• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7761-7762
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• 2013

Alternative strategies such as visual inspection of cervix with acetic acid, are real time, economical and easily implemented methods for cervical cancer screening. However, variable sensitivity and specificity have been observed in various community based studies. The possible reasons could include variation in man power training, light source used for visualization, and preparation of diluted (4-5%) acetic acid and its storage. A standardized protocol for training, teaching material (easy to understand in the local language) for trainees, supervision and reinforcement by intermittent and supplementary training to check the quality of their observation, a standard protocol for preparation dilute acetic acid and its storage and a standard good light source (equivalent to day light) are needed to minimize the variation in sensitivity and specificity of VIA in community settings.

• 산업공학
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• 제16권spc호
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• pp.65-69
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• 2003

Process capability has long been viewed as a critical performance measure to indicate how well a process meet the specifications and customer requirements. Several indices, including $C_p$ and $C_{pk}$, have been proposed and widely implemented to quantify the process capability. However, these indices have been obtained without regard to inspection or screening procedures through which finished products will be truncated at the specifications. Consequently, only a fraction of outgoing products within the specifications will be passed into the customers. From the customer's point of view, it will thus be meaningful to assess the process capability with truncated samples. This article investigates how to estimate the process capability when only incomplete truncated data are available. On the basis of parameter estimation for truncated samples, the proposed methodology may be helpful to evaluate the process capability by examining a sample of items from the lots submitted.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10757-10762
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• 2015

The purpose of this study was to demonstrate the feasibility of VIA screening with cryotherapy and to record normative values for indicators anticipated in similar low resource settings. Women aged 30-49 years were targeted, resulting in 1961 women screened and treated at two primary health care (PHC) centres near Suva, Fiji. Recruitment was through provision of information, education and communication (IEC). Referrals to a gynaecology outpatient department (OPD) at a referral hospital occurred throughout the screening pathway. Participation was 32% (95%CI 31-33%), higher in iTaukei (Melanesians) women (34%, 95%CI 33-36) compared to Fijians of Indian descent (26%, 95%CI 24-28). Regression analysis, adjusted for confounders, indicated significantly lower participation in those of Indian descent, and age groups 35-39 and 45-49 years. Of those examined by VIA, 190 were positive with aceto-white lesions (9.9%), within the expected range of 8-15%, with minor geographic and ethnic variation. Positive VIA results were more common in the peri-urban area, and in those aged 35-39 years. Of women aged 30-49 years, 59 received cryotherapy (none of whom had significant complications), 91 were referred to OPD, two cervical carcinomas were identified and eight cervical intra-epithelial neoplasms (CIN) II-III were diagnosed. These results provide normative findings from a community-based VIA screening program for other similar low resource settings.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4313-4318
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• 2016

Background: This study documented the performance of providers of visual inspection with acetic acid (VIA) at primary health centers, assessing their compliance with the VIA skills checklist and determinants of non-compliance, and exploring their perceptions of VIA training sessions. Materials and Methods: A cross-sectional study was conducted among VIA providers in the $Mekn\grave{e}s$-Tafilalet region of Morocco. Structured observation of their performance was conducted through supervisory visits and multiple focus group discussions (FGDs). Results: Performance of all the recommended steps for effective communication was observed in a low proportion of procedures (36.4%). Midwives/nurses had higher compliance than general practitioners (GPs) (p<0.001). All recommended steps for VIA examination were performed for a high proportion of procedures (82.5%). Compliance was higher among midwives/nurses than among GPs (p<0.001) and among providers in rural areas than those in urban areas (p<0.001). For pre-VIA counselling, all recommended steps were performed for only 36.8% of procedures. For post-VIA counseling, all recommended steps were performed in a high proportion (85.5% for VIA-negative and 85.1% for VIA-positive women). Midwives/nurses had higher compliance than GPs when advising VIA-positive women (p=0.009). All infection prevention practices were followed for only 14.2% of procedures, and compliance was higher among providers in rural areas than those in urban areas (p<0.001). Most FGD participants were satisfied with the content of VIA training sessions. However, they suggested periodic refresher training and supportive supervision. Conclusions: Quality assurance of a cervical cancer screening program is a key element to ensure that the providers perform VIA correctly and confidently.

• 대한산업공학회지
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• 제23권4호
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• pp.793-802
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• 1997

A sampling plan is presented for situations where sampling inspection is based on the quality characteristic of interest and items in rejected lots are screened based on a correlated variable. A cost model is constructed which involves the costs of misclassification errors, sampling and screening inspections. A method of finding optimal values of sample size, acceptance number and cutoff value on the correlated variable is presented, and numerical studies are given.

