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cervical cancer screening low resource setting

Melissa S Lopez, Ellen S Baker, Mauricio Maza, Georgia Fontes-Cintra, Aldo Lopez, Juan M Carvajal, Fernanda Nozar, Veronica Fiol, Kathleen M Schmeler
Cervical cancer is a preventable disease with a known etiology (human papillomavirus), effective preventive vaccines, excellent screening methods, and a treatable pre-invasive phase. Surgery is the primary treatment for pre-invasive and early-stage disease and can safely be performed in many low-resource settings. However, cervical cancer rates remain high in many areas of Latin America. This article presents a number of evidence-based strategies being implemented to improve cervical cancer outcomes in Latin America...
February 7, 2017: Journal of Surgical Oncology
Natasha Buchanan Lunsford, Kathleen Ragan, Judith Lee Smith, Mona Saraiya, Millicent Aketch
BACKGROUND: Cervical cancer is the second most commonly diagnosed cancer in females and is a leading cause of cancer-related mortality in Kenya; limited cervical cancer screening services may be a factor. Few studies have examined men's and women's perceptions on environmental and psychosocial barriers and benefits related to screening. MATERIALS AND METHODS: In 2014, 60 women aged 25-49 years and 40 male partners participated in 10 focus groups (6 female and 4 male), in both rural and urban settings (Nairobi and Nyanza, Kenya), to explore perceptions about barriers to and benefits of cervical cancer screening...
February 6, 2017: Oncologist
Amidu O Raifu, Mariam El-Zein, Ghislain Sangwa-Lugoma, Agnihotram Ramanakumar, Stephen D Walter, Eduardo L Franco
BACKGROUND: Visual inspection with acetic acid (VIA) and Lugol's iodine (VILI) are used to screen women for cervical cancer in low-resource settings. Little is known about correlates of their diagnostic accuracy by healthcare provider. We examined determinants of VIA and VILI screening accuracy by examiner in a cross-sectional screening study of 1528 women aged 30 years or older in a suburb of Kinshasa, Democratic Republic of Congo. METHODS: We used a logistic regression model for sensitivity and specificity to estimate the diagnostic accuracy of VIA and VILI, independently performed by nurse and physician, as a function of sociodemographic and reproductive health characteristics...
2017: PloS One
L Court
: Many low- and middle-income countries lack the resources and services to manage cancer, from screening and diagnosis to radiation therapy planning, treatment and quality assurance. The challenges in upgrading or introducing the needed services are enormous, and include severe shortages in equipment and trained staff. In this symposium, we will describe examples of technology and scientific research that have the potential to impact all these areas. These include: (1) the development of high-quality/low-cost colposcopes for cervical cancer screening, (2) the application of automated radiotherapy treatment planning to reduce staffing shortages, (3) the development of a novel radiotherapy treatment unit, and (4) utilizing a cloud-based infrastructure to facilitate collaboration and QA...
June 2016: Medical Physics
Chun-Qing Lin, Xi Zeng, Jian-Feng Cui, Guang-Dong Liao, Ze-Ni Wu, Qian-Qian Gao, Xun Zhang, Xiu-Zhang Yu, Wen Chen, Ming-Rong Xi, You-Lin Qiao
Safer, more convenient methods for cervical sample collection and storage are necessary to facilitate human papillomavirus (HPV) DNA testing in low-resource settings. Our study aimed to evaluate the stability of cervical specimens collected with dry swabs and stored dry, compared to liquid-based cytology (LBC) samples, as detected by HPV DNA testing. Women with abnormal cytological findings or HPV-positive results at colposcopy were recruited from the West China Second University Hospital, Sichuan University, between October 2013 and March 2014...
February 2017: Journal of Clinical Microbiology
Nicole G Campos, Vivien Tsu, Jose Jeronimo, Mercy Mvundura, Kyueun Lee, Jane J Kim
Cervical cancer is a leading cause of cancer death worldwide, with 85% of the disease burden residing in less developed regions. To inform evidence-based decision-making as cervical cancer screening programs are planned, implemented, and scaled in low- and middle-income countries, we used cost and test performance data from the START-UP demonstration project in Uganda and a microsimulation model of HPV infection and cervical carcinogenesis to quantify the health benefits, distributional equity, cost-effectiveness, and financial impact of either (1) improving access to cervical cancer screening or (2) increasing the number of lifetime screening opportunities for women who already have access...
