DOI: https://doi.org/10.14710/dmj.v15i2.53467

CERVICAL CANCER SCREENING OVERVIEW USING LIQUID-BASED CYTOLOGY (LBC) AND HUMAN PAPILLOMAVIRUS (HPV) DETECTION IN YOGYAKARTA

*Auliya Suluk Brilliant Sumpono orcid  -  Pathology Anatomy Department, Dr. Sardjito General Hospital, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Indonesia
Faizah Dwi Tirtasari orcid  -  Pathology Anatomy Department, Dr. Sardjito General Hospital, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Indonesia
Muhammad Ary Zucha orcid  -  Obsetric and Gynecology Department, Dr. Sardjito General Hospital, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Indonesia
Fitriya Ramadhani orcid  -  Histology and Biology Cell Department, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Indonesia
Ery Kus Dwianingsih orcid  -  Pathology Anatomy Department, Dr. Sardjito General Hospital, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Indonesia
Irianiwati Widodo orcid  -  Pathology Anatomy Department, Dr. Sardjito General Hospital, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Indonesia
Open Access Copyright 2026 Auliya Suluk Brilliant Sumpono, Faizah Dwi Tirtasari, Muhammad Ary Zucha, Fitriya Ramadhani, Ery Kus Dwianingsih, Irianiwati Widodo
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background: Screening of cervical cancer persists as a critical approach to persevere as a consequence of the gradually increasing cases and causing high mortality in women, including in Indonesia. The liquid-based cytology (LBC) and human papilloma virus (HPV) is a combination technique which promising and prosperous in detecting cervical cancer. Objective: The study aims to overview the cervical cancer screening results clinically using LBC and HPV testing in Yogyakarta. Methods: secondary data obtained from the medical records of 100 participants who participated in cervical cancer screening. The data collected included sociodemographic, clinical condition overview of the cervix, and results of LBC and HPV tests. Results: The sociodemographic data showed the housewives being a higher occupation percentage (59.8%), and the intrauterine devices (IUD) were the widely used types of contraception (42.3%). The screening was dominantly attended by young age (85.6%). The LBC result showed all of the participants had NILM types (100%), while the HPV results obtained five participants (5.2%) with positive results. In those positive results also discovered the bacterial vaginosis and reactive cellular changes associated with inflammation (p ≤ 0.05). Conclusion: This study concluded that the result of screening cervical cancer in Yogyakarta revealed normal cases in the NILM condition based on the LBC test result. However, the HPV test indicates sensitivity properties from the capability to detect HPV in asymptomatic participants. Thus, the LBC and HPV testing are very suitable and effective to use as a combination for cervical cancer screening strategy.

Fulltext View|Download
Keywords: Cervical cancer; HPV; LBC; NILM; screening
Funding: Dana Hibah Pengabdian Kepada Masyarakat 2023 under contract 4406/UN1/FKKMK.1.4/KAP/PKM/2023

Article Metrics:

