Cervical cancer is the seventh most common cancer among women in Iraq. This study aimed to assess the factors influencing Pap smear practice among married primary school teachers in Diyala City, Iraq. A total of 222 teachers (aged 20 years to 63 years) residing in Diyala City were enrolled in a cross sectional study from 1st August till 30th September 2012. The sampling method was a self-administered survey using a multistage sampling technique. The prevalence of Pap smear practice was very low (12.6%). Relatives and friends were the main source of information about the Pap smear test for more than one third (41.9%) of the respondents. However, the medical doctor’s advice was the most important reason for undergoing a Pap smear test in more than two third (60.7%) of respondents. Only 32.4% of the teachers have good knowledge about cervical cancer and Pap smear test, but 76.1% of them showed a positive attitude toward learning about cervical cancer and Pap smear. Based on multiple logistic regression analysis results only the husband’s encouragement (p= 0.003, prevalence odds ratio [POR] = 0.256, 95%CI 0.10-0.63) was significantly associated with Pap smear practice. A more effective educational program is needed to educate Iraqi women about cervical cancer and screening tests, including Pap smear.
Papanicolaou Test

No abstract available.
Mass Screening* ; Papanicolaou Test* ; Uterine Cervical Neoplasms*

No abstract available.
Mass Screening* ; Papanicolaou Test* ; Uterine Cervical Neoplasms*

"To evaluate whether different qualifications of a cytologic diagnosis of atypical squamous cells of undetermined significance (ASCUS) predict a greater or lesser likelihood of tissue diagnosis of uterine cervix, we compared different cytologic qualifications of ASCUS with the tissue diagnosis. One hundred twenty-two con- secutive Papanicolaou smears showing ASCUS in women who had undergone cervical biopsy within nearest 30 days were collected. The 122 smears were qualified as ""favor reactive (25%), favor low grade squamous intraepithelial lesion (LSIL) (24%), favor squamous intraepithelial lesion (SIL) (16%), favor high grade squa- mous intraepithelial lesion (HSIL) (16%), and not otherwise specified (19%). Squamous intraepithelial or invasive lesion was pathologically confirmed by cervical biopsy in 13% of the favor reactive, 27% in favor LSIL, 70% in ""favor SIL, 75% in favor HSIL, and 35% in not otherwise specified smears. There were significant associations between the favor reactive smear and the benign biopsy finding and between the favor SIL smear and the biopsy showing a squamous intraepithelial or more severe lesion. Nevertheless, rnost of favor LSIL smears exhibit reactive process in tissue biopsy. Conclusively, qualified ASCUS stratifies women into different risk groups for SIL. The cytopathologist should make the cytologic diagnosis of ASCUS, favor LSIL circumspectly."
Biopsy ; Cervix Uteri ; Diagnosis ; Female ; Humans ; Papanicolaou Test ; Venous Thrombosis*

OBJECTIVE: To evaluate the efficacy of loop electrosurgical excision procedure (LEEP) combined with cold coagulation for treating cervical intraepithelial neoplasia (CIN). METHODS: We reviewed clinic-pathologic data of 498 patients treated with LEEP alone (n=354), and LEEP combined with cold coagulation (n=144) between January 2000 and December 2011. After LEEP, we followed up all patients by using Papanicolaou smear and human papillomavirus (HPV) test, and evaluated abnormal cervical cytology-free interval and high-risk HPV infection-free interval. Moreover, we investigated independent factors affecting abnormal cervical cytology or high-risk HPV infection after LEEP. RESULTS: Abnormal cervical cytology-free interval was longer in patients treated with LEEP combined with cold coagulation than in those treated with LEEP alone (mean, 92.4 vs. 84.4 months; P=0.01), and patients treated with LEEP combined with cold coagulation also showed longer high-risk HPV infection-free interval than those treated with LEEP alone (mean, 87.6 vs. 59.1 months; P=0.01). Moreover, CIN 3 and cold coagulation were factors affecting abnormal cervical cytology after LEEP (adjusted hazard ratios, 1.90 and 0.61; 95% confidence intervals, 1.27 to 2.84 and 0.39 to 0.96), and CIN 3, positive deep cervical margin and cold coagulation were also factors affecting high-risk HPV infection after LEEP (adjusted hazard ratios, 2.07, 4.11, and 0.64; 95% confidence intervals, 1.38 to 3.08, 1.63 to 10.39, and 0.43 to 0.96). When we performed subgroup analyses for patients with CIN 2 or CIN 3, the result were similar. CONCLUSION: LEEP combined with cold coagulation may be more effective for treating CIN than LEEP alone. Moreover, cold coagulation may decrease the risk of potential of recurrence after LEEP.
Cervical Intraepithelial Neoplasia* ; Cohort Studies* ; Humans ; Papanicolaou Test ; Recurrence

