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Perception and Practices on Screening and Vaccination for Carcinoma Cervix among Female Healthcare Professional in Tertiary Care Hospitals in Bangalore, India

  • Swapnajaswanth, M.;Suman, G.;Suryanarayana, S.P.;Murthy, N.S.
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6095-6098
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    • 2014
  • Background:Cervical cancer is potentially the most preventable and treatable cancer. Despite the known efficacy of cervical screening, a significant number of women do not avail themselves of the procedure due to lack of awareness. Objectives: This study was conducted to elicit information on the knowledge, attitude and practice (KAP) regarding screening (Pap test) and vaccination for carcinoma cervix among female doctors and nurses in a tertiary care hospital in Bangalore and to assess barriers to acceptance of the Pap test. Materials and Methods: A cross-sectional, descriptive study was conducted with semi-structured, self-administered questionnaire among female health professionals. The study subjects were interviewed for KAP regarding risk factors for cancer cervix, Pap test and HPV vaccination for protection against carcinoma cervix. Results: Higher proportion of doctors 45 (78.9%) had very good knowledge as compared to only 13 (13.3%) of the nurses, about risk factors for cancer cervix and Pap test (p=0.001). As many as 138(89.6%) of the study subjects had favorable attitude towards Pap test and vaccination, but 114 (73.6%) of the study subjects never had a Pap test and the most common reason 35 (31%) for not practicing was absence of disease symptoms. Conclusions: In spite of good knowledge and attitudes towards cancer cervix and Pap test being good, practice remained low among the study subjects and most common reasons for not undergoing Pap test was absence of disease symptoms. The independent predictors of ever having a Pap test done was found to be the occupation and duration of married life above 9yrs. Hence there is a strong need to improve uptake of Pap test by health professionals by demystifying the barriers.

Effects of Prevention Education on Human Papillomavirus linked to Cervix Cancer for Unmarried Female University Students (미혼 여대생에게 적용한 인유두종 바이러스 연계 자궁경부암 예방교육의 효과)

  • Kim, Hae-Won
    • Journal of Korean Academy of Nursing
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    • v.39 no.4
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    • pp.490-498
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    • 2009
  • Purpose: This study was done to identify the effects of a Human Papillomavirus (HPV) linked to cervix cancer prevention education program for unmarried university female students. A new model in the cervix cancer prevention is provided. Methods: The research design was a nonequivalent control group pretest-posttest design. Participants were 63 female students in one of two university in an experimental group (29 students) and control group (34 students). After 4 weeks education, the differences between the two groups in the measurement variables were compared. Twelve weeks later, a follow-up test was done for experimental group only. Results: After the education, experimental group showed significantly higher scores in all variables, the intention for Pap test (Z=-3.73, p<.001), intention for HPV vaccination (Z=-3.14, p=.002), general cancer prevention behavior (Z=-2.20, p=.028), attitudes to Pap (Z=-3.23, p=.001), benefits of cancer prevention behavior (Z=-3.97, p<.001), and HPV linked to cervix cancer knowledge (Z=-5.40, p<.001). In the follow-up study, the experimental group showed intermediate effects in intention for Pap test, intention of HPV vaccination and HPV linked to cervix cancer knowledge as well as short term effects in general cancer prevention behavior, attitudes to Pap and benefits of cancer prevention behavior. Conclusion: The program developed for this study on prevention education of HPV linked to cervix cancer was effective for unmarried university students in the short term and intermediate duration. Other educational approaches should be developed and short term effects and longitudinal changes of the education should be assessed. This education program should also be replicated for other female groups including unmarried working women or female adolescents.

Cytologic Features of Signet Ring Cell Carcinoma of the Uterine Cervix - A Report of Two Cases - (자궁목 반지세포암종의 세포학적 소견 -2예 보고-)

  • Cho, Hyun-Yee;Ha, Seung-Yeon;Chung, Jae-Gul;Oh, Young-Ha;Chung, Dong-Hae;Kim, Na-Rae;Lee, Jong-Min;Lee, Eui-Don
    • The Korean Journal of Cytopathology
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    • v.14 no.2
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    • pp.66-70
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    • 2003
  • Signet ring cell carcinoma is a rare type of mucinous adenocarcinoma of the uterine cervix. To the best of our knowledge, there is no report on cytologlc findings of primary signet ring cell carcinoma of the uterine cervix in the literature. Recently, we experienced two cases of signet ring cell carcinoma of the uterine cervix. The finding of characteristic signet ring cells on cervicovaginal smear led to the diagnosis of signet ring cell carcinoma. However, primary signet ring cell carcinoma could not be cytologically distinguished from more common metastatic tumor. Therefore, diagnosis rests upon the recognition of signet ring cells and the absence of signet ring cell carcinoma elsewhere.

