical cancer, most women do not take the test. Therefore, this study is sought to describe the barriers to pap smear uptake among Sudanese women. Materials and Method: This total coverage observational, analytical and cross sectional, hospital-based study was conducted in Saad Abu El Ella Hospital in April 2022. The study was conducted using an anonymous questionnaire to assess the perceived barriers of 93 participants. All data were computerized using Microsoft Excel’17 and the data were described and analyzed using statistical package for social science (SPSS23). Results: The findings revealed that the mean age of the participants was 39.5 years and only 3.2% had ever undergone a pap smear test. Identified barriers were lack of information, not knowing where to go, and fear of pain. The majority, 72% are willing to routinely perform a pap smear test if well informed about it. The study also demonstrates that there is a significant correlation between perceived barriers score and willingness to perform the pap smear test (p value = 0.008), and between the perceived barriers score and the sociodemographic factors: Age (p value = 0.006), educational level (p value = 0.028) and occupation (p value = 0.040), but no association with the economic status was found (p value = 0.378). Conclusion: The detection rate is too low compared to the national target of over 70%. Therefore, more work is needed to reduce perceived barriers to cervical cancer screening by providing education/raising for popular awareness;addressing misconceptions and false beliefs;informing women about the necessity and importance of Pap smear;and health promotion using mass media such as national television, social media, radio, billboards, and newspapers and other print media.

Selection of Surgical Approach and Clinical Significance of Lower Cervical Spine Injuries Guided by SLIC Scoring System

Objective: To explore the feasibility and clinical significance of surgical approach selection for cervical spine injury guided by SLIC scoring system. Methods: The clinical data of 75 patients with lower cervical injury surgery from January 2020 to November 2022 were retrospectively analyzed, including 48 males and 27 females. Age: 28 - 65 years old. Causes of injury: 39 cases of traffic accidents, 15 cases of ice and snow sports, 12 cases of falling from high places, 9 cases of heavy objects. There were 12 cases of C3-4, 33 cases of C4-5, 21 cases of C5-6, and 9 cases of C6-7. Time from injury to medical treatment: 4 h - 2 d. Cervical spine X-ray, MRI, MDCT examination and preoperative SLIC score were performed on admission. Anterior approach was performed by subtotal cervical vertebrae resection or discectomy, titanium Cage or cage supported bone grafting and anterior titanium plate fixation. Posterior approach was performed with cervical laminoplasty, lateral mass or pedicle screw fixation and fusion. The combined anterior-posterior operation was performed by the anterior methods+ posterior methods. The time from injury to surgery is 12 h to 3 d. The function before and after operation was evaluated by JOA efficacy evaluation criteria. The correlation between the three surgical approaches and postoperative efficacy and SLIC score was compared. SPSS 22.0 software was used for statistical analysis of the data. Results: In this group of 75 patients, 32 cases of anterior operation, 22 cases of posterior operation and 21 cases of combined operation were followed up for no less than 12 months. There was no significant difference in age, gender, injury cause, injury segment, time from injury to treatment, and time from injury to operation among the three surgical approaches, which were comparable. The SLIC scores of mild, moderate and severe injuries of anterior surgery, posterior surgery and combined anterior and posterior surgery, They were (5.26 ± 1.24, 5.86 ± 1.67, 8.25 ± 0.21), (5.57 ± 1.43, 5.99 ± 1.85, 9.00 ± 0.25), (0, 5.98 ± 0.33, 9.44 ± 0.34), respectively. By comparing the SLIC scores and JOA scores of anterior surgery and posterior surgery, there was no difference in SLIC scores and JOA scores between the two groups for mild and moderate injuries (P > 0.05). However, the JOA scores at 3 months, 6 months and 12 months after surgery were different from those before surgery, and the postoperative efficacy and JOA scores were significantly improved (P & lt;0.05), indicating that the two surgical methods had the same therapeutic effect, that is, anterior or posterior surgery could be used to treat mild or moderate injuries (P > 0.05). There were differences in SLIC scores among the three surgical approaches for severe injury (P 0.05). The postoperative efficacy and JOA score of combined anterior-posterior approach were significantly improved compared with those before operation (P Conclusion: SLIC score not only provides accurate judgment for conservative treatment or surgical treatment of cervical spine injury, but also provides evidence-based medical basis and reference value for the selection of surgical approach and surgical method. According to the SLIC score, the surgical approach is safe and feasible. When the SLIC score is 4 - 7, anterior surgery is selected for type A injury, and posterior surgery is selected for type B injury. When the SLIC score is ≥8, combined anterior-posterior surgery should be selected. It is of great significance for clinical formulation of precision treatment strategy.

