A Profile of Mexican-Born Women Who Adhere to National Cervical Cancer Screening Recommendations

The purpose of this study was to examine Mexican-born women’s utilization and adherence to cervical cancer screening guidelines. Ninety-seven women in the southeastern United States participated. Data were collected in Spanish. The majority of women met adherence guidelines for the pap exam. Marital status, educational attainment, marianismo, blood pressure knowledge, fatalism, cultural cancer beliefs, trust in provider, and perceived provider communication abilities were not associated with utilization or adherence to screening guidelines. This study had higher than expected adherence to screening guidelines. Nearly all women received screenings through safety net services indicating the need to advocate for continued public health funding.     

Social Support and Cervical and Breast Cancer Screening in Argentinean Women From a Rural Population

ABSTRACT Objective: To examine whether emotional social support influences the use of 3 cancer screening tests in females.
Design: Cross-sectional study.
Sample: Data were collected via a household survey of a random sample of 200 Argentinean women.
Measurements: The questionnaire included self-reported data about the cancer screening tests (Papanicolaou [Pap] test for cervical cancer, breast self-examination, and clinical examination for breast cancer), and socioeconomic background information. Social support was measured by the Duke-UNC-11 questionnaire.
Analysis: Logistic models were used to investigate the association between social support and cancer screening tests.
Results: Emotional social support was associated with having participated in Pap screening within 3 years before this study, but a link between social support and self or clinical breast examination was not supported.
Conclusion: Emotional social support may play a role in early cervical cancer detection among Argentinean females, specifically by encouraging performance of the Pap test. The educational practices accomplished by nurses should include actions that involve the family and community; therefore, emphasizing the importance of social ties on health and promoting interactions between target women and existent social groups in the community.     

Prevalence and Predictors of Breast and Cervical Cancer Screening Among Spanish Women With Diabetes

OBJECTIVE

To examine the use of mammography and Papanicolaou (Pap) smear among women with diabetes and to identify predictors of adherence to these tests.

RESEARCH DESIGN AND METHODS

We analyzed data of a nationally representative sample of Spanish women. Diabetes status was self-reported. Screenings were assessed asking whether they had a mammography (≥40 years) and a Pap smear (18–69 years) within the previous 2 and 3 years, respectively.

RESULTS

Women with diabetes were less likely to receive mammography (57.9%) or have a Pap smear (61.5%) than women without diabetes (mammography 61.9%, P < 0.05; Pap smear 65.6%, P < 0.05). After adjusting for age, educational level, income, comorbidity, tobacco use, obesity, and physician visits, the corresponding odds ratios remained significant (0.84, 95% CI 0.72–0.97) and (0.82, 95% CI 0.66–0.98). Higher educational level was a positive predictor for both tests among diabetic women.

CONCLUSIONS

Spanish women with diabetes underuse breast and cervical cancer screening tests.Women with diabetes have an increased incidence of breast cancer, and women diagnosed with this cancer who have preexisting diabetes are at increased risk of breast cancer mortality compared with those without diabetes (1,2).The relationship between diabetes and risk of cervical cancer remains to be evaluated, but cervical cancer mortality is higher in obese women, being these conditions are strongly associated with diabetes (3,4).Spanish preventive practice guides recommend mammography for women aged 50–69 years every 1–2 years and beginning at 40 years if any condition that increases risk exists (5). For cervical carcinoma, recommendations include screening with Papanicolaou (Pap) smear for 2 years starting 3 years after women become sexually active, and if both yield normal results, repeat every 3 years (6). In Spain, population-based programs for breast and cervical cancer prevention are established by the Public Health System and provide free mammography and Pap smears to target populations (5,6). However, adherence to the cancer screening guidelines is not known among Spanish women with diabetes.Studies conducted in the U.S. and Canada have shown that women with diabetes undergo mammography and Pap smear less frequently than women without diabetes (7–10). We aimed to examine and compare the prevalence of receiving breast and cervical cancer screenings among women with and without diabetes and to identify predictors of adherence to these recommendations among women with diabetes.     