This study was performed to compare manual liquid-based preparation with conventional Papanicolaou tests in view of the cytologic diagnoses and specimen adequacy. The specimens of 5,979 women from 33 local clinics and 1 general hospital were prepared by both manual liquid-based preparation and conventional Papanicolaou test. The cytologic diagnoses and specimen adequacy were evaluated in Department of Pathology in Kyoungpook National University School of Medicine. A conventional Papanicolaou test was always prepared first, after that residual material on the sampling device was rinsed into a liquid preservative, and then thin-layer slides were prepared using manual method of liquid-based cervicovaginal cytology. Conventional and liquid-based slides were read independently, and cytologic diagnoses and specimen adequacy were classified using the Bethesda System. Of the cases, 5,763(96.3%) had the same interpretation, and there was no significant diagnostic difference in 5,853(97.8%) cases. When evaluating cases with more than one diagnostic class difference, the manual liquid-based preparation demonstrated a statistically significant overall improvement(2.1%) in the detection of squamous intraepithelial lesion and invasive cancer. Using manual method of liquid- based preparation, there was 14.1% reduction in unsatisfactory slides through excellent cellular presentations. In conclusion, the manual liquid-based preparation produces standardized quality, superior sensitivity and improved adequacy as compared to the conventional method.
Diagnosis ; Female ; Hospitals, General ; Humans ; Papanicolaou Test* ; Pathology

To evaluate whether different qualifications of a cytologic diagnosis of "atypical squamous cells of undetermined significance(ASCUS)" predict a greater or lesser likelihood of tissue diagnosis of uterine cervix, we compared different cytologic qualifications of ASCUS with the tissue diagnosis. One hundred twenty-two con secutive Papanicolaou smears showing ASCUS in women who had undergone cervical biopsy within nearest 30 days were collected. The 122 smears were qualified as "favor reactive"(25%), "favor low grade squamous intraepithelial lesion (LSIL)"(24%), "favor squamous intraepithelial lesion(SIL)"(16%), "favor high grade squa mous intraepithelial lesion(HSIL)"(16%), and "not otherwise specified"(19%). Squamous intraepithelial or invasive lesion was pathologically confirmed by cervical biopsy in 13% of the "favor reactive", 27% in "favor LSIL", 70% in "favor SIL", 75% in "favor HSIL", and 35% in "not otherwise specified" smears. There were significant asso ciations between the favor reactive smear and the benign biopsy finding and between the favor SIL smear and the biopsy showing a squamous intraepithelial or more severe lesion. Nevertheless, most of favor LSIL smears exhibit reactive process in tissue biopsy. Conclusively, qualified ASCUS stratifies women into different risk groups for SIL. The cytopathologist should make the cytologic diagnosis of "ASCUS, favor LSIL" circumspectly.
Biopsy* ; Cervix Uteri ; Diagnosis* ; Female ; Humans ; Papanicolaou Test

OBJECTIVE: This study aims to assess the knowledge and attitudes of female adolescents aged 14-19 years old seeking consult at Philippine Children's Medical Center regarding cervical cancer screening and HPV vaccine.

DESIGN: Cross-sectional survey of mid to late adolescents.