Clinical Analysis of Patients with Cervical Cancer After Adequate Radiotherapy and Surgery

Objective:To explore the effect of giving adequate radiotherapy before surgery on the recovery of patients with cervical cancer.Methods:An experimental study was carried out in Aviation General Hospital(hereafter referred as our hospital)from March 2022 to March 2023.Fifty patients with cervical cancer were retrospectively analyzed.The patients underwent surgery 15-20 days after adequate external radiotherapy,and the clinical effect was analyzed.Results:The symptoms of the patients were relieved,among which contact bleeding and irregular vaginal bleeding completely resolved in 27 patients and 19 patients,respectively;although intermittent vaginal bleeding persisted in 3 patients,the symptom improved compared with before treatment;for 1 patient,the treatment was ineffective,as there was no significant improvement in symptoms.For patients with stage IB2 cancer,the tumor reduction rate after treatment was about 50%-70%,but the reduction in 2 patients was insignificant.Conclusion:Cervical cancer is a serious condition.Adequate radiotherapy before surgery has a significant effect.It reduces the difficulty of surgery and creates an opportunity for patients to undergo surgery,thus improving the treatment effect.Therefore,it is worthy of clinical promotion.

Cervical Cancer Prevention Challenges and Barriers to Cervical Cancer Screening and HPV Vaccinations in Ukraine and Eastern Europe

Objectives: To identify the obstacles and issues that hinder effective cancer prevention efforts in Ukraine. The study aims to provide a comprehensive assessment of the barriers to cancer prevention, including both infrastructure and behavioral factors, and identify potential solutions to address these challenges. Study Design: Comprehensive literature review. Methods: The following databases were searched: National Center for Biotechnology Information (NCBI) and PubMed (U.S. National Library of Medicine at the National Institutes of Health). The keywords used in the search included “Cervical Cancer”, “Human Papillomavirus Vaccination (HPV)”, “Ukraine”, “Eastern Europe”, “Healthcare Infrastructure in Disasters”, “Cervical Cancer Prevention”, “Pap Smear”, and “HPV Testing”. Results: A total of 3500 articles were screened. A total of 65 articles met the inclusion criteria. Limited public awareness and limited access to vaccination and screening, combined with inadequate treatment facilities lead to higher rates of cervical cancer. The COVID pandemic, war with Russia, and the Chernobyl disaster are significant factors for the low level of vaccination in Ukraine. Conclusion: The prevention and treatment of cervical cancer in Ukraine face significant challenges due to the inadequate HPV vaccination rates and screening by cytology. Efforts to improve funding and increase education of both the population and health care providers are necessary to increase interventions such as HPV vaccination, cervical cytology, and HPV testing to reduce cervical cancer rates in Ukraine.

Assessment of quality of life for the patients with cervical cancer at different clinical stages

With improved overall survival of cervical cancer patients, the importance of the quality of life (QOL) is increasingly recognized. This study was conducted to compare the QOL of women with different stage cervical cancer before and after treatment to facilitate improved cervical cancer prevention and treatment. We used the generic Medical Outcomes Study Short Form-36 (MOS SF-36) to collect QOL information. Based on SF-36, we interviewed cervical cancer patients at West China Second Affiliated Hospital and Sichuan Cancer Hospital between May 2010 and January 2011. A total of 92 patients with precancerous lesions, 93 with early cancer, and 35 with advanced cancer responded to our survey. Average physical component summary (PCS) scores were significantly different between the three groups at every time point (P < 0.05). Average mental component summary (MCS) scores were significantly different between the three groups after treatment (P < 0.05). Average PCS and MCS scores increased gradually from the pretreatment to posttreatment period for patients with precancerous lesions. However, they reached the lowest at 1 month after treatment for patients with early and advanced cancers and rebounded between 1 and 6 months after treatment. Our results indicate that patients with precancerous lesions and early cervical cancer show better overall QOL than do those with advanced cervical cancer. Additionally, patients with early cancer recover more quickly than do those with advanced cancer in terms of both physical and mental functions. Thus, early detection and treatment initiatives may improve the QOL for patients with precancerous lesions and cervical cancer.