• 산업경영시스템학회지
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• 제21권45호
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• pp.201-213
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• 1998

We address the problem of choosing the most economic mean value for an automatic filling operation on a production line through the sampling inspection. If quality characteristic of a unit is less than inspection specification then the goods is not accepted. Otherwise, it is accepted. The lots that the numbers of non-conforming units in a sample are larger than the allowable number of non-conforming units are rejected. The non-conforming units in the rejected lots are separated by the screening inspection. The non-conforming units separated are sold in discount price. We assume that quality characteristic is larger-the-better characteristic, the distribution of quality characteristic is normal distribution, and the standard deviation of the distribution is known. This paper presents total expected profit function model considering sales revenue, inspection costs, and material costs. The manufacturing process mean value maximizing total expected profit is determined, and the results of the process target value and total expected profit is analyzed as coefficients change.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.4169-4172
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• 2012

Background: The majority of women in rural India have poor or no access to cervical cancer screening services, although one.quarter of all cervical cancers in the world occur there. Several large trials have proven the efficacy of low-tech cervical cancer screening methods in the Indian context but none have documented the necessary components and processes of implementing this evidence in a low-resource setting. Methods: This paper discusses a feasible model of implementation of cervical cancer screening programme in low-resource settings developed through a pilot research project carried out in rural Tamilnadu, India. The programme used visual inspection of cervix after acetic acid application (VIA) as a screening tool, nurses in the primary care centres as the primary screeners and peer educators within Self-Help Women groups to raise community awareness. Results: The uptake of screening was initially low despite the access to a screening programme. However, the programme witnessed an incremental increase in the number of women accessing screening with increasing community awareness. Conclusions: The investigators recommend 4 key components to programme implementation in low-resource setting: 1) Evidence-based, cost-effective test and treatment available within the reach of the community; 2) Appropriate referral pathways; 3) Skilled health workers and necessary equipment; and 4) Optimisation of health literacy, beliefs, attitudes of the community.

• 대한산업공학회지
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• 제25권1호
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• pp.1-7
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• 1999

This paper considers the problem of determining the optimum target values of the quality characteristic of interest Y and the screening limits of a surrogate variable X which is correlated with Y under two-stage screening procedure. In the two-stage screening procedure, X is measured first to decide whether an item should be accepted, rejected or additional observations should be taken. If it is difficult to decide on the result of measured value of X, Y is then observed to classify the undecided items. Assuming that Y and X are jointly normally distributed, a model is constructed which involves selling and reduced prices, production, inspection, and penalty costs. Methods of finding the optimum process mean and the screening limits are presented. A numerical example and analysis of the results are also presented.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3529-3533
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• 2012

Objectives: To investigate the current prevalence and knowledge of cervical cancer, breast cancer and reproductive tract infections (RTIs) in rural Chinese women, and to explore the acceptance and feasibility of implementing a combined screening program in rural China. Methods: A population-based, cross-sectional study was conducted among women aged 30 to 59 years old in Xiangyuan County, Shanxi Province from 2009 to 2010. Socio-demographic characteristics, knowledge of cervical cancer, breast cancer and RTIs, and the attitude toward single or combined screening were collected by an interview questionnaire. Each participant received a clinical examination of the cervix, breast and reproductive tract. Examinations included visual inspection, mammography, laboratory tests and pathological diagnosis. Results: A total of 1,530 women were enrolled in this study. The prevalence of cervical precancerous lesions, suspicious breast cancer, suspicious benign breast disease and RTIs was 1.4%, 0.2%, 14.0% and 54.3%, respectively. Cervicitis, trichomonas vaginitis, and bacterial vaginitis were the three most common RTIs among our participants. Television, radio broadcast, and public education during screening were the major source of healthcare knowledge in rural China. Moreover 99.7% of women expressed great interest in participating in a combined screening project. The affordable limit for combined screening project was only 50 RMB for more than half of the rural women. Conclusion: A combined screening program would be more effective and popular than single disease screening projects, while appropriate accompanied education and a co-pay model for its successful implementation need to be explored, especially in low-resource settings.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5101-5105
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• 2013

The incidence and mortality of cervical cancer remains high in India even after sixty years of introduction of the Pap smear (cervical cytology) which is an effective means of identifying preinvasive lesions of carcinoma cervix. The morbidity and mortality due to cervical cancer has come down drastically in countries with well established screening programmes at national level. This study aims at screening women for cervical cancer opportunistically during their visit to hospital and to study various types of neoplastic and non-neoplastic lesions of the cervix by cervical smear study (Pap smear study). In the present study, a total of 350 cervical smears were studied. The age of patients ranged from 19 years to 80 years with mean age being 37.5 years. Out of 350 cases, the diagnosis of neoplasia was given in 43 cases and 258 cases were diagnosed as inflammatory smears. Forty-cases were normal and 9 cases were inadequate to evaluate. Forty-three patients who were found to have neoplastic lesions on cytology were referred for further investigations like colposcopy and biopsy to confirm the diagnosis and avail proper treatment. Limitation of the present study was small sample size as all female patients aged between 20 and 60 years visiting hospital were not included in the screening, other screening tests like VIA (visual inspection with acetic acid test) and HPV DNA (human papilloma virus) tests were not done. Until the time centrally organised screening programmes for cervical cancer are established in India, arrangements should be made for hospital based opportunistic screening for all women attending hospital. The cost effectiveness of different screening tests for cervical cancer should be evaluated.