March 15, 2017: International Journal of Cancer. Journal International du Cancer
Renu Ranga, Shweta Rai, Aruna Kumari, Sandeep Mathur, Alka Kriplani, Reeta Mahey, Nutan Agarwal, Garima Kachhawa, Perumal Vanamail, Neerja Bhatla
OBJECTIVE: Colposcopic scoring systems provide an objective diagnosis and select patients who require treatment. A new scoring system, Swede score, has added lesion size as a parameter. This study aimed to compare the strength of association of Reid colposcopic index versus Swede score and assess their utility in low-resource settings. METHODS: In this prospective study, 150 women aged 30 to 59 years with abnormal screening result were enrolled. All women underwent colposcopy; the findings were scored by both Reid colposcopic index and Swede score, biopsy taken from all abnormal areas...
January 2017: Journal of Lower Genital Tract Disease
Nora T Oliver, Elizabeth Y Chiao
PURPOSE OF REVIEW: To review current knowledge of different cancer states affecting women with HIV infection. RECENT FINDINGS: With improved survival of persons with HIV in the post-cART era, the landscape of malignancies in this population has greatly changed with fewer AIDS-defining malignancies (ADM) and a growing number of non-AIDS defining malignancies (NADM). Women, however, continue to represent a vulnerable population at risk for certain ADM and NADM such as cervical, anal, and breast cancer...
January 2017: Current Opinion in HIV and AIDS
Nicole G Campos, Monisha Sharma, Andrew Clark, Jane J Kim, Stephen C Resch
BACKGROUND: Cervical cancer is the fourth leading cause of cancer death in women, with 85% of cases and deaths occurring in developing countries. While organized screening programs have reduced cervical cancer incidence in high-income countries through detection and treatment of precancerous lesions, the implementation of organized screening has not been effective in low-resource settings due to lack of infrastructure and limited budgets. Our objective was to estimate the cost of comprehensive primary and secondary cervical cancer prevention in low- and middle-income countries...
2016: PloS One
Tara J Wu, Karen Smith-McCune, Miriam Reuschenbach, Magnus von Knebel Doeberitz, May Maloba, Megan J Huchko
OBJECTIVE: A biomarker with increased specificity for cervical dysplasia compared with human papillomavirus (HPV) testing would be an attractive option for cervical cancer screening among HIV-infected women in resource-limited settings. p16(INK4a) has been explored as a biomarker for screening in general populations. DESIGN: A 2-year cross-sectional study. SETTING: 2 large HIV primary care clinics in western Kenya. PARTICIPANTS: 1054 HIV-infected women in western Kenya undergoing cervical cancer screening as part of routine HIV care from October 2010 to November 2012...
September 13, 2016: BMJ Open
Sunny S Shah, Satyajyoti Senapati, Flora Klacsmann, Daniel L Miller, Jeff J Johnson, Hsueh-Chia Chang, M Sharon Stack
Mucosal infection by the human papillomavirus (HPV) is responsible for a growing number of malignancies, predominantly represented by cervical cancer and oropharyngeal squamous cell carcinoma. Because of the prevalence of the virus, persistence of infection, and long latency period, novel and low-cost methods are needed for effective population level screening and monitoring. We review established methods for screening of cervical and oral cancer as well as commercially-available techniques for detection of HPV DNA...
September 9, 2016: Cancers
Thomas C Randall, Rahel Ghebre
Virtually all cases of invasive cervical cancer are associated with infection by high-risk strains of human papilloma virus. Effective primary and secondary prevention programs, as well as effective treatment for early-stage invasive cancer have dramatically reduced the burden of cervical cancer in high-income countries; 85% of the mortality from cervical cancer now occurs in low- and middle-income countries. This article provides an overview of challenges to cervical cancer care in sub-Saharan Africa (SSA) and identifies areas for programmatic development to meet the global development goal to reduce cancer-related mortality...
2016: Frontiers in Oncology
Nicolas Çuburu, John T Schiller
Persistent human papillomavirus (HPV) is the primary etiologic agent of cervical cancer and causes a significant number of vulvar, penile, anal and oropharyngeal cancers. The development of highly effective HPV therapeutic vaccines is a reasonable goal given the recent advances in basic and applied immunology. A number of vaccine strategies designed to induce systemic T cell responses have been tested in clinical trials against high grade cervical or vulvar high grade neoplasia and cancers, but with limited success...
November 2016: Human Vaccines & Immunotherapeutics
Yu-Ligh Liou, Tao-Lan Zhang, Tian Yan, Ching-Tung Yeh, Ya-Nan Kang, Lanqin Cao, Nayiyuan Wu, Chi-Feng Chang, Huei-Jen Wang, Carolyn Yen, Tang-Yuan Chu, Yi Zhang, Yu Zhang, Honghao Zhou
BACKGROUND: Opportunistic screening in hospitals is widely used to effectively reduce the incidence rate of cervical cancer in China and other developing countries. This study aimed to identify clinical risk factor algorithms that combine gynecologic examination and molecular testing (paired box gene 1 (PAX1) or zinc finger protein 582 (ZNF582) methylation or HPV16/18) results to improve diagnostic accuracy. METHODS: The delta Cp of methylated PAX1 and ZNF582 was obtained via quantitative methylation-specific PCR in a training set (57 CIN2- and 43 cervical intraepithelial neoplasia ≥grade 3 (CIN3+) women), and the individual and combination gene sensitivities and specificities were determined...