Pap Smear Screening, the Way Forward for Prevention of Cervical Cancer? A Community Based Study in the Buea Health District, Cameroon

Introduction: Cancer of the cervix is the second most common gynecologic malignancy in the world due to lack of awareness and poor uptake of cervical cancer screening services especially in low income countries. In Cameroon, though there is a national cervical cancer-screening program the service has been limited to some main cities without an appreciable impact. Aims: The objectives of this study were to determine the knowledge, attitude, practice towards Pap smear screening, thus evaluating its suitability as a screening procedure in Cameroon, through this pilot study in the Buea Health District. Methods: The study was a community-based cross-sectional descriptive survey that involved 309 women. Women from 18 years were enrolled for the study from 9th?October to 20th?November 2013. Results: The mean age of the participants was 32.3 years (SD = 11.7 years). Most of the women (29.5%) who had gone for the Pap test were in the 41 - 50 years age group. Only 3.6% of the study participants had “good” knowledge of cervical cancer and Pap smear screening. Approximately 20% of the women had a previous Pap smear test with 55.7% of them having the test just once. Eighty two percent of those who had secondary and tertiary levels of education had never had a Pap smear test. Awareness of risk factors for cervical cancer was low. Fear of pain, positive results after screening, non-curability of cervical cancer were some factors associated with a low Pap test uptake (p < 0.05). Conclusion: There is poor knowledge and perceived barriers by women about Pap smear screening and follow-up services. For an impact to be made in the prevention of cervical cancer, Pap smear screening is not the preferred method because of these limitations in this community.

Knowledge of Cervical Cancer and Practice of Pap Smear Testing among Secondary School Teachers in Nnewi North Local Government Area of Anambra State, South Eastern Nigeria

Introduction: Cervical cancer is one of the commonest cancers of the female genital tract and accounts for about a hundred and ninety thousand deaths each year, most of which occur in developing countries. Early cervical screening methods have contributed to the fall of cervical cancer deaths in the developed world. This is different in developing countries where people have limited knowledge about this disease condition and the screening methods for prevention. This study determined the knowledge and practice of cervical cancer screening among female secondary school teachers in Nnewi North Local Government Area of Anambra State. Method: This was a cross-sectional descriptive study in which self-administered questionnaires were returned by 142 respondents and results were analyzed using Statistical Package for Social Sciences version 17. Results: The mean age of the respondents was 35.6 ± 1.76 years. A high proportion of the respondents were aware of cervical cancer 106 (74.6%). About 44 (41.5%) knew of cervical cancer screening by Pap smear, out of which only 20.5% had done a pap smear. The most common reasons given for not doing the test were;not deeming the test necessary, not knowing where the test could be done and feeling of not being at risk of developing cervical cancer. Conclusion/Recommendation: Though the level of awareness of cervical cancer screening was high, the level of uptake of Pap smear was still very low. A national cervical cancer Pap smear campaign should be intensified to change the negative perception towards Pap smear test.

The Social Ecology of Cervical Cancer: The Challenges to Pap Smear Screening

Cervical cancer is a preventable disease. The risk factors for the development of cervical cancer include both biologic factors and social factors. In the United States, the leading risk factor for the development of cervical cancer is not having a Pap smear for five years prior to the diagnosis of cancer. In low and middle income countries, cervical cancer incidence and mortality are directly related to the lack of both screening programs and cancer treatment facilities. This paper examines the social ecology of cervical cancer. The literature is reviewed on social and cultural barriers to access to health care and its effect of cervical cancer rates and outcomes.

