• Korean Journal of Clinical Laboratory Science
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• v.43 no.1
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• pp.26-31
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• 2011

The genotypes of Human Papilloma Virus (HPV) are important in the carcinogenesis of uterine cervical cancer. Diagnosis of uterine cervical cancer screening has been executed using Papanicolau method (Pap) and HPV DNA Chip method. We researched the interrelation of HPV DNA genotypes in single and multiple infections and analyzed the results of Pap and HPV DNA Chip tests at Gunsan Medical Center (GMC). The correlation analysis was surveyed on collected results from 599 patients who have been tested with both Pap and HPV DNA chip tests from November 2004 to May 2010 at GMC. The inconsistency between Pap and HPV DNA Chip tests was 41.1%. The HPV DNA Chip genotype related with high risk cases were type 16 (13.5%), type 52 (10.5%), type 58 (10.1%), and type 18 (3.4%). Those related with low risk cases were type 70 (8.9%), type 6 (1.7%), type 40 (1.2%), type 11 (1.3%), and other types (14.3%). Among the 195 cases of HPV positive status, 161 cases were associated with single infection; 108 (67.1%) cases were related with high risk genotype; 19 (11.8%) cases were low risk genotype; 31 (21.1%) cases were related with other types. 29 cases were associated with double infections; 23 (79.3%) cases were high risks; 5 (17.2%) cases were mixed high and low risks; 1 (3.5%) case was low risk.

• Korean Journal of Health Education and Promotion
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• v.15 no.2
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• pp.163-183
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• 1998

To evaluate the impacts of the health education programs including smoking cessation, pap smear and breast self-examination(BSE), a community trial was conducted during one year from December 1996 to December 1997 in Kyongju City. Before health education, a base-line survey was implemented and the target population was allocated randomly to case and control groups. The case and control groups were divided into three categories which were smoking cessation, pap smear and BSE. The series of health education leaflets about anti-smoking, pap smear and BSE were mailed to case group and the evaluation survey was conducted at the end of this trial to compare the change of health related behaviours of case and control groups. Smoking prevalence of case group did not decline significantly after anti-smoking education but the cessation rates of the elderly and low educated were higher than others. The knowledge level of case group on the health risk associated with smoking was higher than that of control group and the willingness of case group to quit smoking was higher than the control group. The case group's compliance with pap smear for cervical cancer was more increased compared to control group after health education. Of the case group, the younger and lower educated women were screened at a higher rate than others. The knowledge level of case group on the risk factors of cervical cancer and how to prevent it was higher than that of control group. Nearly 60 percent of case group reported that the health education leaflet influenced them to have the pap smear. The unscreened cases were highly motivated to get the pap smear test in the future.

• Journal of Korea Association of Health Promotion
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• v.2 no.1
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• pp.27-37
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• 2004

Background 'For many years, the Papanicolaou smear has been used to detect pre-malignant and malignant disease of the cervix. Although cervical cytology screening programmes have result in the reduction of cervical cancer incidence and mortality, Pap smear have been subjected to intense scrutiny and criticism in recent years. So cervicography is introduced. Cervicography is an adjunct method of cervical cancer screening intended to complement Papanicolaou smear. Cervicography involve obtaining and evaluating a photographic image of the cervix. The purpose of this investigation was to evaluate the efficacy of Papanicolaou smear and cervicography in cervical cancer screening. Materials & Methods : This study population was of 74 women, who visited department of obstetrics & Gynecology, Korea association of Health Promotion Chung-nam branch from January, 20O2 to October, 2003. All patients were taken Pap smear before cervicography, and then two cervicography was obtained with applying5% acetic acid. Those women in whom abnormalities were detected by either test subsequently obtained histologic specimen. Results : 1. The sensitivity and the specificity of Papanicolaou smear was 92.1% and 72.7%respectively.2. The sensitivity and the specificity of cervicography was 88.9% and 54.5% respectively. The false negative rate, and false positive rate of Papanicolaou smear were 7.9%, 27.2% respectively. The false negative rate, and false positive rate of cervicography were 11.1%,45.5% respectively. Conclusions . Papanicolaou smear is a useful method and an important tool for detecting cervical cancer. However when Papanicolaou smear and Cervicograpy is used together, the sensitivity is higher than for Papanicolaou smear used alone.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7235-7239
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• 2014

