• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3753-3756
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• 2014

Background: Cervical cancer is relatively common in Thai women, but the proportion of females receiving Pap smear screening is still low. Objective: The purpose of this cross-sectional study was to study factors related to cervical cancer screening uptake by Hmong hilltribe women in Lomkao District, Phetchabun Province. Materials and Methods: Interview data were collected from 547 of these women aged 30-60 years living in the study area and analyzed using multiple logistic regression. Results: The results showed that 64.9% of the study sample had received screening, and that 47.2% had attended due to a cervical screening campaign. The most common reason given for not receiving screening was lack of time (21.4%). The factors found to be positively associated with uptake (p value <0.05) were as follows: number of years of school attendance (OR=1.56, 95%CI:1.02-2.38), animistic religious beliefs (OR=0.55, 95%CI:0.33-0.91), a previous pregnancy (OR=6.20, 95%CI:1.36-28.35), receipt of information about cervical cancer screening (OR=2.25, 95%CI:1.35-3.76), and perceived risk of developing cervical cancer (OR=1.83, 95%CI:1.25-2.67). Conclusions: To promote the uptake of cervical screening, Hmong hilltribe women need to know more about cervical cancer and cervical cancer screening, and access to screening services should be provided in conjunction with existing everyday services, such as family planning and routine blood pressure monitoring or diabetes services.

• 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.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.635-639
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• 2015

Background: In the absence of routine screening program for cervical cancer in Iran and high rate of diagnosed cancer in its advanced stage, recognition of sociodemographic factors related to delayed diagnosis of cancer in Iran could be helpful in reducing the burden of disease in our community. The aim of this study was to determine the stage of cervical cancer at diagnosis and factors related to delayed diagnosis of cervical cancer in Isfahan, Iran. Materials and Methods: In this cross sectional study women diagnosed with cervical cancer for the first time by histo-pathological examination were enrolled. According to the clinical and paraclinical findings and staging of the cancer, they were classified into early and delayed diagnosis of cervical cancer. Sociodemographic factors were compared in the two groups. Results: In this study of 55 women mean age was $48.3{\pm}12.0.$ According to our classification 6/55 (10.9%) and 49/55 (89.1%) of them had early and delayed diagnosis of cervical cancer. Delayed diagnosis of the cancer was significantly higher in patients with lower degree of education, lower socioeconomic status, having smoker and addict husband and those who did not have a history of Pap smear test (p<0.05). Conclusions: The results of this study indicated risk factors related to delayed diagnosis of cervical cancer. The affected women should be targeted for implementation of specialized educational programmes for improving knowledge and screening test.

• Women's Health Nursing
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• v.17 no.5
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• pp.463-473
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• 2011

Purpose: Cervical cancer can be prevented by regular cervical screening. Embarrassment has been reported as one important barrier to cervical screening uptake. The absence of appropriate instrumentation, however, has limited our understanding of the links between embarrassment and health care outcomes. The purpose of this study was to evaluate psychometric attributes of the uterine cervical cancer screening embarrassment questionnaire. Methods: A convenience sample for field study was recruited from four gynecological clinics in Gyeongju, Korea. Within a cross-sectional descriptive design, 339 women who had cervical screening completed self-administered measures of embarrassment including a visual analogue, general medical embarrassment, dispositional embarrassment, and Pap smear related negative emotion. Results: Rasch analysis of items demonstrated the evidence of one-dimensional construct and good 7-point rating scales functioning. Factor analysis revealed that uterine cervical cancer screening embarrassment was comprised of two domains-bodily manifestations and perceiving an undesirable social face. Construct validity was demonstrated by a high subscale-to-subscale correlation. Convergent and discriminant validity was evidenced by significant correlations with a 100 mm VAS scale, general medical embarrassment, and Pap smear related negative emotion. Known-group validity was established by comparing women with high versus low trait embarrassment. Both two sub-scales and overall scale demonstrated good internal reliability. Conclusion: The Uterine uterine cervical cancer screening questionnaire is a reliable and valid instrument suited to assessing the manifestations of embarrassment during screening. The use of instrument can be extended to understand the client's embarrassment undergoing health examinations which require the exposure of their private parts.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6489-6494
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• 2014

Cervical cytology remains the principal screening method to detect pre-invasive and invasive cervical lesions. Management of abnormal cervical cytology depends on the risk of encountering a significant cervical lesion or high-grade cervical disease. These risks may vary in different areas across the country. Thus, determining the rate of significant cervical lesion associated with each type of abnormal cervical cytology in each area is of critical importance for designing area-specific management approach. This review was conducted to evaluate the rate of high-grade cervical disease among Thai women with abnormal cervical cytology. A relatively high incidence of underlying significant lesions including invasive disease was demonstrated even in those having only minimal smear abnormality. This baseline information is crucial and must be taken into consideration in management of women with abnormal cytological screening to achieve the goals of comprehensive cervical cancer control in Thailand.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.503-506
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• 2013