Cervical Cancer in Women with Inflammatory Pap Smears

In spite of preventive measures such as Papanicolaou cervical cytological analysis and, more recently, vaccination against HPV infection, cancer of the uterine cervix continues to be one of the most frequent causes of mortality among women worldwide, particularly in developing countries. In this prospective study, sixty patients with inflammatory Pap smears had a colposcopy with directed biopsies. The average age of our patients was 42 years. Results showed that colposcopy is normal in 10% of women. It showed normal transformations, ectropion, a colpotis and polyp at 8.33%, 21.66%, 13.33% and 5% respectively. It was able to detect changes with Grade I atypical transformations (28.33%), and Grade II atypical transformations in 13.33% of cases. The biopsies were objectified dysplasia and carcinoma in 24.13% of cases with carcinoma in situ, micro invasive squamous cell carcinoma and invasive carcinoma glandular. Moreover, we detected HPV-specific antibodies in sera of these patients. Results showed that six patients (10%) showed a positive reactivity to at least one of the HPV-16 or HPV-18 antigens and sera showed different reactivity to the different antigens with the following percentages: 5%, 3%, 2%, 3% and 3% for L1 HPV-16, E6 HPV-16, E7 HPV-16, E6 HPV-18 and E7 HPV-18 respectively. Among patients having positive antibody response, 83.33% were cases of dysplasia and carcinoma. We concluded that the Pap smear, examination of key screening for cervical cancer, is a screening test without diagnostic value and more specifically any inflammatory Pap smear should be considered a positive test and led to further investigations. Moreover, colposcopy is an exam that is performed on an outpatient basis;it allows a detailed study of the cervix and reduces the negative rate of cytology. In addition, early detection of HPV antibodies could help the follow-up of patients.

Assessment of Knowledge of Cervical Cancer and Pap Smear Screening in Makurdi Metropolis

Knowledge of cervical cancer and Pap smear screening in a sample population in Makurdi metropolis was assessed using a survey design. Five hundred and seventy-four （574） participants aged 18-60 years, who were accidentally/conveniently sampled in the town, took part in the study. Of this number, 48.3% （N = 277） were males, and 51.7% （N = 297） were females and from diverse occupations. Data were collected using a standardized questionnaire, the knowledge of cervical cancer and Pap Smear Screening Scale （KCPS） with ten items. Results reveal that participants have limited knowledge on cervical cancer and Pap Smear Screening with 35.3% （N = 203） having knowledge, while 64.7% （N = 371 ） having limited knowledge. No statistical significant difference in the knowledge of cervical cancer and Pap Smear Screening between older and younger participants t （553） = -1.69; P 〉 0.05, Single and Married participants t （562） = -0.97; P 〉 0.05, low and high levels of education t （564） = -1.83; P 〉 0.05 was found. Surprisingly, males （mean = 33.55） significantly had more knowledge of cervical cancer and Pap Smear Screening than females （mean = 32.26） t （572） = 2.03; P 〈 0.05 and other participants had better knowledge than health workers t （572） = -2.43; P 〈 0.05. Enlightenment campaigns, Magazines and News papers, Television, Radio, Friends and Schools were some of the sources participants acquired knowledge of cervical cancer and Pap Smear Screening. It is obvious that knowledge of cervical cancer and Pap Smear Screening is limited among the population in Makurdi metropolis, therefore a need to intensify enlightenments and awareness campaigns targeted at all groups of people is imperative.

Update on prevention and screening of cervical cancer

Cervical cancer is the third most common cause of cancer in women in the world. During the past few decades tremendous strides have been made toward decreasing the incidence and mortality of cervical cancer with the implementation of various prevention and screening strategies. The causative agent linked to cervical development and its precursors is the human papillomavirus(HPV). Prevention and screening measures for cervical cancer are paramount because the ability to identify and treat the illness at its premature stage often disrupts the process of neoplasia. Cervical carcinogenesis can be the result of infections from multiple high-risk HPV types that act synergistically. This imposes a level of complexity to identifying and vaccinating against the actual causative agent. Additionally, most HPV infections spontaneously clear. Therefore, screening strategies should optimally weigh the benefits and risks of screening to avoid the discovery and needless treatment of transient HPV infections. This article provides an update of the preventative and screening methodsfor cervical cancer, mainly HPV vaccination, screening with Pap smear cytology, and HPV testing. It also provides a discussion of the newest United States 2012 guidelines for cervical cancer screening, which changed the age to begin and end screening and lengthened the screening intervals.