Chemoradiation Related Acute Morbidity in Carcinoma Cervix and Correlation with Hematologic Toxicity: A South Indian Prospective Study

  • Kumaran, Aswathy;Guruvare, Shyamala;Sharan, Krishna;Rai, Lavanya;Hebbar, Shripad
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.11
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    • pp.4483-4486
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    • 2014
  • Purpose: To assess chemoradiation related acute morbidity in women with carcinoma cervix and to find and correlation between hematologic toxicity and organ system specific damage. Materials and Methods: A prospective study was carried out between August 2012 and July 2013 enrolling 79 women with cancer cervix receiving chemo-radiotherapy. Weekly assessment of acute morbidity was done using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4 and the toxicities were graded. Results: Anemia [77 (97.5%)], vomiting [75 (94.8%)] and diarrhea [72 (91.1%)], leukopenia [11 (13.9%)], cystitis [28 (35.4%], dermatitis [19 (24.1%)] and fatigue [29 (36.71%)] were the acute toxicities noted. The toxicities were most severe in $3^{rd}$ and $5^{th}$ week. All women could complete radiotherapy except two due to causes unrelated to radiation morbidity; seven (8.86%) had to discontinue chemotherapy due to leukopenia and intractable diarrhea. Though there was no correlation between anemia and other toxicities, it was found that all with leukopenia had diarrhea. Conclusions: Chemoradiation for cancer cervix is on the whole well tolerated. Leukopenia and severe diarrhea were the acute toxicities that compelled discontinuation of chemotherapy in two women. Though anemia had no correlation with gastrointestinal toxicity, all of those with leukopenia had diarrhea.

The Cytologic Analysis of Microinvasive Squamous Cell Carcinoma of the Uterine Cervix on Cervical Smear (자궁경부 세포도말 검사에시 미세침윤성 편평세포암종의 세포학적 분석)

  • Choi, Hyun-Joo;Park, In-Ae
    • The Korean Journal of Cytopathology
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    • v.12 no.1
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    • pp.31-37
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    • 2001
  • Whlie cytologic characteristics of squamous dysplasia, carcinoma in situ, and invasive squamous cell carcinoma of the uterine cervix are well documented, relatively few studios have dealt with the cellular features of microinvasive carcinoma. In order to describe the cellular characteristics of microinvasive squamous cell carcinoma, we retrospectively reviewed 45 cervovaginal smears(15 carcinoma in situ, 15 microinvasive cancer, 15 invasive cancer) which were confirmed by histologic examination of specimens obtained by hysterectomy at the Seoul National University Hospital during S years from 1995 to 1999. The cytologic features about tumor diathesis, inflammatory background, ceil arrangement, anisonucleosis, nuclear membrane irregularity, nuclear chromatin pattern, and nucleoli were observed. The cytologlc characteristics of microinvasive squamous cell carcinoma of the uterine cervix are syncytial pattern, mild tumor diathesis, the irregularity of nuclear membrane, irregularly distributed nuclear chromatin, and occurrence of micronucleoli. But, correlation between the depth of Invasion and the cytologic feature had limited value.

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Metastatic Small Cell Neuroendocrine Carcinoma of the Liver from the Uterine Cervix (간으로 전이된 자궁경부의 신경내분비 소세포암의 세포학적 소견)

  • Kim, Yee-Jeong;Lee, Kwang-Gil
    • The Korean Journal of Cytopathology
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    • v.2 no.2
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    • pp.98-104
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    • 1991
  • We present the cytologic features of small ceil neuroendocrine carcinoma of the liver metastasized from the uterine cervix. Cytologically, tumor cells were arranged in a pattern of solid sheet in necrotic background. The tumor cells were characterized by uniform, small cells, round hyperchromatic nuclei, and high nuclear cytoplasmic ratio. The smears showed frequent mitotic figures and rosette formation. These findings were identified with the previous histologic sections of uterine cervix. To make a diagnosis of metastatic small ceil neuroendocrine carcinoma on the Papanicolaou smear, a high index of suspicion and careful review of clinical history are needed.

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Cytologic Features of Glassy Cell Carcinoma of the Uterine Cervix (자궁 경부의 유리질 세포 암종의 세포학적 소견)

  • Kong, Gu;Kim, Eun-Kyung;Hong, Eun-Kyung;Lee, Jung-Dal
    • The Korean Journal of Cytopathology
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    • v.2 no.1
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    • pp.62-66
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    • 1991
  • Glassy cell carcinoma is an unusual neoplasm of the uterine cervix with highly aggressive clinical behavior. On cervico-vaginal smear examination, the tumor has well confused of atypical repair ceil of the endocervix. Recently, we have experienced two cases of glassy cell carcinoma of the uterine cervix, diagnosed on cervico-vaginal smears and confirmed on fellowing histologic sections. The cervico-vaginal smears revealed abundant clusters with well defined boarders. The cell clusters were composed of large tumor cells. The tumor cells had distinct granular cytoplasm and eosinophilic macronucleoli, Characteristic cytologic features of this tumor were discussed in view of differential diagnosis.

