• Journal of Korean Academy of Nursing
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• v.27 no.3
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• pp.563-576
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• 1997

This study was carried out to identify basic data for more efficient operation of comprehensive health check-up centers in the national health care system. The researcher reviewed and analyzed the main symptoms of the subjects according to sex, age, occupation and positive rate in the screening tests of a comprehensive health check-up, performed at one comprehensive health check-up center in located in a hospital. The subjects were 512 persons who had a check-up at the comprehensive health check-up, center in K university hospital in Seoul from October 2, 1996 to March 30, 1997. A questionaire developed by the researcher to obtain subject's general characteristics, main symptoms, medical examination, diagnosed disease was used as the tool for the study. The researcher analyzed the data with SPSS PC/sup +/ program. : the distribution of the subject's general characteristics and main symptoms was described with percentages and the difference between main symptoms and screening tests analyzed with X²-test, t-test, ANOVA. The result of this study are as follows : 1. For the distribution of diagnosis in males. liver disease was most frequent and hypertension was second : in females, hypertention and liver disease were not common in that order. 2. The most common complaints were indigestion in the digestive system, sputum in the respiratory system, irregular heart beat in the cardiovascular system, frequent urine in the urinary system vertigo in the hematologic system. 3. The main symptoms according to sex were for females, a statistically siguificant higher rate of complaints in the digestive system, cardiovascular system, urinary system, hematologic system, musculoskeletal, mental & nervous system as compared to males. 4. The main symptoms according to age were that in the the second decade there wara higher rate of complaints in the digestive system, and cardiovascular system than in the older age groups : and in the fifth decade more in the musculoskeletal system. 5. The main symptoms according to occupation were that formers and fishers had a higher rate of complaints in the mental and nervous system as compared to other occupation groups : and office workers, in gynecology. 6. The main symptoms according to diagnosis, were symptoms of the digestive system, frequent in liver disease : symptoms of the cardiovascular system in allergic disease. 7. The screening tests which showed the highest rates were UGI /FGS, PFT : In males a higher rate of abnormality was seen in abdominal ultrasono- graphy and in, females, in mammography. 8. In screening tests according to sex, males showed a higher positive rate for chest X-rays, and LFT, and females, in mammography, pap smear, CBC. 9. In screening tests according to age, higher positive rates of obesity, high blood pressure, chest X-ray, mammography, pap smear, FBS, CBC, urine test were seen in the fifth decade : PFT and abdominal ultrasonography in the third decade. The subjects who wanted comprehensive health check-up were not asymptomatic but had an illness with several symptoms. It is found that the most frequent diagnosed diseases were hypertention and liver disease. So proper observations must be done for them. Comprehensive health check-ups should be changed to a comprehensive examination including treatment beyond examination for those subjects with positive results.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3645-3651
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• 2012

Conventional pap smear (CPS) examination has been the mainstay for early detection of cervical cancer. However, its widespread use has not been possible due to the inherent limitations, like presence of obscuring blood and inflammation, reducing its sensitivity considerably. Automated methods in use in developed countries may not be affordable in the developing countries due to paucity of resources. On the other hand, manual liquid based cytology (MLBC) is a technique that is cost effective and improves detection of precursor lesions and specimen adequacy. Therefore the aim of the study was to compare the utility of MLBC with that of CPS in cervical cancer screening. A prospective study of 100 cases through MLBC and CPS was conducted from October 2009 to July 2010, in a Medical College in India, by two independent pathologists and correlated with histopathology (22 cases). Morphological features as seen through MLBC and CPS were compared. Subsequently, all the cases were grouped based on cytological diagnosis according to two methods into 10 groups and a subjective comparison was made. In order to compare the validity of MLBC with CPS in case of major diagnoses, sensitivity and specificity of the two methods were estimated considering histological examination as the gold standard. Increased detection rate with MLBC was 150%. The concordance rate by LBC/histopathology v/s CPS/histopathology was also improved (86% vs 77%) The percentage agreement by the two methods was 68%. MLBC was more sensitive in diagnosis of LSIL and more specific in the diagnosis of inflammation. Thus, MLBC was found to be better than CPS in diagnosis of precursor lesions. It provided better morphology with increased detection of abnormalities and preservation of specimen for cell block and ancillary studies like immunocytochemistry and HPV detection. Therefore, it can be used as alternative strategy for cervical cancer prevention in limited resource settings.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.10
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• pp.4297-4302
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• 2015