2016: Clinical Epigenetics
Curtis W Peterson, Donny Rose, Jonah Mink, David Levitz
In many developing nations, cervical cancer screening is done by visual inspection with acetic acid (VIA). Monitoring and evaluation (M&E) of such screening programs is challenging. An enhanced visual assessment (EVA) system was developed to augment VIA procedures in low-resource settings. The EVA System consists of a mobile colposcope built around a smartphone, and an online image portal for storing and annotating images. A smartphone app is used to control the mobile colposcope, and upload pictures to the image portal...
2016: Diagnostics
Nancy Jain, Ajay Halder, Ragini Mehrotra
Low uptake of cervical cancer screening is not a matter of poor coverage of health care facilities only. We wish to identify the perceived reasons behind low uptake of screening in Bhopal region and also possible solutions for an urban setting. In a mixed research, through a series of focused group discussions, we wished to do thematic interpretation of the perceptions towards cervical cancer screening by deductive content analysis of FGD and also to obtain a free list of perceived causes and solutions with Smith's saliency score and perform cluster analysis by pile sorting...
2016: Scientifica
Adriana T Lorenzi, José Humberto T Fregnani, Júlio César Possati-Resende, Márcio Antoniazzi, Cristovam Scapulatempo-Neto, Stina Syrjänen, Luisa L Villa, Adhemar Longatto-Filho
BACKGROUND: Human papillomavirus (HPV) DNA testing can be crucial for women who have limited access to traditional screening. The current study compared the results obtained through HPV DNA testing with those obtained through cytology-based screening. METHODS: A total of 3068 women aged 18 to 85 years were enrolled in an opportunistic cervical cancer screening program developed by the Barretos Cancer Hospital and performed by a team of health professionals working within a mobile unit from March to December 2012, followed by statistical analyses...
August 2016: Cancer Cytopathology
Christine Campbell, Savel Kafwafwa, Hilary Brown, Graeme Walker, Belito Madetsa, Miriam Deeny, Beatrice Kabota, David Morton, Reynier Ter Haar, Liz Grant, Heather A Cubie
The incidence of cervical cancer in Malawi is the highest in the world and projected to increase in the absence of interventions. Although government policy supports screening using visual inspection with acetic acid (VIA), screening provision is limited due to lack of infrastructure, trained personnel, and the cost and availability of gas for cryotherapy. Recently, thermo-coagulation has been acknowledged as a safe and acceptable procedure suitable for low-resource settings. We introduced thermo-coagulation for treatment of VIA-positive lesions as an alternative to cryotherapy within a cervical screening service based on VIA, coupled with appropriate, sustainable pathways of care for women with high-grade lesions and cancers...
August 15, 2016: International Journal of Cancer. Journal International du Cancer
Rubina Shaikh, Vasumathi G Prabitha, Tapas Kumar Dora, Supriya Chopra, Amita Maheshwari, Kedar Deodhar, Bharat Rekhi, Nita Sukumar, C Murali Krishna, Narayanan Subhash
Optical spectroscopic techniques show improved diagnostic accuracy for non-invasive detection of cervical cancers. In this study, sensitivity and specificity of two in vivo modalities, i.e diffuse reflectance spectroscopy (DRS) and Raman spectroscopy (RS), were compared by utilizing spectra recorded from the same sites (67 tumor (T), 22 normal cervix (C), and 57 normal vagina (V)). Data was analysed using principal component - linear discriminant analysis (PC-LDA), and validated using leave-one-out-cross-validation (LOOCV)...
March 1, 2016: Journal of Biophotonics
Lynne Hampson, Innocent O Maranga, Millicent S Masinde, Anthony W Oliver, Gavin Batman, Xiaotong He, Minaxi Desai, Parmenas M Okemwa, Helen Stringfellow, Pierre Martin-Hirsch, Alex M Mwaniki, Peter Gichangi, Ian N Hampson
BACKGROUND: Cervical cancer is the most common female malignancy in the developing nations and the third most common cancer in women globally. An effective, inexpensive and self-applied topical treatment would be an ideal solution for treatment of screen-detected, pre-invasive cervical disease in low resource settings. METHODS: Between 01/03/2013 and 01/08/2013, women attending Kenyatta National Hospital's Family Planning and Gynaecology Outpatients clinics were tested for HIV, HPV (Cervista®) and liquid based cervical cytology (LBC-ThinPrep®)...
2016: PloS One
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