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Application of the Theory of Planned Behavior and the Theory of Reasoned Action to Predicting Cervix Cancer Screening Behavior (자궁암 조기검진행태 예측을 위한 계획된 행동이론과 이성적 행동이론의 적용)

  • Kim, Yong-Ik;Kim, Chang-Yup;Shin, Young-Soo;Lee, Kun-Sei
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.4
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    • pp.379-388
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    • 2001
  • Background : Cervix cancer is the most common form of cancer among Korea women. in spite of proof that cervical cancer screening could reduce death rates substantially, the screening rates reported by previous Korean studies remain stubbornly very low. Behavioral studies to increase the cervix cancer screening rate are essential in order to develop the cancer screening program. Objective : To evaluate the factors which are related to the intention and behavior for cervix cancer screening using the Theory of Planned Behavior (TPB) and the Theory of Reasoned Action (TRA). Methods : The survey was conducted from July 21 st to 26th in 1998. Of 3,218 women, 303(12.2%) between 30 and 55 years old, voluntarily participated in the survey in the 3 Myeons in Choongju city. Charge-free cervix cancer screening was provided for the subjects 3 months later. Results : The R-square of both TPB and TRA to the intention (30% and 42%, respectively) was greater than the actual behavior (21% and 13%, respectively. TPB and TRA were found to provide an appropriate framework for the study of cervix cancer screening behavior. However, TRA was more powerful in explaining the intention, not only because the perceived behavioral control component exhibited lower reliability and validity than other components(altitude and subjective norm), but also because there may have been a few limitations in this study design. Consequently, the use of TRA is preferred in attempting to explain intention and actual behavior in this study. Conclusions : This study suggests that a successful intervention program should focus on changing attitudes and reducing psychologic barriers, rather than on just providing information. Physician recommendations, and the support of family members and friends are also very important factors in cervix cancer program participation. Physicians, friends, family members, and opinion leaders in rural areas, all of whom could affect the individual subjective norm, may all have the potential to play great roles as facilitators.

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Intraarterial Scintigraphy in Recurrent Cervix Cancer - The Evaluation of Radionuclide Therapeutic Trials - (자궁경부재발암 환자의 국소동맥 주입식 동위원소 검사 -방사성 동위원소의 치료시도를 위한 평가-)

  • Kim, Eun-Young;Suh, Jin-Suck;Park, Chang-Yun;Lee, Jong-Tae;Yoo, Hyung-Sik
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.2
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    • pp.293-298
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    • 1990
  • We performed 17 intraarterial scintigraphies in six patients with recurrent cervix cancer. With Seldinger method, the agent (four different radiopharmaceuticals) was perfused at the same speed of infusion of anticancer drugs (25 cc/hour) through internal iliac artery. There were four different radiopharmaceuticals; I-131-Lipiodol, Tc (Technetium)-99m-HSa (Human Serum Albumin), $^{99m}Tc-Sucralfate$ and $^{99m}Tc-MAA$ (Macroaggraegated Albumin). We evaluate the distribution pattern of radioactivity by the use of ratio of Tumor/Extratumor uptake (T/ET ratio). Our results reveals that $^{99m}Tc-MAA$ scan showed the highest T/ET ratio and the other were not ideal agents for intraarterial therapy of recurrent cervix cancer. In conclusion, an ideal radioisotope and tracer which can block capillary, for example MAA, should be re-evaluated or produced in order to treat the patient with recurrent cervix cancer.

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Composite Tumor of Adenocarcinoma and Small Cell Neuroendocrine Carcinoma of the Uterine Cervix -A Case Report- (자궁 경부의 선암과 혼합된 신경내분비 소세포 암종 - 1 증례 보고 -)

  • Park, Hye-Rim;Lee, Yong-Woo;Park, Young-Euy
    • The Korean Journal of Cytopathology
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    • v.1 no.1
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    • pp.111-120
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    • 1990
  • Small cell neuroendocrine carcinoma of the uterine cervix is a distinct subtype of cervical cancer that appears analogous to oat cell carcinoma and carcinoid tumors of the lung. It has been assumed to be derived from the neural crest via argyrophilic cells in the normal endocervix. We have recently encountered a case of small cell neuroendocrine carcinoma of the uterine cervix coexisting with adenocarcinoma which was argyrophil negative. A 66-year-old multiparous woman was admitted because of vaginal bleeding for 2 months. Cervicovaginal smear revealed several scattered clusters and sheets of monotonous small cells with some peripheral palisading in the background of hemorrhage and necrosis. Radical hysterectomy specimen revealed an ulcerofungating tumor on endocervical canal which was composed of two components. Major component of the tumor was made up of monomorphic population of small oval-shaped tumor cells arranged in sheets and partly in acinar structures or trabecular fashion. Other component was adenocarcinoma, endocervical well-differentiated type. Argyrophilia was present on the Grimelius stain and immunohistochemical studies revealed diffuse positivity to neuron-specific enolase and carcinoembryonic antigen. Electron microscopic examination showed clusters of small round to oval cells, which had a few well-formed desmosomes and several membrane-bound, dense-core neurosectetory granules.

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