No abstract available.
*Colposcopes ; Early Detection of Cancer/*instrumentation ; Female ; Humans ; Optical Imaging/*instrumentation ; Uterine Cervical Dysplasia/*diagnosis ; Uterine Cervical Neoplasms/*diagnosis

OBJECTIVE: Ideal cancer screening program should be not only accurate but also cost-effective. However, in Korea, the two aspect of cervix cancer screening program was not yet evaluated. Thus we conducted this study to evaluate the cost-effectiveness and accuracy of various screening methods for detecting uterine cervical neoplasia. METHODS: We used various methods (conventional Pap smear, cervicography and HPV test) to detect cervical neoplasia on 255 women who visited the Seoul National University Hospital from Dec. 1996 to Jul. 1997 and analyzed the accuracy and cost-effectiveness of each method along with various combinations of methods using Bayesian theorem. The accuracy was judged by the final histopathologic diagnosis. RESULTS: Sensitivity (SE) and specificity (SP) of each method to detect cervical intraepithelial neoplasia (CIN) 1 or above were 83.0% and 69.4% in Pap smear, 53.7% and 85.2% in cervicography, and 57.8% and 80.6% in HPV test, respectively. The combination of Pap smear with cervicography or with HPV test for detecting CIN 1 or above had same SE and SP of 89.1% and 62.0% respectively. The combination of cervicography and HPV test had SE of 78.9% and SP of 70.4%. Three methods combination showed 93.9% SE and 54.6% SP. The estimated cost per method was highest in three methods combination (117,000 won) and lowest in Pap smear alone (12,000 won). The cost for detection of one case of cervical neoplasia was highest in combination of cervicography and HPV test (241,907 won) and lowest in Pap smear alone (25,385 won). CONCLUSION: The combinations of each method showed increased SE. These combinations, however, had low SP and high cost than individual method. Cervicography or HPV test alone should not be considered as an alternative to Pap smear for cervical cancer screening because its cost-effectiveness is not significantly better than that of Pap smear.
Cervical Intraepithelial Neoplasia ; Diagnosis ; Early Detection of Cancer ; Female ; Humans ; Korea ; Mass Screening* ; Sensitivity and Specificity ; Seoul ; Uterine Cervical Neoplasms

Cervical cancer is the third most prevalent cancer in women around the world. Recently in Korea, the incidence of cervical cancer has decreased, but in all stages of cervical intraepithelial neoplasia (CIN), CIN has shown a 91% increase from 1999 to 2008. Persistent human papillomavirus (HPV) infection has been found to be the main cause of cervical cancer. HPV types 16 and 18 have been found in 70% of cervical cancer patients around the world. Cervical cancer screening such as cytology has limitations in terms of sensitivity and specificity. A discussion about the need for the HPV test is becoming active in order to compensate for the limitation of cytology. After the role of HPV in cervical cancer was identified, the importance of HPV detection test as a screening was emphasized. Several tests have been developed and each test has its own advantages and disadvantages, and new test method to overcome the disadvantages is still being developed. Today's guidelines and tests are those you would choose from among the large number of cervical cancer screening guidelines and tests, based on the consideration that the selected guidelines and the test are effective.
Cervical Intraepithelial Neoplasia ; Early Detection of Cancer ; Female ; Humans* ; Incidence ; Korea ; Mass Screening* ; Methods ; Papillomaviridae ; Perimenopause* ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

Multiple primary cancer means that more than two cancers are independently developed in one individual. The frequency of multiple primary neoplasm is increasing as a result of the lengthening average lifetime, progress in cancer screening technique, and improved cancer therapy. Gynecologic malignancies are especially prone to associated with primary neoplasms elsewhere. The frequency of multiple primary cancers was significantly higher in patients with uterine corpus cancer than in those suffering from cervical cancer. This case has different cell types of cancer in uterine cervix, thyroid and colon simultaneously. So, we report the case with a brief review of literatures.
Cervix Uteri ; Colon ; Early Detection of Cancer ; Female ; Humans ; Neoplasms, Multiple Primary ; Thyroid Gland ; Uterine Cervical Neoplasms

Recently, a number of evidences that human papillomavirus (HPV) testing was efficient in cervical cancer screening were introduced. Moreover, successful trial outcome of preventive cancer vaccine opened new era of cervical cancer prevention. However, undoubtedly, applying new cancer screening and prevention strategy would bring on economical concern about increased medical expense. Therefore, appropriate cost-benefit analysis is very important before establishing new strategy as standard policy. In this article, we presented a few recent results about cost-benefit effectiveness by other group. And we also suggested what would be needed to perform successful.
Cost-Benefit Analysis ; Early Detection of Cancer ; Humans* ; Mass Screening ; Uterine Cervical Neoplasms

OBJECTIVETo evaluate the effectiveness of FTA Elute® Cartridge (GE healthcare, Kent, UK) in combination with hybrid capture 2 (HC2) testing for cervical cancer screening.