阴道镜结合活检在宫颈癌筛查中的临床应用

目的总结分析阴道镜结合活检在筛查宫颈癌中的应用价值。方法选择2014年1月~2015年1月我院组织进行宫颈癌筛查的1218例妇女为研究对象,采用TCT宫颈液基细胞学检查、HPV高危乳头瘤病毒检查,必要时进行阴道镜检查与组织细胞活检,以病理检查诊断结果为金标准,分析比较诊断结果。结果 172例TCT检查阳性中CIN和宫颈癌的检出数为112例,检出率为65.12%（112/172）,其中LSIL、HSIL和宫颈癌的病理阳性检出率分别为56.98%（49/86）、93.18%（41/44）和52.38%（22/42）。220例HPV检查中阳性中CIN和宫颈癌的检出数为132例,检出率为60.00%（132/220）,其中LSIL、HSIL和宫颈癌的病理阳性检出率分别为28.18%（31/110）、76.47%（39/51）和96.61%（57/59）。1218例阴道镜检查与组织细胞活检诊断1062例宫颈炎,156例CIN与宫颈癌,其57例CINI、33例CINII、12例CINIII、原位癌49例、腺癌3例、浸润癌2例,活检阳性率为12.81%（156/1218）。采用TCT宫颈液基细胞学检查联合HPV高危乳头瘤病毒检查,对可疑病例进行阴道镜检查与组织细胞活检病理诊断的模式,对于提前诊断病例的宫颈癌治愈率达到100%。结论采用宫颈液基细胞学检查和HPV高危乳头瘤病毒联合检查后对可疑病例进行阴道镜活检的行阴道镜检查下宫颈多点活检应用价值高,可以提高检出率,对早发现宫颈癌具有重要的实际意义。     

贵州地区宫颈癌机会性筛查资料分析

目的探讨贵州地区进行宫颈癌机会性筛查的价值。方法回顾性分析2010年11月-2011年10月贵州省人民医院妇科门诊及住院进行宫颈癌机会性筛查的1 842例患者资料,筛查方法包括液基细胞学技术、宫颈刮片、人乳头瘤病毒(HPV)分型检测、HPV第2代捕获杂交法检测、阴道镜检查,以病理确诊宫颈癌前病变及宫颈癌。结果贵州地区女性人群的HPV平均感染率为21.87%。共检出宫颈癌前病变39例(2.12%),宫颈癌2例(0.11%)。结论医院内就诊女性宫颈病变检出率高,应高度重视其机会性筛查,有助于早期干预治疗。     

Increasing Adherence to Cervical Cancer Screening Guidelines

The dramatic changes in the 2009 American College of Obstetrician and Gynecologists’ (ACOG) cervical cancer screening guidelines created challenges in clinical implementation. When audited in October 2010, adherence to the new guidelines by clinicians in a university health center was 73.95%. After implementation of a multifaceted quality-improvement project, adherence significantly improved to 90.20%. This article discusses the components of a quality-improvement project focused on increasing providers’ adherence to guideline-consistent practice.     

HPV DNA病毒载量检测在亚临床型女性宫颈癌筛查中的应用价值

目的 探讨人乳头瘤病毒(human papillomavirus,HPV)DNA的病毒载量检测在亚临床型女性宫颈癌筛查中的应用价值.方法 拟设计4条分别针对HPV16,18,33,58与人β-球蛋白的特异性引物与探针,建立一种新型的荧光定量PCR方法,对541例亚临床型女性宫颈组织细胞进行HPV型别和病毒载量检测.结果 541例样本中β-球蛋白结果阳性的标本521例,其中56例HPV DNA阳性.HPV16,HPV18型以及多重感染的阳性检出率分别为46.42%(26/56),23.21%(13/56),30.36%(17/56);感染的最低病毒载量分别为≥103拷贝/"细胞",≥104拷贝/"细胞",≥102拷贝/"细胞";单一型别HPV感染的病毒载量高于多重感染的病毒载量,且二者之间差异有统计学意义(P<0.05).结论 HPV16,HPV18是亚临床女性感染HPV的主要型别,HPV DNA病毒载量的检测为宫颈癌的常规筛查提供了一个动态监测手段.     