Cervical cancer: Can it be prevented?

Cervical cancer prevention requires a multipronged approach involving primary, secondary and tertiary prevention. The key element under primary prevention is human papilloma virus(HPV) vaccination. So far, only prophylactic HPV vaccines which prevent HPV infection by one or more subtypes are commercially available. Therapeutic HPV vaccines which aid in clearing established infection are still under trial. Secondary prevention entails early detection of precancerous lesions and its success is determined by the population coverage and the efficacy of the screening technique. A number of techniques are in use, including cytology, visual inspection(using the naked eye, magnivisualizer, acetic acid and Lugol's iodine), HPV testing and a combination of these methods. Updated screening guidelines have been advocated by the American Cancer Society in light of the role of HPV on cervical carcinogenesis. Recent research has also focussed on novel biomarkers that can predict progression to cancer in screen positive women and help to differentiate those who need treatment from those who can be left for follow-up. Last but not the least, effective treatment of precancerous lesions can help to reduce the incidence of invasive cervical cancer and this constitutes tertiary prevention.A combination of these approaches can help to prevent the burden of cervical cancer and its antecedent morbidity and mortality, but all of these are not feasible in all settings due to resource and allocation constraints. Thus, all countries, especially low and middle income ones, have to determine their own cocktail of approaches that work before we can say with certainty that yes, cervical cancer can be prevented.

Factors associated with cervical cancer knowledge and practice among Bahraini women

The study was conducted to assess the women’s knowledge and attitude towards cervical cancer and cervical cancer screening,to support the health education programs in this field.A total sample of 350 women(n = 350 ),70 women from each health center was chosen based on a multistage sampling technique according to a number of 21 health centers that serve the population.One health center from each government was selected based on the population it serves,thus the health center with the highest population number was chosen.The main tool of data collection was a face to face interview questionnaire.When assessing the knowledge,attitude, and practice(KAP) of our sample,we observed that approximately equal percentages(70%) of women have heard of both Pap smear and cervical cancer.Only 47.4%had ever had Pap smear and of those 35.1% had it during a period of 5 years or less.The main source of knowledge for those who have done the procedure is the family physician(30.8%).When asked about the reason behind having a Pap smear,the majority (62.3%) had it during postnatal visits.Nevertheless,those that didnt have it,almost half(46.6%) disapproved to do so because they are healthy even after being told that Pap smear is a painless significant procedure. In conclusion,majority of respondents have a good knowledge about cervical cancer but is not reflected in their practice.The results strongly recommend continued health education for the women which can be achieved through the introduction of this topic into the schools’curriculum and planning educational programs within antenatal and postnatal visits.

Screening of premalignant and malignant cervical lesions in underdeveloped countries by using Pap smear as routine investigation in outpatient department

Objective: Papanicolou (Pap) smear screening has dramatically reduced the incidence of invasive cervical cancer worldwide. Pap smear screening is still not widely available in developing countries and therefore cannot be used as mass screening tool. This study was designed to establish the role of Pap smear as a routine investigation for females presented to gynecological department. Methods: It was a hospital based study. Patients attending with complaints including irregular vaginal bleeding, vagina discharge, dyspareunia, low backache or lower abdominal pain and primary or secondary infertility were included in the study. All these patients underwent pap smear. Results: Age of females was 25 to 60 years. Ninety females had dysplasia. Mild to moderate dysplasia was positive in 84 females. Six patients had severe dysplasia suspicious for squamous cell carcinoma (SCC) which was confirmed as invasive SCC on biopsy. All patients with mild to moderate dysplasia were regularly followed at 4 to 6 months. Thirty patients were lost during follow up. Forty had negative smear at 6 months, while fourteen having persistent dysplasia on repeated pap smears were referred for biopsies. Histopathology confirmed invasive SCC in five patients while chronic cervicitis was reported in nine patients. Only two of screened patients with high suspicion for cancer showed false negative results. Directed biopsies done in these confirmed invasive SCC. Conclusion: Pap smear is a useful, simple, non-invasive and reliable screening tool for cervical cancer. It may be practiced as a routine investigation in outpatients in developing countries, where mass screening is not available.

