Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introdu...Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introduced HPV DNA testing alongside cytology (co-testing) as the primary screening method in 2019. This study evaluates the effectiveness of co-testing in identifying cervical precancerous lesions (CIN2+) compared to cytology alone. Methods: We conducted a retrospective analysis of women aged 30 - 65 years who participated in the routine cervical cancer screening program in Macao SAR Primary Healthcare Centers from 2019 to 2022. Data from over 70,000 women were analyzed, comparing the detection rates of CIN2+ through co-testing and cytology alone. Women with abnormal cytology or positive HPV results were referred for colposcopy. Results: The introduction of co-testing led to a significant increase in the detection of CIN2+, particularly in women with atypical squamous cells of undetermined significance (ASCUS) or negative for intraepithelial lesion or malignancy (NILM) cytology results. Between 2019 and 2022, the percentage of women with ASCUS/NILM and any high-risk HPV (hrHPV) positive who were diagnosed with CIN2+ after colposcopy were 24%, 13%, 10% and 7.5% respectively. This highlights the ability of co-testing to identify high-risk individuals who would have been missed by cytology alone. Discussion: Our findings demonstrate the effectiveness of co-testing in improving the sensitivity of cervical cancer screening in Macao SAR. The inclusion of HPV DNA testing allows for better risk stratification of women with ASCUS/NILM cytology, leading to more targeted referrals for colposcopy and timely detection of precancerous lesions. The initial high positive rate in 2019 (24%) might be attributed to the small sample size and potentially reflects a backlog of undiagnosed cases prior to co-testing implementation. Conclusion: The implementation of co-testing in Macao SAR’s cervical cancer screening program significantly improves the early detection of precancerous lesions, particularly in women with ambiguous cytology results. This proactive approach contributes to reducing cervical cancer morbidity and mortality and improving women’s health outcomes in Macao SAR.展开更多
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 ke...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.展开更多
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 in...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.展开更多
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 ),...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.展开更多
Oropharyngeal tumor is the eight most common cause of cancer death worldwide. Among the causes of oropharyngeal carcinoma significant are cigarette smoking, abuse of alcohol, multi-partners, high risk HPV (Human Papil...Oropharyngeal tumor is the eight most common cause of cancer death worldwide. Among the causes of oropharyngeal carcinoma significant are cigarette smoking, abuse of alcohol, multi-partners, high risk HPV (Human Papillomavirus) and etc. Cytological material (oral Pap smear) was taken from oral fundus and cheek mucous by the cytobrush. 47 participants with cervix pathology and 42 participants of the control group were investigated. Oral smears were stained by the Papanicolaou method and were diagnosed by a double blind method. After the cytological examination, we carried out detecting low and high risk HPV by chromogenic in-situ hy-bridization (CISH method) to use a positive and negative control. The quantitative statistical analysis was performed by SPSS V.19.0. Numeral data were processed using Pearson correlation and X2 tests. Confidence interval of 95% was regarded statistically significant. Study group’s oral pap smear with atypical cytology was detected in 61.7%. Atypical cytological changes in the control group were confirmed in 38.0%. High risk HPV detection by the CISH, in study group, showed positivity in 46.8% and in the control group—in 4.8%. Participants with cervix pathology will be considered as a risk-group to develop oropharyngeal tumor. Screening program for oropharyngeal cancer combines Pap smear and high risk HPV test together. For the control group, it is recommended to use oral pap smear and in the case of atypical changes using high risk HPV test too.展开更多
文摘Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introduced HPV DNA testing alongside cytology (co-testing) as the primary screening method in 2019. This study evaluates the effectiveness of co-testing in identifying cervical precancerous lesions (CIN2+) compared to cytology alone. Methods: We conducted a retrospective analysis of women aged 30 - 65 years who participated in the routine cervical cancer screening program in Macao SAR Primary Healthcare Centers from 2019 to 2022. Data from over 70,000 women were analyzed, comparing the detection rates of CIN2+ through co-testing and cytology alone. Women with abnormal cytology or positive HPV results were referred for colposcopy. Results: The introduction of co-testing led to a significant increase in the detection of CIN2+, particularly in women with atypical squamous cells of undetermined significance (ASCUS) or negative for intraepithelial lesion or malignancy (NILM) cytology results. Between 2019 and 2022, the percentage of women with ASCUS/NILM and any high-risk HPV (hrHPV) positive who were diagnosed with CIN2+ after colposcopy were 24%, 13%, 10% and 7.5% respectively. This highlights the ability of co-testing to identify high-risk individuals who would have been missed by cytology alone. Discussion: Our findings demonstrate the effectiveness of co-testing in improving the sensitivity of cervical cancer screening in Macao SAR. The inclusion of HPV DNA testing allows for better risk stratification of women with ASCUS/NILM cytology, leading to more targeted referrals for colposcopy and timely detection of precancerous lesions. The initial high positive rate in 2019 (24%) might be attributed to the small sample size and potentially reflects a backlog of undiagnosed cases prior to co-testing implementation. Conclusion: The implementation of co-testing in Macao SAR’s cervical cancer screening program significantly improves the early detection of precancerous lesions, particularly in women with ambiguous cytology results. This proactive approach contributes to reducing cervical cancer morbidity and mortality and improving women’s health outcomes in Macao SAR.
文摘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.
文摘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.
文摘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.
文摘Oropharyngeal tumor is the eight most common cause of cancer death worldwide. Among the causes of oropharyngeal carcinoma significant are cigarette smoking, abuse of alcohol, multi-partners, high risk HPV (Human Papillomavirus) and etc. Cytological material (oral Pap smear) was taken from oral fundus and cheek mucous by the cytobrush. 47 participants with cervix pathology and 42 participants of the control group were investigated. Oral smears were stained by the Papanicolaou method and were diagnosed by a double blind method. After the cytological examination, we carried out detecting low and high risk HPV by chromogenic in-situ hy-bridization (CISH method) to use a positive and negative control. The quantitative statistical analysis was performed by SPSS V.19.0. Numeral data were processed using Pearson correlation and X2 tests. Confidence interval of 95% was regarded statistically significant. Study group’s oral pap smear with atypical cytology was detected in 61.7%. Atypical cytological changes in the control group were confirmed in 38.0%. High risk HPV detection by the CISH, in study group, showed positivity in 46.8% and in the control group—in 4.8%. Participants with cervix pathology will be considered as a risk-group to develop oropharyngeal tumor. Screening program for oropharyngeal cancer combines Pap smear and high risk HPV test together. For the control group, it is recommended to use oral pap smear and in the case of atypical changes using high risk HPV test too.