Cervical cancer, the third commonest cancer in women worldwide, can be prevented through early detection by cervical screening (Pap smear). The aim of this study was to investigate the attitudes and practice of cervical cancer screening among female undergraduate university students from 25 low, middle income and emerging economy countries. Using anonymous questionnaires, data were collected from 9,194 female undergraduate university students aged 18-26 years (mean age 20.9, SD=2.0) from 26 universities in 25 countries across Asia, Africa and the Americas. Overall, 11.6% of the female students indicated that they had conducted one or more times a cervical (Pap) smear test; 8.3% among 18-20 year-olds and 15.6% among 21-26 year-old students. There was considerable country variation on having had a cervical (Pap) smear test among 21-26 year-old female university students, ranging from 59.2% in Colombia and 50.9% in Barbados to 0% in India and 1.0% in Tunesia. Logistic regression showed that cervical cancer screening importance or positive attitude were highly associated with the cervical screening practice. Moreover, risky sexual behaviour and tobacco use, two cervical cancer risk factors, were associated with screening. Cervical cancer screening practices were found to be inadequate and e fforts should be made to develop programmes that can increase the uptake of cervical cancer screening.

• Journal of Biomedical Engineering Research
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• v.22 no.3
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• pp.231-239
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• 2001

This paper proposes a region segmenting method for the Pap-smear image. The proposed method uses a pixel classifier based on neural network, which consists of four stages : preprocessing, feature extraction, region segmentation and postprocessing. In the preprocessing stage, brightness value is normalized by histogram stretching. In the feature extraction stage, total 36 features are extracted from $3{\times}3$ or $5{\times}5$ window. In the region segmentation stage, each pixel which is associated with 36 features, is classified into 3 groups : nucleus, cytoplasm and background. The backpropagation network is used for classification. In the postprocessing stage, the pixel, which have been rejected by the above classifier, are re-classified by the relaxation algorithm. It has been shown experimentally that the proposed method finds the nucleus region accurately and it can find the cytoplasm region too.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1527-1530
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• 2014

Background: Time to colposcopy (TC) after abnormal Pap smears was evaluated for influence on cytohistologic correlation (CHC). Materials and Methods: This retrospective study assessed the correlation between TC and CHC of women who had abnormal Pap smears. Colposcopic chart review included participants from 2010-2013 who attended a colposcopic clinic, Thammasat University Hospital, Thailand. Results: Four hundred and sixty cases who had abnormal Pap smears were recruited. Pap reports were atypical smears with low grade squamous intraepithelial lesion (SIL), high grade SIL and cancer at 339, 114 and 7 cases, respectively. One hundred and twenty four patients underwent loop electrosurgical excision procedure (LEEP). A half of the cases were colposcopically examined within 1-2 months after abnormal Pap collection. CHC was 88 percent and not affected at all by TC. Subjects who attended cervical cancer screening from affiliated health providers had shorter TC than those screened in our tertiary hospital. Conclusions: Time to colposcopy with abnormal Pap smears conducted at Thammasat University Hospital had a highest frequency of 42 days, in line with the literature. Length of TC does not affect the correlation between Pap and histopathologic reports. A longer waiting period for colposcopy did not alter progression or regression of the disease.

• Biomedical Science Letters
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• v.4 no.2
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• pp.143-151
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• 1998

To study the incidence and epidemiological factors of uterine cervical cancer in medical underserved area females, the questionnaire survey and Pap. smear for uterine cervical cancer was done on total 330 women who lived in Ullungdo from 5th to 12th August, 1998. The results were summarized as follows： The age distribution of subjects was 50s (24.5%), 60s (24.5%) and their educational level was “no schooling” (14.2%) and “elementary school” (42.7%). The first coital age of subjects was 19∼21yrs (30.0%), 16∼18yrs (13.9%) and the first pregnancy age was 22∼24yrs (36.7%) and 19∼21yrs (30.0%). The frequency of total pregnancy of subjects was over 5 times (52.1%). The frequency of total delivery was “3∼4 times” (35.5％) and “5∼6 times” (15.2％). 68.8% of subjects had experience of abortion and 80.0% of their husband were on the phimosis. 172 (52.1%) subjects had gynecological symptoms, their symptoms were leukorrhea (48.3%), pruritus (21.5%) and leukorrhea with pruritus (20.3%). 63.9% of total subjects have been received Pap. smear and the frequency of their Pap. smear was “only 1 time” (44.1 ％), “irregularly” (30.3%) and the reason of respondents who have not been received Pap. smea. was “no specific symptom” (51.3%). Among the 330 women screened there were negative (45.8%), inflammation (47.3%), trichomoniasis and candidiasis (1.8%), atypical cells (4.5%) and dysplasia (0.6%).