Background: To evaluate HPV testing by Hybrid Capture II (HCII) in conjunction with cytology in detecting the residual/recurrence disease after treatment of high-grade cervical intraepithelial neoplasia (CIN II-III) with loop electrosurgical excision procedure (LEEP). Materials and Methods: A retrospective review of 158 patients with histologically confirmed CIN II-III who underwent LEEP between January 2011 and October 2012 was conducted. Post-treatment control was scheduled at the 3rd, 6th, 12th and 18th month. All patients were followed up by Pap smear and HR-HPV genotype and viral load testing. Results: Pre-treatment, HR-HPV DNA, was detected in all specimens of the patients. At follow-up, 25 patients were diagnosed as the residual/recurrent disease during the FU visit, among whom, 16 patients with positive margin: 13 patients (52%) with HR-HPV DNA+/cytology+, 2 patients (8%) with HR-HPV DNA+/cytology-, 1 patient (4%) with cytology+/HR-HPV DNA-; 9 patients with clean margin - 5 patients (55.6%) with HR-HPV DNA+/cytology+; 2 patients (22.2%) with HRHPV DNA+/cytology-, 2 patients (22.2%) with cytology+/HR-HPV DNA-. None of them persisting HR-HPV DNA-/cytology-with positive or negative margin was identified as the residual/recurrent disease. The majority of residual/recurrent disease was detected at the 12th and 18th month FU, and there was almost no difference in the sensitivity and negative predictive value (NPV) between at the 3rd month and the 6th month FU visits. 14 residual/recurrence disease (14/46:30.4%) had pre-treatment high viral load (>5 000 RUL/PC) and 11 (11/112, 9.8%) with pre-treatment low viral load, P<0.05. Conclusions: (1) The persistence HR-HPV DNA is the root cause of the residual/recurrent disease for the women treated for high-grade CIN; the pre-treatment viral load and margin can be seen as the predictor. (2) The FU visit beginning at the 6th month post-treatment and lasting at least 24 months with the combination of cytology and HPV testing. (3) Patients with high pre-treatment HPV load, which is considered as one risk of developing the residual/recurrent disease, should be paid more attention (especially above 500RUL/PC) to by clinicians.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.579-583
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• 2015

This study was conducted on female patients with different gynecological problems attending the gynecology out-patient departments of two tertiary care hospitals in Peshawar city of Khyber Pakhtunkhwa, Pakistan between August 2012 and October 2013. The 200 patients had an age range of 21-65 years. Smears were taken with cervical brushes and preserved in preservative medium and processed for manual liquid based cytology (MLBC) for Pap staining. Out of 200 collected samples, 30 samples were found inadequate on cytology. Of the remaining 170 samples, 164 (96.47%) were normal, 5 (2.94%) were of atypical squamous cells of unknown significance (ASCUS) and 1 (0.6%) was of high grade squamous intraepithelial lesion (HSIL). On PCR all the samples were positive for beta globin gene fragment including those reported inadequate on cytology. Out of the 5 ASCUS samples, 2 samples were positive for HPV, one each for HPV 16 and HPV 18, and the rest of the 3 samples were negative for HPV DNA. The 1 sample of HSIL was positive for HPV 16 on PCR. Out of 164 normal samples on cytology, only 1 sample was HPV 16 positive. So overall, 4 (2%) out of 200 samples were positive for HPV DNA, where 3 were HPV 16 (1.5%), and 1 was HPV 18 (0.5%) positive, and thus the ratio of infection with of HPV 16 to HPV 18 was 3:1 in the general population. In conclusion, PCR based HPV detection is a more sensitive method for screening of HPV infection than cytology as sample inadequacy does not affect the results. However, it can be combined with cytology methods in a HPV positive female to achieve the maximum results.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4457-4461
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• 2016