Article Info
Section: Original Articles
Language : EN
Recent articles
THE EFFECT OF DELAY, STORING WHOLEBLOOD WITH K3EDTA AND NA2EDTA ANTICOAGULANTS ON EXAMINATION RESULTS OF ERYTHROCYTE COUNTS, HEMOGLOBIN LEVELS AND ERYTHROCYTE MORPHOLOGY CORRELATION BETWEEN FASTING BLOOD GLUCOSE LEVELS AND SERUM TRIGLYCERIDE AND HDL CHOLESTEROL LEVELS IN ELDERLY PATIENTS WITH TYPE 2 DIABETES MELLITUS PROFILE OF VISUAL FUNCTION AFTER PHACOEMULSIFICATION AT A SECONDARY HOSPITAL CHALLENGES IN PULMONARY TUBERCULOSIS MANAGEMENT IN A LIVER TRANSPLANT RECIPIENT WITH CROHN’S DISEASE: A CASE REPORT EXOGENOUS ENDOPHTHALMITIS WITH IMPENDING PERFORATION MANAGEMENT AND OUTCOME AT RURAL HOSPITAL: A CASE REPORT OF 28-YEARS OLD MALE WITH POST-TRAUMATIC ENDOPHTHALMITIS More recent articles
  1. Herrero R, Murillo R. Cervical Cancer. In: Thun MJ, Linet MS, Cerhan JR, Haiman C, Schottenfeld D. (Eds.). Cancer Epidemiology and Prevention. 4th ed. Oxford University Press; 2017. p. 925‐46
  2. Brisson M, Kim JJ, Canfell K, Drolet M, Gingras G, Burger EA, et al. Impact of HPV vaccination and cervical screening on cervical cancer elimination: a comparative modelling analysis in 78 low-income and lower-middle-income countries. Lancet 2020;395(10224):575–90. doi: 10.1016/S0140-6736(20)30068-4
  3. Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2024:74(3):229–63. doi: 10.3322/caac.21834
  4. Singh D, Vignat J, Lorenzoni V, Eslahi M, Ginsburg O, Lauby-Secretan B, et al. Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative. Lancet Glob Health 2023;11(2):197-206
  5. National Statistic Agency (BPS) [internet]. Indonesia's Human Development Index (HDI) in 2024 reached 75.02, an increase of 0.63 points or 0.85 percent compared to the previous year which was 74.39 [cited 2023 March 3]. Available from: https://www.bps.go.id/en/pressrelease/2024/11/15/2296/indonesias-human-development-index--hdi--in-2024-reached-75-02--an-increase-of-0-63-points-or-0-85-percent-compared-to-the-previous-year-which-was-74-39-.html
  6. GLOBOCAN [internet]. Cancer Today GLOBOCAN 2022, Indonesia [cited 2023 March 3]. Available from: https://gco.iarc.who.int/media/globocan/factsheets/populations/360-indonesia-fact-sheet.pdf
  7. ICO/IARC [internet]. Indonesia, Human Papillomavirus and Related Cancer, Fact Sheet 2023 [cited 2023 March 4]. Available from: https://hpvcentre.net/statistics/reports/IDN_FS.pdf
  8. Wahidin M, Febrianti R, Susanty F. Burden of cervical cancer in Indonesia: Findings from the global burden of disease study 1990-2017. Adv Health Sci Res 2020;22:213-17
  9. WHO [internet]. Indonesia cervical cancer profile [cited 2023 March 4]. Available from: https://www.who.int/publications/m/item/cervical-cancer-idn-country-profile-2021
  10. Vahedpoor Z, Behrashi M, Khamehchian T, Abedzadeh-Kalahroudi M, Moravveji A, Mohmadi-Kartalayi M. Comparison of the diagnostic value of the visual inspection with acetic acid (VIA) and Pap smear in cervical cancer screening. Taiwanese J Obstet Gynecol 2019;58(3):345–348. doi: 10.1016/j.tjog.2019.03.010
  11. Lohiya A, Daniel RA, Kumar D, Varghese C, Rath RS., SA Ridwan, Nongkynrih B. Effectiveness of Visual Inspection with Acetic Acid (VIA) Screening on cervical cancer mortality and incidence - a systematic review and meta-analysis. Asian Pac J Cancer Prev 2022;23(2):399–407. doi: 10.31557/APJCP.2022.23.2.399
  12. Rebolj M, Bonde J, Ejegod D, Preisler S, Rygaard C, Lynge E. A daunting challenge: Human Papillomavirus assays and cytology in primary cervical screening of women below age 30years. Eur J Cancer 2015;51(11): 1456–66. doi: 10.1016/j.ejca.2015.04.012
  13. Sangrajrang S, Laowahutanont P, Wongsena M, Muwonge R, Karalak A, Imsamran W, et al. Comparative accuracy of Pap smear and HPV screening in Ubon Ratchathani in Thailand. Papillomavirus Res 2017;3:30–5. doi: 10.1016/j.pvr.2016.12.004
  14. Fleider LA, de Los Ángeles Tinnirello M, Gómez Cherey F, García MG, Cardinal LH, García Kamermann F, et al. High sensitivity and specificity rates of COBAS® HPV test as a primary screening test for cervical intraepithelial lesions in a real-world setting. PloS one 2023;18(2):e0279728. doi: 10.1371/journal.pone.0279728