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1907-1912
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• 2015

Purpose: The study was designed to: (1) investigate the prevalence of high-risk human papillomavirus (HR-HPV) infection and cervical neoplasia; and (2) evaluate clinical performance of visual inspection with acetic acid/ Lugol's iodine (VIA /VILI), Pap smear, high-risk human papillomavirus (HR-HPV) DNA test for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and (3) explore appropriate screening approach in rural areas of Shandong Province. Materials and Methods: A total of 3,763 eligible women from Yiyuan County in Yimeng mountainous areas of rural Shandong, China, were enrolled and underwent Pap smear, HR-HPV DNA testing by Hybrid Capture 2 (HC2), and VIA /VILI tests. Women positive in any test were referred to colposcopy and biopsy as indicated. Results: The prevalence of HR-HPV infection among all enrolled women was 11.1% and that in healthy women was 9.9%. In total 33 cases of CIN1, 16 cases of CIN2, 6 cases of CIN3 but none of cervical cancer were detected and the crude prevalence of CIN2+ was 0.58%. For detecting CIN2+, the sensitivity of HR-HPV DNA testing, VIA/VILI, Pap smear was 90.9%, 77.3%, 81.8%, respectively. Pap smear had the best specificity of 98.2%, followed by HR-HPV DNA testing with specificity of 89.4%, VIA/VILI had the lowest specificity of 81.2%. Colposcopy referral rate of HR-HPV DNA testing, VIA/VILI, Pap smear was 11.1%, 18.5%, 2.3%, respectively. Conclusions: Our results suggest that HR-HPV DNA testing alone might be appropriate for primary cervical cancer screening in rural low-resource areas of Shandong Province, China.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6697-6704
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• 2015

Background: The burden of breast and cervical cancer is changing over time in developing countries. Regular screening is very important for early detection and treatment. In this study, we assessed inequalities in breast and cervical cancer screening rates in women according to household wealth status, and analyzed the potential predictors associated with a low cancer screening rate in Jordan. Materials and Methods: A nationwide populationbased cross-sectional survey collected information on different variables at the national level. All ever-married women (the phrase is used throughout the text to refer to women who had ever married) aged 15-49 years were included in the survey. Analysis of breast self-examination (BSE) and clinical breast examination (CBE) at least once in the previous year was carried out in 11,068 women, while lifetime Pap-smear testing was carried out in 8,333 women, aged 20-49 years. Results: Over 39% and 19% of ever-married Jordanian women reported having undergone a breast examination during the previous year and Pap smear examination at least once in their lifetime, respectively. The rate of BSE in the previous year was 31.5%, that of CBE in the previous year was 19.3%, and that of Pap smear examination at least once in life was 25.5%. The adjusted OR was higher for performing BSE (aOR 1.22, 95% CI 1.04-1.43), undergoing CBE (aOR 1.31, 95% CI 1.08-1.60) and undergoing Pap smear examination (aOR 2.38, 95% CI 1.92-2.93) among women in the highest wealth-index quintile as compared to those in the lowest quintile. The concentration index was 0.11 for BSE, 0.01 for CBE, and 0.27 for Pap smear examination. Women in their twenties, living in rural or the southern region of Jordan, with an elementary school education or less, who listened to the radio or read the newspaper not more than a few times a year, and nulliparous women were less likely to undergo breast and cervical cancer screening. Conclusions: The rates of breast and cervical cancer screening are low in Jordan. Reducing the sociodemographic and economic inequalities in breast and cervical cancer screenings requires concerted outreach activities for women living under socially deprived conditions.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.6909-6912
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• 2015

Cancer is a major public health problem due to the jeavy disease burden, fatality and tendency for increased incidence. Of all cancer types, cervical cancer is reported to be the fourth most common cancer in women, and the seventh overall, with an estimated 528,000 new cases worldwide in 2012. It features a long preclinical phase with slowly progressing precancerous lesions such as CIN 2 and 3 and adenocarcinoma in situ. Therefore, screening programs such as with Pap smear tests may play an important role in cervical cancer prevention. The purpose of this study was to present results of a Pap smear screening survey for cervical cancer targeting women living in an urban area in the province of Mersin, located in the Mediterranean region of Turkey. This community-based descriptive study included women living at Akdeniz county of Mersin province. A total of 1,032 screened women between 30 and 65 ages within the routine screening programme constituted the study population. The mean age of the participants was $43.8{\pm}8.6$ (min. 30, max. 65) years. The percentage of the participants who had previously undergone smears was 40.6%. Epithelial cell changes were found in 26 (2.5%) participants, with ASC-US in 18 (1.7%), ASC-H in 2 (0.2%), LSIL in 5 (0.5%) and HSIL in 1 (0.1%). The most common clinical presentation together with epithelial changes was abnormal vaginal discharge. Taking into account the presence of women who had never undergone Pap test; it should be offered at primary level of health care in the form of a community-based service to achieve reduced morbidity and mortality rates.