Publications by authors named "Vassilakos P"

Article Synopsis
  • - The WHO recommends HPV testing for cervical cancer screening due to its high sensitivity, but further triage is needed to identify women with high-grade lesions (CIN2+) who need treatment.
  • - The ANRS-12375 study evaluated various triage methods like visual inspection (VIA) and different genotyping options in Côte d'Ivoire, Burkina Faso, and Cambodia to detect CIN2+ lesions among women living with HIV.
  • - Results showed that VIA and extended genotyping had high sensitivity (89%), with VIA also exhibiting the best specificity among the tests, making them effective options for identifying women who require treatment for CIN2+.
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Objective: To assess the impact of thermal ablation (TA) for the treatment of cervical dysplasia on fertility and pregnancy outcomes among women screened for cervical cancer in Cameroon.

Design: Retrospective cohort study.

Setting: Dschang health district, Cameroon.

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Article Synopsis
  • The objective of the study was to find out if understanding cytology improves colposcopists' accuracy in diagnosing cervical intraepithelial neoplasia grade 2 and worse (≥ CIN2).
  • Healthcare professionals evaluated colposcopy images from 80 patient cases in two surveys, one with cytology information and one without, to see how it affected their diagnostic decisions.
  • Results showed that knowing cytology significantly increased sensitivity to 63.7% and specificity to 76.6%, indicating that better cytology information leads to more accurate diagnoses of ≥ CIN2 lesions.
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Background: Screening participation at recommended intervals is a crucial component of cervical cancer prevention effectiveness. However, little is known regarding the rate of re-screening in a Sub-Saharan context. This study aimed to estimate the re-screening rate of women in a semi-rural after an initial HPV-based screening and identify factors that influence adherence.

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Screening Papanicolaou test samples has proven to be highly effective in reducing cervical cancer-related mortality. However, the lack of trained cytopathologists hinders its widespread implementation in low-resource settings. Deep learning-assisted telecytology diagnosis emerges as an appealing alternative, but it requires the collection of large annotated training datasets, which is costly and time-consuming.

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Introduction: Cytology is an option for triaging human papillomavirus (HPV)-positive women. The interpretation of cytologic slides requires expertise and financial resources that are not always available in resource-limited settings. A solution could be offered by manual preparation and digitization of slides on site for real-time remote cytologic diagnosis by specialists.

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Visual inspection with acetic acid (VIA) is one of the methods recommended by the World Health Organization for cervical cancer screening. VIA is simple and low-cost; it, however, presents high subjectivity. We conducted a systematic literature search in PubMed, Google Scholar and Scopus to identify automated algorithms for classifying images taken during VIA as negative (healthy/benign) or precancerous/cancerous.

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Purpose: Thermal ablation (TA) has become the conventional method for treatment of precancerous cervical lesions in low-resource settings. After TA, both the squamocolumnar junction (SCJ) and the transformation zone (TZ) may be subject to change. Our aim was to evaluate SCJ and TZ variability after TA.

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Background: In low-resource countries, interpretation of the transformation zone (TZ) using the classification of the International Federation for Cervical Pathology and Colposcopy (IFCPC), adopted by the World Health Organization, is critical for determining if visual inspection with acetic acid (VIA) screening and thermal ablation treatment are possible. We aim to assess inter- and intra-observer agreement in TZ interpretation.

Methods: We performed a prospective multi-observer reliability study.

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Objective: To explore the utility of extended Human Papillomavirus (HPV) genotyping to detect cervical intraepithelial neoplasia grade 2 or more (CIN2+) in a 'screen-and-treat' strategy for HPV-positive women in low-resource settings.

Design: Prospective study of diagnostic accuracy.

Setting: The study took place in West Cameroon between September 2018 and March 2020.

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Article Synopsis
  • HPV testing is becoming the preferred method for cervical cancer screening, potentially replacing traditional cytological methods.
  • A study assessed the effectiveness and outcomes of various cervical screening strategies for unscreened women aged 25 and over.
  • Results showed that self-collected HPV testing (Self-HPV) every 5 years led to lower cancer incidence and mortality, with fewer lifetime visits compared to cytological methods, suggesting it may offer a good balance of benefits and harms.
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Background: Cervical cancer is a major public health issue among women in Cameroon and uptake of screening programs remains a challenge in many low- and middle-income countries. Community healthcare workers can play an important role in promoting cervical cancer services. This study aimed to explore factors affecting the motivation of community healthcare workers in a cervical cancer screening program in Dschang, Cameroon.