Objectives: To determine human papillomavirus (HPV) frequency, genotypes and the relation between cervical smear results, risk factors and types in women living in Manisa, Turkey. Materials and Methods: A total of 410 women were included in the study. Cervical specimens were obtained for linear array HPV genotyping and pathological testing. Conventional Pap test and Bethesda system were used for evaluation of cytology specimens. Results: A total of 410 women with a mean age of 34.9 years were tested. A positive result of any HPV was found in 35 patients (8.5%). Among them, 26 different serotypes of HPV were identified and the most frequent type was HPV 16 (28.5%) followed by type 45 and 53 (11.4%). Patients were infected by 65.7% high risk, 11.4% probable high risk and 22.9% low risk HPV types. Multiple HPV positive results were found in 13 patients (37.1%). Patients with single partner, history of abnormal smear or condyloma had positive HPV results and this was statistically significant (p<0.05). Correlation analysis showed a statistically weak relation between positive HPV and abnormal smear results (r=0.120). Conclusions: Determining HPV types of genital HPV infections is important for epidemiological studies. We have found the rate of positive HPV as 8.5% which implies the need for extended screening programs in order to diagnose oncogenic HPV at an early stage.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5503-5506
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• 2013

This cross-sectional analytic study aimed to investigate any relationship between the body mass index (BMI) and an abnormal Pap smear. The subjects were 7,720 women aged 30-69 years who lived in Khon Kaen Province, Thailand, and had been recruited as participants in the Khon Kaen Cohort Study during 1990-2001. All had received Pap smear screening for cervical cancer. The data were analyzed using descriptive and inferential statistics. Multiple logistic regression was used to determine the relationship between body mass index and an abnormal Pap smear. The mean BMI was $24.53kg/m^2$ (SD=3.98), and 2.14% had abnormal Pap smears. Compared with the reference group of women with a BMI ${\leq}22.9kg/m^2$, those with a body mass index of $23.0-24.9kg/m^2$ had a reduced risk of an abnormal smear (ORadj=0.92, 95%CI: 0.57-1.47), but women with a BMI $25.0-29.9kg/m^2$ were found to have an approximately 1.24 times higher risk ($OR_{adj}=1.24$, 95%CI: 0.86-1.80), and those with a BMI ${\geq}30.0kg/m^2$ had an approximately 1.63 times higher risk ($OR_{adj}=1.63$, 95%CI: 0.98-2.69). The results indicated that the risk of Pap smear abnormalities is increased in women who have a higher than normal body mass index, but this finding was not statistically significant. Nevertheless, public health personnel should encourage women to maintain their BMI in the normal range to reduce the possible future risk of cervical cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2501-2505
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• 2015

Purpose: The present study was carried out to measure knowledge level and behavior of family health personnel (FHP) in Izmir on early diagnosis of breast and cervical cancers. Materials and Methods: The study population of this cross-sectional study was not selected. A questionnaire was applied to all FHP to measure knowledge level and behavior about cancer. The participation rate was 88%. Breast examination, mammography analysis, Papanicolaou smear applications were determined as dependent variables, and knowledge level about breast and cervical cancer, age, professional time as FHP as independent variables. Data were evaluated using definitive statistics, chi-square and logistic regression tests in SPSS software package for Windows 15.0. Results: A total of 970 family health personnel participated in the research. The age range was 20-45 years (82.4%). Mean age was $37.9{\pm}7.4$. Response rate was 87.3%. Of the participants, 88.4% performed breast self-examination. Rate of performing mammography at least once was 24.1%. Rate of performing Pap-smear examination at least once was 61.0%. In logistic regression analyses, it was determined that people with knowledge on breast and cervical cancer were those performing breast self-examination, mammography and Pap-smear examinations (p<0.05. Conclusions: It is essential that the knowledge, behavior and manners of health providers on early diagnosis for cancer increases awareness in the general population and provides information on execution ofthe most effective methods for generating a healthy society.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8491-8494
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• 2016

Purpose: To compare unsatisfactory rates and detection of abnormal cervical cytology between conventional cytology or Papanicolaou smear (CC) and liquid-based cytology (LBC). Materials and Methods: A total of 23,030 cases of cervical cytology performed at King Chulalongkorn Memorial Hospital during 2012-2013 were reviewed. The percentage unsatisfactory and detection rates of abnormal cytology were compared between CC and LBC methods. Results: There was no difference in unsatisfactory rates between CC and LBC methods (0.1% vs. 0.1%, p = 0.84). The detection rate for squamous cell abnormalities was significantly higher with the LBC method (7.7% vs. 11.5%, p < 0.001), but those for overall abnormal glandular epithelium were similar (0.4% vs. 0.6%, p = 0.13). Low grade squamous lesion (ASC-US and LSIL) were more frequently detected by the LBC method (6.1% vs. 9.5%, p < 0.001). However, there was no difference in high gradd squamous lesions (1.1% vs. 1.1%, p = 0.95). When comparing between types of glandular abnormality, there was no significant difference the groups. Conclusions: There was no difference in unsatisfactory rates between the conventional smear and LBC. However, LBC could detect low grade squamous cell abnormalities more than CC, while there were similar rates of detection of high grade squamous cell lesions and glandular cell abnormalities.

• 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.