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Liquid-based cytology (LBC) for cervical cancer screening is now more common than the conventional smears, which when digitised from glass slides into whole-slide images (WSIs), opens up the possibility of artificial intelligence (AI)-based automated image analysis. Since conventional screening processes by cytoscreeners and cytopathologists using microscopes is limited in terms of human resources, it is important to develop new computational techniques that can automatically and rapidly diagnose a large amount of specimens without delay, which would be of great benefit for clinical laboratories and hospitals. The goal of this study was to investigate the use of a deep learning model for the classification of WSIs of LBC specimens into neoplastic and non-neoplastic. To do so, we used a dataset of 1605 cervical WSIs. We evaluated the model on three test sets with a combined total of 1468 WSIs, achieving ROC AUCs for WSI diagnosis in the range of 0.89–0.96, demonstrating the promising potential use of such models for aiding screening processes.

Background Australia is working towards eliminating cervical cancer as a public health issue by 2035, by achieving an incidence rate of less than 4 cases per 100,000 people. Increasing cervical screening participation, particularly in under-screened groups, is critical to achieving this goal equitably. On 1 December 2017, the National Cervical Screening Program (NCSP) transitioned from two-yearly Papanicolaou smear-based screening to five-yearly primary human papillomavirus (HPV) based cervical screening tests (CST) for all women and people with a cervix aged 25–74 years. Since July 2022, all eligible participants can choose to undertake self-collected CST, a collection method to help overcome barriers to screening. We aimed to investigate self-collection uptake in Victoria, including HPV positivity rates and time to colposcopy, after universal availability. Methods We investigated self-collection uptake by age group, regionality, and screening status as a proportion of all CST from 1 December 2017 until 30 June 2024. We also compared rates of HPV detection, invalid results, and time to colposcopy with practitioner-collected samples during the same period. The analysis presented was conducted using the March 2025 Victorian raw data extract sourced from the National Cancer Screening Register and publicly available screening coverage rates in Victoria. R was used to prepare our descriptive analysis. Results Twenty-nine percent of the 598,055 CST from 1 July 2022 to 30 June 2024 were self-collected compared with 0.41% of 1,279,416 tests prior to universal availability. The findings indicate a notable increase in self-collection uptake in older age groups, regional areas, and under- and never-screened women. While uptake of self-collection increased, there was a reduction in overall screening coverage in 2023. The median time to colposcopy assessment was similar for women who used self-collection and practitioner-collected screening. HPV positivity and invalid rates were low for both collection methods, although there were slightly higher overall positivity and invalid rates in self-collected tests. Conclusions Self-collection was used by a wide range of NCSP participants when universally available, despite a reduction in overall screening coverage. Our findings offer insights for programs seeking to widen population level availability of self-collection for cervical screening.

Each year the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, a report on data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, current ACS cancer screening guidelines are summarized, as are updated guidelines on cervical cancer screening and lung cancer screening with low-dose helical computed tomography. The latest data on the use of cancer screening from the National Health Interview Survey also are described, as are several issues related to screening coverage under the Patient Protection and Affordable Care Act of 2010. [PUBLICATION ABSTRACT]

Background: Australia has recently introduced a new screening program for cervical cancer. There has also been a decline in participation rates for cervical screening. Aim: To complete a systematic literature review of the factors that prevent Australian women from participating in cervical screening. Methods: Authors searched CINAHL, Medline, SCOPUS and the Cochrane Library to obtain articles discussing Australian women's self-identified barriers to cervical screening. Quantitative studies published in peer-reviewed journals after 1991 were considered. PROSPERO Registration Number: CRD42018105028. Results: The final search produced 1749 studies, with 13 quantitative papers included in the narrative synthesis after screening by two independent reviewers. No articles were excluded due to bias. Discussion: Self-identified barriers to screening were categorised into personal, practitioner, test-related and logistical factors. The most commonly stated barriers included lack of time, embarrassment, fear of results, irrelevance and male health professionals. The use of HPV triage in cervical screening was not a barrier to screening, however, some women regarded self-collected HPV testing as a barrier. Barriers to self-collection included desire for the general practitioner to complete the test, fear of doing the test incorrectly, wishing to include it in a general check-up and concerns about the test itself. Conclusion: A variety of personal, practitioner, test-related and logistical barriers negatively impact the screening participation of Australian women. Further research into barriers in the Australian population, and women's attitudes towards HPV testing and self-collection is required to create effective health interventions to improve participation in cervical screening.