广西沿海地区妇女宫颈病变感染人乳头瘤病毒分布特点

目的分析广西沿海地区妇女宫颈病变感染HPV的状况和分布规律;探讨HPV感染与宫颈病变发生的关系。方法将164例临床宫颈有病变、HPV-DNA分型检测阳性患者,按病理检查结果分为3组：慢性炎症组（n=22）、宫颈上皮内瘤变（CINⅠ、Ⅱ、Ⅲ）组（n=73）和宫颈癌组（n=69）。采集患者宫颈脱落细胞样本,用人乳头瘤病毒核酸扩增分型检测方法作HPV基因分型检测,分析HPV感染状况及HPV基因型在各组疾病中的分布。结果 164例HPV阳性标本中,21种亚型有20种亚型被检测到,未被检出是低危型HPV42型;HPV单一感染者117例（71.3%）,多重感染47例（28.7%）。慢性炎症组的阳性率13.4%,常见HPV基因型为16、52、58、18、33、53;宫颈上皮内瘤变组阳性率为44.5%,常见HPV基因型为16、18、33、52、58、31;宫颈癌组阳性率为42.1%,常见HPV基因型为16、18、33、31、58、52。结论广西沿海地区妇女宫颈病变以HPV16、18型感染为主,其次是33、52、58、31型。HPV-DNA分型检测可为宫颈癌高危人群的筛查、临床诊断、预后判断及疫苗的研制提供重要的理论依据。     

子宫颈癌筛查方法研究现状

目的:探讨目前宫颈癌筛查方法进展.方法:子宫颈癌筛查方法采用宫颈细胞学检查、肉眼醋酸及碘试验、阴道镜检查、人乳头瘤病毒(HPV)的检测.结果:随着宫颈癌病因学的研究发展,其防治方法也在不断地提高和发展.结论:宫颈阴道细胞涂片技术的重大进步,TBS分类的出台、HPV检测自动化和标准化等,使宫颈癌的防治和筛查提升了一个新水平.     

An Association Between Trichomonas vaginalis and High-Risk Human Papillomavirus in Rural Tanzanian Women Undergoing Cervical Cancer Screening

Objective

The goal of this study was to determine the prevalence of vaginitis and its association with high-risk human papillomavirus (HR HPV) in women undergoing cervical cancer screening in rural Tanzania.

Methods

For the purpose of cervical cancer screening, cytology and HR HPV polymerase chain reaction data were collected from 324 women aged between 30 and 60 years. Microscopy and gram stains were used to detect yeast and bacterial vaginosis. Cervical nucleic acid amplification test specimens were collected for the detection of Trichomonas vaginalis (TV), Chlamydia trachomatis, and Neisseria gonorrhoeae.

Results

The majority of women were married (320 of 324) and reported having a single sexual partner (270 of 324); the median age of participants was 41 years. HR HPV was detected in 42 participants. Forty-seven percent of women had vaginitis. Bacterial vaginosis was the most common infection (32.4%), followed by TV (10.4%), and yeast (6.8%). In multivariable logistic regression analysis, TV was associated with an increased risk of HR HPV (odds ratio, 4.2 [95% CI, 1.7–10.3]). Patients with TV were 6.5 times more likely to have HPV type 16 than patients negative for TV (50% vs 13.3%) (odds ratio, 6.5 [95% CI, 1.1–37]).

Conclusions

Among rural Tanzanian women who presented for cervical cancer screening, Trichomonas vaginitis was significantly associated with HR HPV infection (specifically type 16).