Purpose: To determine the prevalence of abnormal cervical cytology, as diagnosed using a liquid-based cytology technique, in pregnant women attending the Antenatal Care (ANC) clinic at Siriraj Hospital. Materials and Methods: This cross-sectional study included 655 first-visit pregnant women who attended ANC clinic at Siriraj Hospital during June to November 2015 study period. After receiving routine antenatal care, cervical cytology screening was performed with the Siriraj liquid-based cytology technique. All specimens were reviewed by a certified cytopathologist using Bethesda System 2001 criteria. Patients with abnormal PAP results characterized as epithelial cell abnormalities were referred to a gynecologic oncologist for further management according to ASCCP Guidelines 2012. Results: Mean age of participants was $28.9{\pm}6.2$ years. Prevalence of abnormal cervical cytology was 3.4% (95% CI: 2.0-4.7). Among this group, there were ASC-US, ASC-H, LSIL, HSIL for 12(1.8%), 2(0.3%), 7(1.1%) and 1(0.2%), respectively. In 633 specimens of the normal group, infection was identified in 158 specimens (24.1%) which were caused by Candida spp. and Trichomonas vaginalis. Regarding patient perception about the importance of cervical cancer screening, although most women perceived screening to be important, 54% of participants had never been screened for cervical cancer. Rate of loss to follow-up in the postpartum period was as high as 41.8%. Conclusions: Prevalence of abnormal cervical cytology in pregnant women attending the ANC clinic at Siriraj Hospital was 3.4%. Inclusion of cervical cancer screening as part of antenatal assessment can help to identify precancerous lesions or cervical cancers in patients who might otherwise not be screened, thereby facilitating early treatment and improved patient outcomes.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2069-2074
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• 2014

Purpose: To appraise the frequency of cervical cytological abnormalities in a population at normal risk via analysing the archive records of cytology for the period of approximately 9,5 years, comparing them with patient demographic charecteristics, and discuss the results for women under age of 35. Materials and Methods: A total of 32,578 cases of Pap smears were retrieved and analysed from our archive included the Pap tests performed between January 2001 and April 2010 at the Early Cancer Screening, Diagnosing and Education Center by the consent of three pathologists via utilizing the Bethesda System Criteria 2001 and the results were compared with some demographical characteristics. Results: Our rate of the cervical cytological abnormality was 1.83%, with ASCUS in 1.18%, LSIL in 0.39, HSIL in 0.16%, AGUS in 0.07%, squamous cell carcinoma in 0.02%, and adenoarcinoma in 0.006%. Cytological abnormalities were detected mostly in those with higher age, lower parity, and premenopausal period whereas the smoking status was without influence. Bacterial vaginosis (5.6%) was the most frequent infectious finding (Candida albicans 2.7%; Actinomyces sp. 1.3%; and Trichomonas vaginalis 0.2%) detected on the smears. The rate of abnormal cervical cytology was 9.5% among the women aged between 30-34. Conclusions: Early detection of the cervical abnormalities by means of the regular cervical cancer screening programmes is useful to attenuate the incidence, mortality, and morbidity of cervical cancer. Our prevalence of the cytological abnormalities was much lower than the one in Western populations in general but very similar to those reported from other Islamic countries that may be explained by the conservative lifestyle and the lower prevalence of HPV in Turkey. A remarkable rate of abnormal cervical cytology of women aged 30-34 was pointed out in the present study.

• Journal of the Korea Society of Computer and Information
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• v.13 no.3
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• pp.179-187
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• 2008

In this paper, we apply a set of algorithms to classily normal and cancer nucleus from uterine cervical pap-smear images. First, we use lightening compensation algorithm to restore color images that have defamation through the process of obtaining $1{\times}400$ microscope magnification. Then, we remove the background from images with the histogram distributions of RGB regions. We extract nucleus areas from candidates by applying histogram brightness, Kapur method, and our own 8-direction contour tracing algorithm. Various binarization, cumulative entropy, masking algorithms are used in that process. Then, we are able to recognize normal and cancer nucleus from those areas by using three morphological features - directional information, the size of nucleus, and area ratio - with fuzzy membership functions and deciding rules we devised. The experimental result shows our method has low false recognition rate.