Comparison of efficacy and safety between late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy for cervical cancer complicated with pelvic lymph node metastasis

Objective This study aimed to compare and analyze the clinical efficacy and safety of late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy(IMRT) for cervical cancer complicated with pelvic lymph node metastasis. Methods Sixty patients with cervical cancer complicated with pelvic lymph node metastasis who were admitted to our hospital from January 2013 to January 2015 were enrolled. The patients were randomly divided into the late-course dose-increasing IMRT group and the simultaneous integrated dose-increasing IMRT group, with 30 cases included in each group, respectively. All patients were concurrently treated with cisplatin. After treatment, the clinical outcomes of the two groups were compared. Results The remission rate of symptoms in the simultaneous integrated dose-increasing IMRT group was significantly higher than that in the late-course dose-increasing IMRT group(P < 0.05). The follow-up results showed that the overall survival time, progression-free survival time, and distant metastasis time of patients in the simultaneous integrated dose-increasing IMRT group were significantly longer than those in the late-course dose-increasing IMRT group(P < 0.05). The recurrent rate of lymph nodes in the radiation field in the simultaneous integrated dose-increasing IMRT group was significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in the incidence of cervical and vaginal recurrence and distant metastasis between the two groups(P > 0.05). The radiation doses of Dmax in the small intestine, D1 cc(the minimum dose to the 1 cc receiving the highest dose) in the bladder, and Dmax in the rectum in the simultaneous integrated dose-increasing IMRT group were significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in intestinal D2 cc(the minimum dose to the 2 cc receiving the highest dose) between the two groups(P > 0.05). The incidence of bone marrow suppression in the simultaneous integrated dose-increasing IMRT group was significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group.Conclusion The application of simultaneous integrated dose-increasing IMRT in the treatment of cervical cancer patients complicated with pelvic lymph node metastasis can significantly control tumor progression, improve the long-term survival time, and postpone distant metastasis time with high safety.

Improvement method for cervical cancer detection: A comparative analysis

Cervical cancer is a prevalent and deadly cancer that affects women all over the world.It affects about 0.5 million women anually and results in over 0.3 million fatalities.Diagnosis of this cancer was previously done manually,which could result in false positives or negatives.The researchers are still contemplating how to detect cervical cancer automatically and how to evaluate Pap smear images.Hence,this paper has reviewed several detection methods from the previous researches that has been done before.This paper reviews pre-processing,detection method framework for nucleus detection,and analysis performance of the method selected.There are four methods based on a reviewed technique from previous studies that have been running through the experimental procedure using Matlab,and the dataset used is established Herlev Dataset.The results show that the highest performance assessment metric values obtain from Method 1:Thresholding and Trace region boundaries in a binary image with the values of precision 1.0,sensitivity 98.77%,specificity 98.76%,accuracy 98.77%and PSNR 25.74%for a single type of cell.Meanwhile,the average values of precision were 0.99,sensitivity 90.71%,specificity 96.55%,accuracy 92.91%and PSNR 16.22%.The experimental results are then compared to the existing methods from previous studies.They show that the improvement method is able to detect the nucleus of the cell with higher performance assessment values.On the other hand,the majority of current approaches can be used with either a single or a large number of cervical cancer smear images.This study might persuade other researchers to recognize the value of some of the existing detection techniques and offer a strong approach for developing and implementing new solutions.

