• 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.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.333-340
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• 2013

Background: The aim of the study was to identify the relationship between 'Health Belief Model Scale for Cervical Cancer and the Pap Smear Test' subscale scores and demographic/gyneco-obstetric characteristics. Materials and Methods: This cross-sectional study was conducted with 256 women. Data were obtained using the 'Demographic and Gyneco-Obstetric Identification Form' and the 'Health Belief Model Scale for Cervical Cancer and the Pap Smear Test. Results: The percentage of women who had heard about the Pap test was 77.7 whereas only 32.4% had actually undergone the test. Some 45.7% of the women stated that they did not know the reason for having a Pap test. Women who had obtained a Pap smear test had statistically significantly fewer perceived barriers than those who had never had (p<0.05). Scores with regard to the subscales including 'Benefits of Pap Smear Tests and Health Motivation', 'Perceived Seriousness of Cervical Cancer', 'Susceptibility to Cervical Cancer' and 'Cervical Cancer Health Motivation' did not differ with demographic/gyneco-obstetric characteristics such as womens' educational level, whether or not young age at first marriage, whether or not having family history of female cancer, and whether or not having had a Pap test (p>0.05). Conclusions: Increasing knowledge about benefits of Pap smear tests, increasing motivation to obtain Pap Smear Test and increasing perceived seriousness of cervical cancer could promote attendance at cervical cancer screening. Different strategies are needed for behavioural change. Implementation of educational programmes by nurses in a busy environment could result in a major clinical change, based on the findings of this study.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6445-6450
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• 2013

Background: Cervical cancer is the second most common cancer among women worldwide. Failure to prevent cervical cancer is partly due to non-participation in regular screening. It is important to plan and develop screening programs directed towards underscreened women. In order to identify the factors associated with underscreening for cervical cancer among women, this study examined Pap test participation and factors associated with not having a time-appropriate (within 3 years) Pap test among a representative sample of women in Ontario, Canada using Canadian Community Health Survey (CCHS) data. Materials and Methods: Univariate analyses, cross-tabulations, and logistic regression modeling were conducted using cross-sectional data from the 2007-2008 CCHS. Analyses were restricted to 13,549 sexually active women aged 18-69 years old living in Ontario, with no history of hysterectomy. Results: Almost 17% of women reported they had not had a time-appropriate Pap test. Not having a time-appropriate Pap test was associated with being 40-69 years old, single, having low education and income, not having a regular doctor, being of Asian (Chinese, South Asian, other Asian) cultural background, less than excellent health, and being a recent immigrant. Conclusions: Results indicate that disparities still exist in terms of who is participating in cervical cancer screening. It is crucial to develop and implement cervical cancer screening programs that not only target the general population, but also those who are less likely to obtain a Pap tests.

• Journal of Korean Public Health Nursing
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• v.31 no.1
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• pp.135-148
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• 2017

Purpose: This study was conducted to predict the effects of behavioral intention on pap screening tests in unmarried college women using a path model. Methods: The study subjects were 216 university students and data were collected through self-report questionnaires including knowledge, attitude, subjective norms, perceived behavioral control, behavioral intentions to take the Pap test, and health responsibility. Results: Knowledge regarding the Pap test was moderate. The factors of knowledge, attitude, and perceived behavioral control negatively influenced the behavioral intention of the Pap test. However, the factors of subjective norms and health responsibility positively influenced behavioral intention. Conclusion: Subjective norms are the most importance factor to increase the intentions of the Pap test among unmarried college women. It is also necessary to eliminate barriers to undergoing pap testing, as well as to provide nursing intervention to obtain correct knowledge and a positive attitude regarding the Pap screening test.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8905-8910
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• 2014