• Journal of Korean Academy of Nursing
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• v.32 no.6
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• pp.832-843
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• 2002

The aim of this study was to describe women's embarrassability and embarrassment during cervical screening. Method: The subjects of this study were 82 women who had a cervical screening at a National University Hospital. The data were collected through personal interview using a questionnaire from February 4, 2001 to February 22, 2002. The questionnaire consisted of embarrassability scale, embarrassment Scale, and demographic data. Result: 1) The mean scores of situational embarrassability was 82.6 and that of dispositional embarrassability was 106.7. 2) The mean scores of subject's embarrassment was 54.3 and 48.7 in 10 stages of cervical screening. The following three situations of 10 stages of cervical screening were highly ranked as to be embarrassing: 'during the examination', 'waiting for a doctor', and 'climbing up the exam chair and positioning her thigh for a exam'. 3) There was a positive correlation between dispositional embarrassability and embarrassment of 10 stages of cervical screening. 4) There were significant differences in situational embarrassability of subjects according to education and the locations of service. There were significant differences in dispositional embarrassability of subjects with regard to frequencies of pregnancy. 5) There were significant differences in embarrassment of subjects during cervical screening with respect to age, age at the time of first smear and gender of the examiner. Conclusion: The finding of this study indicates that women experienced a high level of embarrassment during cervical screening, assuming a need for nursing intervention reduces women's embarrassment. Also, there is a positive correlation between embarrassability and embarrassment of cervical screening, suggesting a need for further research identifying the effect of nursing intervention on embarrassment according to embarrassability.

• The Korean Journal of Cytopathology
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• v.15 no.1
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• pp.17-27
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• 2004

To investigate a population-based survey of the prevalence of human papillomavirus (HPV) infection in South Korea, we performed Papanicolaou smears and tests for HPV DNA and anti-HPV antibody detection in 909 sexually active general women (age range; 20-74 years, median 44 years) who were randomly selected residents from S district of Busan City. The presence of DNA of 36 different HPV types was detected by means of a GP 5+/6+ primer-mediated PCR enzyme immunoassay in cervical exfoliated cells, and IgG antibodies against L1 virus-like particles (anti-VLPs) of 5 HPV types 16, 18, 31, 33, and 58 were tested by means of enzyme linked immunoassay. The incidence of cytologic abnormality was 5.2% in Pap smear. The positive rate of HPV DNA was 10.4%, high in young women younger than 35 years old and proportionally increased according to the cytologic grades. The most often found HPV type was HPV 70, followed by HPV 16 and 33, and high-risk HPV types were more frequent in women younger than 35 years old. The most common HPV type in abnormal cytologic smears was HPV 16, followed by HPV 58 and 66. Anti-VLPs was positive in 19.7% and the frequent anti-VLPs type was against HPV 18, followed by HPV 31 and 16. The concordance between the markers for each specific HPV type was noted in 10 women and HPV 16 was the most frequent one. The incidence of multiple HPV infection was 18.9% and that of multiple anti-VLPs antibodies was 31%. Among 103 self-reported virgins, 4.9% had anti-VLP antibodies.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2473-2476
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• 2014

Background: Little is known about the cancer screening prevalence and correlates in older adults from different racial backgrounds. In the context of heightened efforts for prevention and early diagnosis, we collected information on screening for two major types of cancers: cervical and breast cancer in order to establish their prevalence estimates and correlates among older South African women who participated in the Study of Global Ageing and Adults Health (SAGE) in 2008. Materials and Methods: We conducted a national population-based cross-sectional study with a multi-stage stratified cluster sample of 3,840 individuals aged 50 years or older in South Africa in 2008. In this analysis, we only considered the female subsample of (n=2202). The measures used included socio-demographic characteristics, health variables, anthropometric and blood pressure measurements. Multivariable regression analysis was performed to assess the association of socio-demographic factors, health variables and cancer screening. Results: Overall, regarding cervical cancer screening, 24.3% ever had a Papanicolaou (PAP) smear test, and regarding breast cancer screening, 15.5% ever had a mammography. In multivariate logistic regression analysis, younger age, higher education, being from the White or Coloured population group, urban residence, greater wealth, and suffering from two or more chronic conditions were associated with cervical cancer screening, and higher education, being from the White or Indian/Asian population group, greater wealth, having a health insurance, and suffering from two or more chronic condtions were associated with breast cancer screening. Conclusions: Cancer screening coverage remains low among elderly women in South Africa in spite of the national guideline recommendations for regular screening in order to reduce the risk of dying from these cancers if not detected early. There is a need to improve accessibility and affordability of early cervical and breast cancer screening for all women to ensure effective prevention and management of cervical and breast cancer.