The human papillomavirus (HPV) is implicated in nearly all cases of cervical cancer. While most HPV infections resolve spontaneously, persistent infections can lead to high-grade lesions and cancer. Traditionally, cervical screening has relied on cervical cytology, but since 2016, HPV mRNA testing has been integrated to enhance the detection of high-grade lesions (CIN2+) in women with normal cytology. This study, conducted at the Department of Clinical Pathology at UNN from 2016 to 2019, evaluates the impact of HPV mRNA testing on quality assurance, with follow-up adhering to national guidelines through December 2022. Among 98,648 cervical samples analyzed, 61,635 women exhibited normal cytology. Of these, 752 (1.2%) tested positive for HPV mRNA, specifically targeting HPV types 16, 18, and 45. Upon the re-evaluation of the index cytology, 70.7% of these women retained normal cytology findings, while biopsies identified high-grade lesions (CIN2+) in 34% and severe lesions (CIN3+) in 14%. Notably, older women constituted a larger portion of the normal cytology group but a smaller percentage of those testing positive for HPV and exhibiting significant lesions. This underscores the effectiveness of HPV mRNA testing in promptly identifying high-grade lesions, highlighting its potential to significantly reduce cervical cancer incidence through targeted re-evaluation of a small, at-risk population.

To monitor and improve the quality of the Danish national cervical cancer screening program, an annual report is published, including nine quality indicators. The screening target group consisted of 1.5 million Danish women aged 23-64 years, but in the calculation of quality indicators, the dataset varies according to indicators being Danish women, cervical cancer cases, or cytology samples. The variables include the number of cytology samples per pathology laboratory, participation rate, percentage of unsatisfactory samples, diagnostic sensitivity and specificity, percentage of samples answered within ≤10 days, percentage of atypical squamous cells of undetermined significance samples in women aged >30 years with human papillomavirus-triage, coverage, percentage of non-normal samples not followed up according to recommendations, number of incident cervical cancers, incidence of cervical cancer in the past 5 years, and upcoming percentage of incident cervical cancers undergoing audit. Annual reports have been published since 2009. Better fulfillment of quality standards has been seen for the size of pathology departments, percentage of unsatisfactory samples, percentage of atypical squamous cells of undetermined significance with human papillomavirus-triage, and a slight decrease in the percentage of non-normal samples not followed up within the recommended time intervals. Stable patterns have been observed for participation rate, coverage, and number of incident cervical cancer cases. With a coverage of 75%, and with presently 16% of non-normal samples not followed up in a timely manner, there is definitely a scope for improvement in the screening program. The database has pinpointed the strengths and weaknesses of the national cervical cancer screening program. Measures to enhance participation rate/coverage and to improve follow-up of non-normal cytology samples are warranted.

Cervical cancer continues to be a major public health problem in India in the absence of wide spread organised cervical screening programs. Visual inspection of the cervix with acetic acid (VIA) is an effective, inexpensive screening test that can be combined with simple treatment procedures for early cervical lesions, provided by trained health workers. We report 7 years experience in early detection of cervical cancer and pre-cancers using the VIA test in a community-based program in rural Andhra Pradesh, India where there are no existing organised cervical screening programs. Eligible women aged between 26 and 60 were opportunistically screened by trained health wor kers using the VIA test. Women who tested positive were further evaluated and those with cervical lesions were treated either by cryotherapy in the screening clinic or referred to a higher center. A total of 18,869 women were screened by a single round of VIA testing with a positive rate of 10.75%. Biopsy proven high-grade squamous intraepithelials (HSILs) were 90 (0.48%) and low-grade squamous intraepithelials (LSILs) were 43 (0.28%). The overall prevalence of cervical intraepithelial neoplasia (CIN) 2+ lesion rate is 1.05%. A total of 312 (1.65%) cryotherapies were done and 49 women underwent hysterectomy. VIA by trained female health workers is a safe, acceptable, and effective test that can save lives from cervical cancer even in remote areas with few resources. These results have important implications for efficient service delivery in cervical screening programs in low-resourced settings.