METHODSFrom May to June 2012, 412 women aged 25 to 65 years in Jiangxi Tonggu were enrolled in the study. We used pathological outcome as the gold standard, and the accuracy of the FTA card in combination with HC2 testing was investigated from both physician- and self-sampling, respectively.

RESULTSPhysician sampling using the FTA card in combination with HC2 testing showed a comparable sensitivity (12/13) with the liquid based medium, but a higher specificity 69.5% (266/383) vs (77.8%, 298/383) (P < 0.001).When self sampling method was used, the sensitivity and specificity of using the FTA card in combination with HC2 testing with liquid based medium was 10/13 vs 8/13(P = 0.625) and (62.3%, 238/382) vs (75.7%, 289/382) (P < 0.001). The agreement of detection results for HC2 between FTA and liquid-based sampling medium was 86.1% (340/395) and 79.5% (314/395). For physician-collected samples used for HC2 testing to detect CIN2+, the accuracy of the FTA card was superior to that of the liquid-based medium (area under the receiver operating characteristic curve (AUC) = 0.898, 95%CI:0.838-0.958).

CONCLUSIONFTA Elute® cartridge in combination with HC2 testing is a promising method of specimen transport for cervical cancer screening programs with a good precision.With further optimization, it could become an effective method for cervical cancer screening in various economic levels of areas.

The rapid screening testing for cervical cancer prevention in low- and middle-income countries, careHPV assay, is developed by Cancer Hospital, Chinese Academy of Medical Sciences. The careHPV assay is the first HPV DNA detection technique worldwide, which is simple, fast, accurate, safe, and inexpensive. The testing technique was verified using clinical outcome as the endpoint, and its accuracy was similar to the current standard HPV detection technique and even higher than VIA. The popularization and application of careHPV could tremendously contribute to cervical cancer prevention in China as well as other developing countries. This would also reduce the disparity between developed and developing countries in cervical cancer prevention and help reduce the incidence and mortality of this disease.
China ; Developing Countries ; Early Detection of Cancer ; Female ; Humans ; Papillomavirus Infections ; Uterine Cervical Neoplasms

Cervical cancer is a complex disease caused by both genetic susceptibility and environmental factors. Inherited genomic variance, high-risk human papilloma virus (HPV) infection/integration, genome methylation and somatic mutation could all constitute one machine learning model, laying the ground for molecular classification and the precision medicine of cervical cancer. Therefore, for cervical screening, next generation sequencing (NGS)-based HPV DNA and other molecular tests as well as dynamic machine learning models would accurately predict patients with potential to develop the cancer, thereby reducing the burden of repeated screening. Meantime, genome-editing tools targeting HPV would emerge as the next generation gene therapy for HPV-related cervical lesions. In this article, we review the substantial progress on molecular mechanism of cervical cancer development and suggest the future for precise prevention and early treatment of cervical cancer.
Early Detection of Cancer ; Female ; Humans ; Mass Screening ; Papillomaviridae ; Uterine Cervical Neoplasms ; diagnosis ; prevention & control ; therapy ; virology

OBJECTIVE: Human papillomavirus testing by self-sampling and urine sampling might be alternatives to Papanicolaou test (Pap test) for cervical cancer screening (CCS), and may increase compliance and adherence thereto. The present study aimed to explore satisfaction and preferences for cervical screening modalities among Korean women. METHODS: In total, 732 women aged between 20 and 69 years responded to a questionnaire designed to survey the women's perceived satisfaction for the 3 CCS modalities: clinician-collected Pap test, self-collected vaginal sampling (self-sampling) and urine sampling. RESULTS: Overall satisfaction was significantly higher with both the self-sampling and urine sampling than the clinician-collected Pap test (odds ratio [OR]=2.01; 95% confidence interval [CI]=1.48–3.00 and OR=2.47; 95% CI=1.75–3.48, respectively). Psychological distress, including embarrassment, pain, anxiety, discomfort, and stress, with self-sampling and urine sampling were significantly lower than that with the Pap test. 52% of participants reported preferences for self-sampling in the next screening round. CONCLUSIONS: Korean women were more likely to report satisfaction with alternative modalities (self-sampling and urine sampling) for CCS in comparison to the Pap test. This suggests that self-collected modalities may help with improving CCS uptake rates by eliminating burden related with the Pap test. However, further studies for test accuracy and cost-effective analysis of the alternative modalities should be conducted in order to apply CCS.
Anxiety ; Compliance ; Early Detection of Cancer ; Female ; Humans ; Mass Screening ; Papanicolaou Test ; Surveys and Questionnaires ; Uterine Cervical Neoplasms

The advent of the digital era brings new challenges and opportunities for cervical cancer prevention and research.With the development of digital techniques in China,the construction of an information platform for cervical cancer prevention based on the current achievements has become an important trend.This paper expounds the importance,existing problems,and challenges of the data integration of population-based cervical cancer screening and the information platform construction,and puts forwards effective measures to promote its construction.The establishment of an information platform for cervical cancer prevention in the digital era has far-reaching significance for the global elimination of cervical cancer.
China ; Early Detection of Cancer ; Female ; Humans ; Uterine Cervical Neoplasms/prevention & control*