Background: Coverage of cervical pap smear test in Nepal is below general global values. One of the reasons may be that cervical cancer prevention policy of Nepal has 'Visual Inspection of Cervix with Acetic Acid' as the only screening tool. The focus of present study was to find out association of demographic factors, knowledge and attitude regarding cervical Pap smear test with its practice by women in Nepal. Materials and Methods: This cross sectional analytical observational study was conducted between February 1, 2013 and April 30, 2013. Participants were interviewed with the help of a structured questionnaire. Chi square and multivariate logistic regression tests were used to detect associations of variables with pap smear practice. Results: Chi square test showed that practice was significantly associated with knowledge about pap smear test and cervical cancer, having favourable attitude towards the test, urban residency and 36-50 years age-group. Pap smear utilization was not associated with age-at-marriage, parity and age-at-first-child-birth. Multivariate logistic regression showed favorable attitude towards pap smear test as the only variable which significantly influenced pap smear practice (p= 0.006, OR: 2.4). Conclusions: Pap smear coverage has been found to be 15.7% which is lower than global average and that for developing countries. Health education programs which are effective not only in increasing knowledge about cervical cancer and pap smear test but also effective in positively changing attitude towards the test should be organized to increase pap smear coverage.

• Journal of Preventive Medicine and Public Health
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• v.32 no.2
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• pp.147-154
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• 1999

Objectives: To construct basic data to develop strategies for achieving higher Pap test coverage rate by evaluating factors associated with the use of Pap test through population-based survey. Methods: 16.4%(671) of the 4,090 women, who were eligible population for this study, in 3 Myens of Chung-ju City participated in this study voluntarily from July 21 to 26, 1997. After basic physical examination by trained doctors, they were interviewed with structured questionnaire by well-educated interviewers. Results: It shows that only 54.3% of study participants experienced Pap test. The strongest factor which is related with the use of Pap test was the history of having breast screening tests(aOR=8.71, 95% CI=4.25-17.84). Probability of ever having Pap test was also higher in married women(aOR of single=0.46, 95% CI=0.29-0.72), younger(Ptrend<0,051, more educated (Ptrend<0.001), non-smoker (aOR of smoker=0.25, 95% CI=0.12-0.55), women of ever having Hepatitis test(aOR=2.60, 95% CI=1.73-3.88) in multiple lineal logistic analysis. Conclusions : This study suggests that several factors significantly associated with the use of Pap test, and especially, high-risk population for cervical cancer such as women of older ages, less educated, living alone are less likely to have the Pap test. We should concentrate on encouraging high-risk women in the use of Pap test to improve Pap test coverage rate.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6405-6409
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• 2014

Background: To study the prevalence of abnormal anal cytology by Papanicolaou (Pap) technique in HIV-infected women who attended a HIV clinic at Prapokklao Hospital, Chanthaburi, Thailand. Materials and Methods: HIV-infected women who attended a HIV clinic at Prapokklao Hospital from March 2013 to February 2014 were recruited for anal Pap smears. Participants who had abnormal results of equally or over "abnormal squamous/glandular cells of undetermined significance" (ASC-US) were classified as abnormal anal cytology. Results: A total of 590 anal Pap smears were performed at HIV clinic of Prapokklao Hospital during the study period. There were only 13 patients who had abnormal Pap tests, which were: 11 ASC-US and 2 HSIL (high grade squamous intraepithelial lesion). The prevalence of abnormal anal Pap smears in HIV-infected women who attended HIV clinic at Prapokklao Hospital was 2.2 percent. Percentage of high risk HPV in patients who had abnormal Pap test was 88.9 (8/9). Conclusions: The prevalence of abnormal anal Papanicolaou smears in HIV-infected women who attended the HIV clinic at Prapokklao hospital was quite low in comparison to the earlier literature.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5415-5420
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• 2015