Optimal Deep Convolution Neural Network for Cervical Cancer Diagnosis Model

Biomedical imaging is an effective way of examining the internal organ of the human body and its diseases.An important kind of biomedical image is Pap smear image that iswidely employed for cervical cancer diagnosis.Cervical cancer is a vital reason for increased women’s mortality rate.Proper screening of pap smear images is essential to assist the earlier identification and diagnostic process of cervical cancer.Computer-aided systems for cancerous cell detection need to be developed using deep learning(DL)approaches.This study introduces an intelligent deep convolutional neural network for cervical cancer detection and classification(IDCNN-CDC)model using biomedical pap smear images.The proposed IDCNN-CDC model involves four major processes such as preprocessing,segmentation,feature extraction,and classification.Initially,the Gaussian filter(GF)technique is applied to enhance data through noise removal process in the Pap smear image.The Tsallis entropy technique with the dragonfly optimization(TE-DFO)algorithm determines the segmentation of an image to identify the diseased portions properly.The cell images are fed into the DL based SqueezeNet model to extract deeplearned features.Finally,the extracted features fromSqueezeNet are applied to the weighted extreme learning machine(ELM)classification model to detect and classify the cervix cells.For experimental validation,the Herlev database is employed.The database was developed at Herlev University Hospital(Denmark).The experimental outcomes make sure that higher performance of the proposed technique interms of sensitivity,specificity,accuracy,and F-Score.

Optimal Deep Learning Based Inception Model for Cervical Cancer Diagnosis

Prevention of cervical cancer becomes essential and is carried out by the use of Pap smear images.Pap smear test analysis is laborious and tiresome work performed visually using a cytopathologist.Therefore,automated cervical cancer diagnosis using automated methods are necessary.This paper designs an optimal deep learning based Inception model for cervical cancer diagnosis(ODLIM-CCD)using pap smear images.The proposed ODLIM-CCD technique incorporates median filtering(MF)based pre-processing to discard the noise and Otsu model based segmentation process.Besides,deep convolutional neural network(DCNN)based Inception with Residual Network(ResNet)v2 model is utilized for deriving the feature vectors.Moreover,swallow swarm optimization(SSO)based hyperparameter tuning process is carried out for the optimal selection of hyperparameters.Finally,recurrent neural network(RNN)based classification process is done to determine the presence of cervical cancer or not.In order to showcase the improved diagnostic performance of the ODLIM-CCD technique,a series of simulations occur on benchmark test images and the outcomes highlighted the improved performance over the recent approaches with a superior accuracy of 0.9661.

Uptake of Cervical Cancer Screening among Women Attending Health Facilities in the City of Bulawayo, 2012

Introduction: In Zimbabwe, where cervical cancer is the leading female malignancy, no systematic cervical screening program has been introduced. However, selective or opportunistic screening has been performed since the late 1980s. The Ministry of Health and Child Care is relying on screening, which allows early detection of pre-cancerous cells and diagnosis at early stages but many women are not going for the test and no studies have been done to find out why. This study investigated the women’s perception about cervical cancer and its screening using health belief model (HBM) in Bulawayo, where they are two new screening clinics. Methods: We conducted an analytic cross-sectional study. Women from 18 years and above attending health facilities were included in the study. Interviewer administrated questionnaire was used to determine the proportion of screened women and elicit their perception about cervical cancer and its screening. Epi-info version 3.3.2 was used to do bivariate and multivariate analysis. Results: Two hundred women were recruited into the study. The proportion of women who had cervical cancer screening was 52 (26%). Pap smear only had 35 (17.5%) had VIAC only, 13 (6.5%) and Pap smear and VIAC had 4 (2%). Knowledge of cervical cancer and its screening was poor among participants. In multivariate analysis, awareness of cervical cancer screening [adjusted OR 42.05 (95% CI 5.63 - 314.04)] was associated with the uptake of cervical cancer screening and perceiving that having multiple sexual partners[adjusted OR 0.33 (95% CI 0.12 - 0.88)] was independently associated to the uptake of cervical cancer screening. Conclusion: This study demonstrated that lack of awareness of cervical cancer screening is a barrier to the uptake of the screening. Perceiving multiple sexual partners was associated to the uptake of cervical cancer screening. It is therefore necessary to increase awareness in Bulawayo City and educate the community about other risk factors.