  15. Kitchener HC, Almonte M, Thomson C, Wheeler P, Sargent A, Stoykova B, et al. HPV testing in combination with liquid-based cytology in primary cervical screening (ARTISTIC): a randomised controlled trial. Lancet Oncol 2009;10(7):672–82. doi: 10.1016/S1470-2045(09)70156-1
  16. Andrijono A, Wulandari D, Widyahening IS, Mahardhika D, Nurainy N, Sari RM, et al. Diagnostic performance of urine-based HPV-DNA Test (CerviScan, Bio Farma) as cervical cancer screening tool in adult women. INAJOG 2023;11(3):1-5. doi: 10.32771/inajog.v11i3.1968
  17. Makde MM, Sathawane P. Liquid-based cytology: Technical aspects. CytoJournal 2022;19:41. doi: 10.25259/CMAS_03_16_2021
  18. Jug R, Bean SM [internet]. Bethesda system 2014 [cited 2023 March 10]. Available from https://www.pathologyoutlines.com/topic/cervixcytologybethesda.html
  19. Kabagenyi F, Otiti J, Namwagala J, Kamulegeya A, Kalungi S. A descriptive study of human papilloma virus in upper aero-digestive squamous cell carcinoma at Uganda cancer institute assessed by P16 immunohistochemistry. Head & Neck 2020;5:10. doi: 10.1186/s41199-020-00057-3
  20. Hussain E, Mahanta LB, Borah H, Das CR. Liquid based-cytology Pap smear dataset for automated multi-class diagnosis of pre-cancerous and cervical cancer lesions. Data Brief 2020;30:105589. doi: 10.1016/j.dib.2020.105589
  21. Peng RR, Li HM, Chang H, Li JH, Wang AL, Chen XS. Prevalence and genotype distribution of cervical human papillomavirus infection among female sex workers in Asia: a systematic literature review and meta-analysis. Sex Health 2012;9(2):113–19. doi: 10.1071/SH11066
  22. Dany F, Adam K, Handayani S, Wibowo HA, Dewi RM, Kipuw NL, et al. Revisiting HPV infection pattern among urban Indonesian women in general population and its implication on health burden: A cross-sectional analysis from Indonesian Noncommunicable Disease Research 2016. Asian Pac J Trop Med 2023;16(12):558-64. doi: 10.4103/1995-7645.391778
  23. Pan QJ, Hu SY, Guo HQ, Zhang WH, Zhang X, Chen W, et al. Liquid-based cytology and human papillomavirus testing: a pooled analysis using the data from 13 population-based cervical cancer screening studies from China. Gynecol Oncol 2014;133(2):172–79. doi: 10.1016/j.ygyno.2014.03.008
  24. Sangrajrang S, Laowahutanont P, Wongsena M, Muwonge R, Imsamran W, Ploysawang P, et al. (2019). Human papillomavirus (HPV) DNA and mRNA primary cervical cancer screening: Evaluation and triaging options for HPV-positive women. J Med Screen 2019;26(4):212–218. https://doi.org/10.1177/0969141319865922
  25. Wang J. (2019). Analysis of the application values of different combination schemes of liquid-based cytology and high-risk human papilloma virus test in the screening of high-grade cervical lesions. Brazi J Med Biol Res 2019;52(1):e7517. doi: 10.1590/1414-431X20187517
  26. Meites E, Gee J, Unger E, Markowitz L. Chapter 11: Human Papilloma Virus. Epidemiology and Prevention of Vaccine Preventable Diseases. 14th ed. Washington D.C.: Centers for Disease Control and Prevention; 2024
  27. Koshiol J, Lindsay L, Pimenta JM, Poole C, Jenkins D, Smith JS. (2008). Persistent human papillomavirus infection and cervical neoplasia: a systematic review and meta-analysis. Am J Epidemiol 2008;168(2):123–37. https://doi.org/10.1093/aje/kwn036
  28. Major AL, Dvořák V, Schwarzová J, Skřivánek A, Malík T, Pluta M, et al. Efficacy and safety of an adsorbent and anti-oxidative vaginal gel on CIN1 and 2, on high-risk HPV, and on p16/Ki-67: a randomized controlled trial. Arch Gynecol Obstet 2021;303(2):501–11. doi; 10.1007/s00404-020-05816-8
  29. Ismaeel A, Al-Shaikh S, Mubarak A, Ismaeel R. (2024). Atypical squamous cells of undetermined significance cervical cytology in Bahrain: Reporting rates, high-risk HPV testing, and cytologic and histopathologic follow-up findings. CytoJournal, 2024;21:11. doi: 10.25259/Cytojournal_84_2023
  30. Meghana BP, Renuka IV, Ramya C, Baddam DP, Kolla S. A study of liquid-based cytology in cervical smears. Trop J Pathol Microbiol 2020;6(3):238-44. doi: 10.17511/jopm.2020.i03.05
  31. Jain U, Gupta D, Jain A, Jain D. Detection of abnormal cervical cytology by LBC (Liquid Based Cytology). IJAR 2023;13(1):60-3. doi: 10.36106/ijar/4305373