Background: The present study was designed to ascertain knowledge about HPV, cervical cancer (CC) and the Pap test among female dental students of Panineeya Institute of Dental Sciences and Hospital, Hyderabad, India. Materials and Methods: A self-administered questionnaire covering demographic details, knowledge relating to human papilloma virus (HPV) (8 items), cervical cancer (4 items) and the Pap smear (6 items) was employed. Responses were coded as "True, False and Don't Know". Mean and standard deviation (SD) for correct answers and levels of knowledge were determined. Results: Based on the year of study, significant differences in knowledge of HPV werenoted for questions on symptoms (p=0.01); transmission from asymptomatic partners (p=0.002); treatment with antibiotics (p=0.002); start of sexual activity (p=0.004); and recommended age for HPV vaccination (p=0.01). For knowledge regarding CC, significance was observed for the age group being affected (p=0.008) and symptoms of the disease in early stages (p=0.001). Indications for Pap smear tests like symptoms' of vaginal discharge (p=0.002), marital status (p=0.01) and women with children (p=0.02) had significant difference based on the year of study. Based on religion, transmission of HPV via pregnancy, HPV related diseases except CC and preventive measures except condom use and oral contraceptives showed significant differences. However, significant variation with religion was observed only for two preventive measures of CC (Pap test; p=0.004) and HPV vaccination (p=0.003). Likewise, only the frequency of Pap test showed a significant difference for religion (p=0.001). Conclusions: This study emphasizes the lack of awareness with regard to HPV, CC and screening with pap smear even among health professionals. Hence, regular health campaigns are essential to reduce the disease burden.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4665-4667
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• 2012

Cervical cancer is the most common cancer in Laos women and a screening programme, even with the PAP smear test (PAP test), has yet to be established for routine use. The Pap test is accepted as the most appropriate for cervical cancer screening in some settings but it is not commonly available in Laos hospitals, because there are few cytopathologists and gynecologists have little experience. As a pilot program, seminars for the PAP test were given in 2007 and 2008, and then PAP tests were carried out using self-sampling instrument (Kato's device) with 200 healthy volunteers in Setthathirath hospital, Laos, in 2008. The actual examination number was 196, divided into class I 104 (53.1%), class II 85 (43.3%), class IIIa 4 (2.0%), class IIIb 1 (0.5%), and class V 1 (0.5%) by modified Papanicolau classification. Four cases had menstruation. There were 6 cases with epithelial cell abnormalities including malignancy. There were 7 cases with fungus and 2 cases with trichomonas in Class II. More than 70% volunteers felt comfortable with the Kato's device and wanted to use it next time, because of the avoidance of the embarrassment and a low cost as compared with pelvic examination by gynecologists. This first trial for PAP test for healthy Laos women related to a hospital found three percent to have abnormal cervical epithelial cells. Therefore, this appraoch using a self-sampling device suggests that it should be planned for cervical cancer prevention in Laos.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1651-1655
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• 2012

Background: Our aim was to investigate the efficacy of the Pap test in combination with the ThinPrep cytological test (TCT) in screening for cervical cancer in China. Design: From March 2006 to October 2008, 988 women with the mean age $46.4{\pm}10.5$ years (range, 23-80 years) were recruited to receive cervical cancer screening. Pap test results ${\geq}$ grade III and TCT findings ${\geq}$ ASCUS/AGUS were considered abnormal. Subjects with a Pap test result ${\geq}$ grade IIb received TCT. Colposcopy and biopsies were performed in all participants, and final diagnosis was based on pathological findings. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Youden index for predicting CIN I or above were determined. Results: The sensitivity, specificity, PPV, NPV and Youden index of the Pap test were 43.1%, 97.2%, 70.0%, 91.9%, and 40.3%, respectively. The same values for TCT in predicting CIN were 80.0%, 63.2%, 16.0%, 97.3%, and 43.2%, respectively. The two tests in combination gave values for predicting CIN of 64.8%, 87.6%, 43.6%, 94.4%, and 53.5%, respectively. Combined testing exhibited the highest Youden index (53.4%). Conclusion: The Pap test with a reduced threshold in combination with the TCT has high sensitivity and high specificity in screening for cervical cancer.