METHODOLOGY: The survey questionnaire consists of 18 items in the domain of knowledge, attitudes, practice behaviors, barriers and demographic information. Survey forms in a sealed envelope were given to adolescents 14 to 19 years old after obtaining their assent and parents/guardians' consent.

RESULTS: There were a total of 107 respondents; majority belonged to the mid adolescents (14-16 years old), high school level and non sexually active 57%, 64% and 62% respectively. Most of the respondents (60%) were in a relationship or had a boyfriend, 61% engaged in a monogamous sexual relationship with their partners, 10% had 2 partners and 15% had more than 3 partners. There were significantly more late adolescents who are sexually active compared to mid adolescents (67.4% and 14.8%). Awareness of cervical cancer screening is only 23% of the surveyed adolescents (mean age 16.36). Majority of the sexually active respondents knew that HPV infection is through vaginal intercourse, and that pap smear is necessary even if no history of cancer in the family. More respondents with high education knew that avoidance of sexual intercourse, using condom and vaccination are all effective methods of HPV infection prevention. 53% of the respondents heard about HPV vaccine. Sources of information were mostly from the mass media. Majority were willing to receive the vaccine especially if given for free.

CONCLUSION: Knowledge on HPV and Cervical cancer prevention especially through pap smear is poor. Health education and improvement of personal practices should be emphasized as necessary factors for preventing HPV infection acquisition.

OBJECTIVE: To evaluate the risk factors for high grade dysplasia after Loop electrosurgical excision procedure (LEEP). METHODS: LEEP using local anesthesia was performed on an outpatient basis in 1656 patients referred for colposcopy for an abnormal Papanicolaou smear of cervigram during a period of 7 years. We performed a cytologic smear immediately after loop excision. LEEP cone slides were reviewed to assess involvement of margins, multiple quadrants. RESULTS: One hundred seven patients (8.1%) had recurrent dysplasia and mean interval of recurrence after loop excision were 13.2 months. Greater recurrence rates were noted involving margins (36.4% of recurrent group vs. 6.7% of control group), multiple quadrants (3.1% of recurrent group vs. 1.8% of control group), and endocervix immediately after loop excision (19.5% of recurrent group vs. 1% of control group). CONCLUSION: Careful follow-up should be applied in the cases of multiple quadrants involvement, margin positivity, positive Pap result right after LEEP.
Anesthesia, Local ; Colposcopy ; Follow-Up Studies ; Humans ; Outpatients ; Papanicolaou Test ; Recurrence* ; Risk Factors

BACKGROUND: Cervical cytology for uterine cervical cancer screening has transitioned from conventional smear (CS) to liquid-based cytology (LBC), which has many advantages. The aim of this study was to compare the proportion of unsatisfactory specimens from CS versus LBC at multiple institutions including general hospitals and commercial laboratories. METHODS: Each participating institution provided a minimum of 500 Papanicolaou (Pap) test results for analysis. Pap tests were classified according to the participating institution (commercial laboratory or general hospital) and the processing method (CS, ThinPrep, SurePath, or CellPrep). The causes of unsatisfactory results were classified as technical problems, scant cellularity, or complete obscuring factors. RESULTS: A total of 38,956 Pap test results from eight general hospitals and three commercial laboratories were analyzed. The mean unsatisfactory rate of LBC was significantly lower than that of CS (1.26% and 3.31%, p = .018). In the LBC method, samples from general hospitals had lower unsatisfactory rates than those from commercial laboratories (0.65% vs 2.89%, p = .006). The reasons for unsatisfactory results were heterogeneous in CS. On the other hand, 66.2% of unsatisfactory results in LBC were due to the scant cellularity. CONCLUSIONS: Unsatisfactory rate of cervical cancer screening test results varies according to the institution and the processing method. LBC has a significantly lower unsatisfactory rate than CS.
Hand ; Hospitals, General ; Mass Screening* ; Methods ; Papanicolaou Test ; Uterine Cervical Neoplasms*