  32. Afzal M, Sharma A, Tiwari V, Tiwari JK. (2024). A diagnostic study using STARD platform on liquid-based cytology in cervical smear and its positivity rate among females with abnormal vaginal conditions attending a tertiary care center. J Cytol 2024;41(4):207–13. doi: 10.4103/joc.joc_170_23
  33. Ghimire PG, Rawat DB, Sinha K, Jahan K, Shrestha R. (2019). Spectrum of cytological patterns in cervical PAP smears in a tertiary care center of Western region of Nepal. NJMS 2019;4(1):2–8. doi: 10.3126/njms.v4i1.24118
  34. Li W, Liu LL, Luo ZZ, Han CY, Wu QH, Zhang L, et al. Associations of sexually transmitted infections and bacterial vaginosis with abnormal cervical cytology: A cross-sectional survey with 9090 community women in China. PloS one 2020;15(3):e0230712. doi: 10.1371/journal.pone.0230712
  35. Nayak B, Patnaik P, Mohapatra M, Soren D, Patra P, Besra K, et al. Bacterial vaginosis and its association with human papilloma virus and increased risk of cervical intraepithelial lesions: An experience from Eastern India. Indian J Surg Oncol 2020;4(2):67-72. doi: 10.4103/oji.oji_9_19
  36. Martins BCT, Guimarães RA, Alves RRF, Saddi VA. Bacterial vaginosis and cervical human papillomavirus infection in young and adult women: a systematic review and meta-analysis. Revista Saude Publica 2023;56:113. doi: 10.11606/s1518-8787.2022056004412
  37. Suehiro TT, Malaguti N, Damke E, Uchimura NS, Gimenes F, Souza RP, et al. Association of human papillomavirus and bacterial vaginosis with increased risk of high-grade squamous intraepithelial cervical lesions. Int J Gynecol Cancer 2019;29(2):242–49. doi: 10.1136/ijgc-2018-000076
  38. Moitry M, Jégu J, Averous G, Velten M, Fender M, Akladios C, et al. (2017). Reporting reactive cellular changes on smears among women who undergo cervical cancer screening: results of a cohort study after seven years of follow-up. European journal of obstetrics, gynecology, and reproductive biology, 2017;216:232–238. doi: 10.1016/j.ejogrb.2017.07.032
  39. Ferenczy A. Benign Lesions of the Cervix. In: Blaustein, A. (eds) Pathology of the Female Genital Tract. NY: Springer; 1982
  40. Petre I, Sirbu DT, Petrita R, Toma AD, Peta E, Dimcevici-Poesina F. Real‑world study of Cerviron® vaginal ovules in the treatment of cervical lesions of various etiologies. Biomed Rep 2023;19(2):54. doi: 10.3892/br.2023.1618
  41. Banouei F, Tahamtan AG. Investigating the relationship between cervical erosion and ectropion in patients with polycystic ovary syndrome and the relationship with estrogen levels in compared to the control group, J Endocr Disord 2023;7(5). doi: 10.31579/2640-1045/143
  42. Marrazzo JM, Wiesenfeld HC, Murray PJ, Busse B, Meyn L, Krohn M, et al. Risk factors for cervicitis among women with bacterial vaginosis. J Infect Dis 2006;193(5):617–24. doi: 10.1086/500149
  43. Mirzaie-Kashani E, Bouzari M, Talebi A, Arbabzadeh-Zavareh F. Detection of human papillomavirus in chronic cervicitis, cervical adenocarcinoma, intraepithelial neoplasia and squamus cell carcinoma. Jundishapur J Microbiol 2014;7(5):e9930. doi: 10.5812/jjm.9930
  44. Oyardı P, Dağıstanlı F, Albayrak ME, Kayhan M, Ekici MA. (2023). HPV prevalence and risk of premalignant and malignant lesions in women with asymptomatic cervical erosion: A populatıon-based study. Abant Med J 2023;12(3):207-212. doi: 10.47493/abantmedj.1365241
  45. Nijkang NP, Anderson L, Markham R, Manconi F. Endometrial polyps: Pathogenesis, sequelae and treatment. SAGE Open Med 2019;7:2050312119848247. doi: 10.1177/2050312119848247
  46. Pegu B, Srinivas BH, Saranya TS, Murugesan R, Priyadarshini Thippeswamy S, Gaur BPS. (2020). Cervical polyp: evaluating the need of routine surgical intervention and its correlation with cervical smear cytology and endometrial pathology: a retrospective study. Obst Gynecol Sci 2020;63(6):735–42. doi: 10.5468/ogs.20177
  47. Gupta A, Pajai S, Reddy LS, Rathod S. Hysteroscopic removal of an intrauterine contraceptive device obstructed by polyps: A case study. Cureus 2025;17(1):e77990. doi: 10.7759/cureus.77990
  48. Oh H, Park SB, Park HJ, Lee ES, Hur J, Choi W, et al. Ultrasonographic features of uterine cervical lesions. Br J Radiol 2021;94(1121):20201242. doi: 10.1259/bjr.20201242

Last update:

No citation recorded.

Last update:

No citation recorded.