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Background: World Health Organization guidelines for cervical cancer screening recommend HPV testing followed by visual inspection with acetic acid (VIA) for triage if HPV positive. In order to improve visual assessment and identification of cervical intraepithelial neoplasia grade 2 and worse (CIN2+), providers may use visual aids such as digital cameras.

Objectives: To determine whether combined examination by naked-eye and digital VIA (D-VIA) and VILI (D-VILI) improves detection of CIN2+ as compared to the conventional evaluation.

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Background: Developing human resource capacity and efficient deployment of skilled personnel are essential for cervical cancer screening program implementation in resource-limited countries. Our aim was to provide a context-specific training framework, supervision, and effectiveness evaluation of health care providers in a cervical cancer screening program.

Methods: A 5-year cervical cancer screening program was implemented in Dschang, West Cameroon.

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Objectives: A simple system for visual inspection with acetic acid assessment, named ABCD criteria, has been developed to increase accuracy for triaging of high-risk human papillomavirus (HPV)-positive women. This study aimed to determine the accuracy of ABCD criteria for the detection of histologically confirmed cervical intraepithelial neoplasia grade two or worse (CIN2+) in HPV-positive women living in a low-resource setting.

Design: Prospective study of diagnostic accuracy.

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Objectives: The World Health Organization's (WHO) global strategy for cervical cancer elimination has set the target of 70% of women screened in all countries by 2030. Community sensitization through media is often used, but community health workers' (CHW) involvement may contribute to improving screening coverage. We aimed to assess effectiveness and costs of two cervical cancer screening recruitment strategies conducted in a low-resource setting.

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Visual inspection with acetic acid (VIA) is recommended by the World Health Organization for primary cervical cancer screening or triage of human papillomavirus-positive women living in low-resource settings. Nonetheless, traditional VIA with the naked-eye is associated with large variabilities in the detection of pre-cancer and with a lack of quality control. Digital-VIA (D-VIA), using high definition cameras, allows magnification and zooming on transformation zones and suspicious cervical regions, as well as simultaneously compare native and post-VIA images in real-time.

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Background: The World Health Organization recommends thermal ablation as an alternative to cryotherapy to treat women with precancerous lesions in low-resource settings. However, limited data are available on women's experience and adverse events (AEs) of the procedure in the context of Sub-Saharan Africa. The objective of this study was to evaluate the acceptability and safety of thermal ablation in women screened positive for precancerous cervical lesions.

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Human papillomavirus (HPV) self-sampling (Self-HPV) is a promising strategy to improve cervical cancer screening coverage in low-income countries. However, issues associated with women who prefer conventional HPV clinical-sampling over HPV self-sampling may affect screening participation. To address this issue, our study assessed factors associated with women's preferences related to Self-HPV.

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Current follow-up strategy for women after large loop excision of the transformation zone (LLETZ) for cervical intra-epithelial neoplasia (CIN) is burdened by a low compliance. We evaluated the performance of home-based Human Papillomavirus (HPV) self-sampling (Self-HPV) after treatment for CIN with the aim to assess the (i) feasibility and (ii) follow-up compliance. This study took place at the Geneva University Hospitals between May 2016 and September 2020.

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Introduction: Cervical cancer remains a major public health challenge in low- and middle-income countries (LMICs) due to financial and logistical issues. WHO recommendation for cervical cancer screening in LMICs includes HPV testing as primary screening followed by visual inspection with acetic acid (VIA) and treatment. However, VIA is a subjective procedure dependent on the healthcare provider's experience.

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Background: Cervical cancer is the second leading cause of cancer-related death among women in sub-Saharan countries, constituting a major public health concern. In Cameroon, cervical cancer ranks as the second most common type of cancer among women and the leading cause of cancer-related deaths, mainly due to the lack of prevention.

Objectives: Our first and main objective was to understand the barriers affecting women's decision-making process regarding participation in a cervical cancer screening program in the Dschang district (West Cameroon).

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Objective: Cervical cancer in Cameroon ranks as the second most frequent cancer among women and the leading cause of cancer-related deaths, mainly due to the lack of prevention. Our principal objective was to explore potential barriers to an human papillomavirus (HPV)-based cervical cancer screening from a healthcare provider (HCP) perspective in a low-income context. Second, we aimed to explore the acceptability of a single-visit approach using HPV self-sampling.

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