\u202f<\/span>\u00a0<\/span>The American College of Obstetrician and Gynecologists. (2016). Abnormal cervical cancer screening test results. Retrieved from https:\/\/www.acog.org<\/span>\u00a0<\/span><\/p>\n

Sachan, P.L., Singh, M., Patel, M.L., & Sachan, R. (2018). A study on cervical cancer screening using pap smear test and clinical correlation.\u202f<\/span>Asia-Pacific Journal of Oncology Nursing, 5<\/span><\/i>(3), 337-341.<\/span>\u00a0<\/span><\/p>\n

U.S. Preventive Services Task Force. (2012). Cervical Cancer: Screening. Retrieved from https:\/\/www.uspreventiveservicestaskforce.org.<\/span>\u00a0<\/span><\/p>\n

I enjoy reading your post, it was quite informative. Cancer is the second leading cause of death globally, and was responsible for 8.8 million deaths in 2015. Globally, nearly 1 in 6 deaths is due to cancer (WHO, 2018). Approximately 15% of cancers diagnosed in 2012 were attributed to carcinogenic infections, including Helicobacter pylori, Human papillomavirus (HPV), Hepatitis B virus, Hepatitis C virus, and Epstein-Barr virus (Plummer, Martel, Vignat, Ferlay, Bray, & Franceschi, 2016). More specifically, cervical cancer was a known cause of death for American women. However, this rate of death was decreased due to the use of the Pap test (WHO, 2018). It has been my experience that many young women visit the ED with vaginal complaints and have never obtained a Pap smear, let alone visit the gynecologist for these complaints. The challenge as a nurse is educating these young women on the importance of this screening. <\/span><\/p>\n

The views or beliefs held by the young ladies are that they are not in need of this test, embarrassed, or just lack of knowledge. To enable a positive moment where the information presented is grasped by the female patient, the nurse should strive to provide education that stresses the importance of the Pap smear and strategies allowing greater understanding of one\u2019s own body (Plummer et.al, 2016). Additionally, continue to build trust and allow for opportunities to plant the seeds of knowledge.\u202f<\/span>
\nScreening aims to identify individuals with abnormalities suggestive of a specific cancer or pre-cancer who have not developed any symptoms and refer them promptly for diagnosis and treatment. Screening programms can be effective for select cancer types when appropriate tests are used, implemented effectively, linked to other steps in the screening process and when quality is assured. In general, a screening program is a far more complex public health intervention compared to early diagnosis.<\/span>\u00a0<\/span><\/p>\n

Examples of screening methods are:<\/span>
\nvisual inspection with acetic acid (VIA) for cervical cancer in low-income settings;<\/span>
\nHPV testing for cervical cancer;<\/span>
\nPAP cytology test for cervical cancer in middle- and high-income settings; and<\/span>
\nmammography screening for breast cancer in settings with strong or relatively strong health systems.<\/span>\u00a0<\/span><\/p>\n

\u202f<\/span>\u00a0<\/span>Plummer, M., Martel, C., Vignat, J., Ferlay, J., Bray, F., & Franceschi, S. (2016). Global burden of cancers attributable to infections in 2012: a synthetic analysis. Lancet Glob Health. 4(9):e609-16. doi: 10.1016\/S2214-109X(16)30143-7.<\/span>\u00a0<\/span><\/p>\n

World Health Organization (2018). Cancer. Retrieved from http:\/\/www.who.int\/news-room\/fact-sheets\/detail\/cancer on 07\/18\/2018<\/span>\u00a0<\/span><\/p>\n

I would like to add the validity, reliability, and its predictive value found in a peer-reviewed journal. The article analyzed the effectiveness of a Pap smear. In a retrospective study with 266 cases were performed.<\/span>\u00a0<\/span><\/p>\n

The overall sensitivity of Pap smear in cervical cytology in their study found to be as followed: sensitivity 74%, specificity 91%, positive predictive value 86%, negative predictive value 82.5%, false positive percentage 13%, false negative percentage 17.4% (Kudva, 2015). The article did mention possible errors that may have contributed to the under and over diagnosing of cervical cancer, such as sampling technique errors.<\/span>\u00a0<\/span><\/p>\n

Kudva, R. (2015). Accuracy of pap smear predictions: Cytohistologic correlation.\u202f<\/span>American Society for Clinical Pathology, 144<\/span><\/i>\u00a0<\/span><\/p>\n

Thank you for your follow-up! This information is exactly what I was looking for this week. As you are learning this week, sensitivity and specificity are both characteristics of a test. There is always a trade-off between the two. In other words, a test may be more sensitive, but less specific and vice versa. For example, a test that’s very sensitive will pick up even the slightest abnormal finding. This means it will miss few cases of the disease, but it will also mistake some people as having the disease when they don’t. Unlike PPV and NPV, the sensitivity and specificity of diagnostic tests are not affected by the prevalence of the disease\/condition.<\/span><\/p>\n

Instead, they can be influenced by differences in disease characteristics (such as clinical severity or anatomic extent of a disease) and characteristics of patients such as age. As you discuss, the accuracy of a Pap screen greatly depends on the technique and collection method, affecting the quality of the test. \u202fAlso, the threshold utilized creates varied results regarding sensitivity, and specificity. \u202f<\/span>\u00a0<\/span><\/p>\n

\u00a0Cancer screenings are an essential preventative measure to inform and continue educating communities.\u202f Internationally, an estimated 530,000 new cases of cervical cancer are diagnosed each year, which result in 275,000 deaths; more than 80% of all cases of CC occur in developing countries (March & Holle, 2017).\u202f<\/span>\u00a0<\/span><\/p>\n

Dr. Anttila, depending on the sensitivity of a screening exam it can very well result in false positives because of the dire sensitively the test possesses.\u202f Disease epidemiology can very well differ and look different in multiple individuals based of the pre-disposition of the individual; including what the individual has been exposed to.\u202f Referring to cervical cancer, this can incorporate if the individual has ever been affected by a sexually transmitted infection as well as heredity factors that may be prevalent.\u202f Early detection is key; though there may be certain cases of inaccuracy; pap smears have been reported to be 71%-81% when diagnosing abnormalities in patients.<\/span>\u00a0<\/span><\/p>\n