Background Human papillomavirus (HPV) testing is recommended in primary cervical screening to improve cancer prevention. An advantage of HPV testing is that it can be performed on self-samples, which could increase population coverage and result in a more efficient strategy to identify women at risk of developing cervical cancer. Our objective was to assess whether repeated self-sampling for HPV testing is cost-effective in comparison with Pap smear cytology for detection of cervical intraepithelial neoplasia grade 2 or more (CIN2+) in increasing participation rate in primary cervical screening. Methods A cost-effectiveness analysis (CEA) was performed on data from a previously published randomized clinical study including 36,390 women aged 30–49 years. Participants were randomized either to perform repeated self-sampling of vaginal fluid for HPV testing ( n  = 17,997, HPV self-sampling arm) or to midwife-collected Pap smears for cytological analysis ( n  = 18,393, Pap smear arm). Results Self-sampling for HPV testing led to 1633 more screened women and 107 more histologically diagnosed CIN2+ at a lower cost vs. midwife-collected Pap smears (€ 229,446 vs. € 782,772). Conclusions This study resulted in that repeated self-sampling for HPV testing increased participation and detection of CIN2+ at a lower cost than midwife-collected Pap smears in primary cervical screening. Offering women a home-based self-sampling may therefore be a more cost-effective alternative than clinic-based screening. Trial registration Not registered since this trial is a secondary analysis of an earlier published study (Gustavsson et al., British journal of cancer. 118:896-904, 2018).

Malawi has the highest incidence of cervical cancer in the world. Due to various challenges the country faces in terms of cervical cancer control, women have a poor chance to survive this disease. The purpose of our study was to describe the knowledge and practices of cervical cancer and its screening as well as the educational preferences of women living in a rural community in the Chiradzulu District. We conducted a survey among women between the ages 30 and 45, used convenience sampling, a calculated sample size (n = 282) and structured interviews to collect the data. A questionnaire adapted from a previous study served as data collection instrument. The data were analysed in Microsoft Excel and chi-square (p < .05) was used to investigate the relationships between the variables. Content analyses analysed the open-ended questions. The mean age of the sample was 36.1 (SD ± 5.1) and the highest percentage (37.4%; n = 98) belonged to the Yao ethnic group. The majority attended primary school (66.0%; n = 173), were married (74.4%; n = 195) and depended on a small business as source of income (55.7%; n = 146). Most of the women (93.4%; n = 247) had heard of cervical cancer and the visual inspection with acetic acid (VIA) screening programme (67.9%; n = 178) but only 22.9% (n = 60) indicated they had been screened. Lack of knowledge of the screening programme was the most common reason for not being screened. Having a demonstration of the VIA procedure was the most popular educational method (92.0%; n = 241) which gives a fresh approach to educational programmes aimed at preventing cervical cancer.

Cervical cancer is the third most common cancer in women worldwide, with concepts and knowledge about its prevention and treatment evolving rapidly. Human papillomavirus (HPV) has been identified as a major factor that leads to cervical cancer, although HPV infection alone cannot cause the disease. In fact, HPV‐driven cancer is a small probability event because most infections are transient and could be cleared spontaneously by host immune system. With persistent HPV infection, decades are required for progression to cervical cancer. Therefore, this long time window provides golden opportunity for clinical intervention, and the fundament here is to elucidate the carcinogenic pattern and applicable targets during HPV‐host interaction. In this review, we discuss the key factors that contribute to the persistence of HPV and cervical carcinogenesis, emerging new concepts and technologies for cancer interventions, and more urgently, how these concepts and technologies might lead to clinical precision medicine which could provide prediction, prevention, and early treatment for patients. We discussed the key factors that contribute to HPV persistency and cervical carcinogenesis, the perspective and novel potential technologies for early diagnose and effective prevention of the disease, and more importantly, how this knowledge of basic science may translate into clinic to provide better personalized health care for patients with cervical cancer. This review contributed to the deeper understanding of effective prevention, screening, and treatment of HPV‐related cervical cancer.