{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:27:04Z","timestamp":1787776024561,"version":"build-2784847793"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Incidence of cervical cancer can be reduced using screening tests such as Pap smear to detect the premalignant stage of the disease. Although there has been a preference for more expensive human papillomavirus DNA testing due to its higher sensitivity, the Pap smear remains still very relevant in low-resource settings being cheaper and more readily available, hence the need to study factors influencing its performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The objective of this study was to determine if there is a difference in the diagnostic performance of Pap smear performed during the proliferative and secretory phases of a menstrual cycle, using colposcopy as the gold standard.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>It was a community\u2013based, comparative cross-sectional study conducted in Oghara, in Ethiope West Local Government Area, Delta State, Nigeria, over a 32-week period from January to July 2020. The participants had an integrated four-step procedure comprising Pap smear sample collection and colposcopy assessment performed during the proliferative and secretory phases of their menstrual cycle. Consenting participants who had an abnormal colposcopy finding during either phase of the cycle had cervical biopsy sampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There was no significant difference in the sensitivities (0.00 vs. 0.00), specificities (99.04 vs. 97.14,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.300), positive predictive values (0.00 vs. 0.00), negative predictive values (93.63 vs. 94.44,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.672) and accuracies (92.80 vs. 91.60,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.317) of Pap smears performed at proliferative and secretory phases of menstrual cycle.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Pap smear can be collected during either phase of a woman\u2019s menstrual cycle.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/npmj.npmj_296_24","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:00:35Z","timestamp":1747195235000},"page":"120-126","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["The Diagnostic Performance of Pap Smear during Both Phases of the Menstrual Cycle: A Community-based Study in Southern Nigeria"],"prefix":"10.4103","volume":"32","author":[{"given":"Akpome","family":"Akan","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Faculty of Clinical Medicine, College of Health Sciences, Delta State University, Abraka, Nigeria"},{"name":"Department of Obstetrics and Gynecology, Delta State University Teaching Hospital, Oghara, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Omo-Aghoja","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Faculty of Clinical Medicine, College of Health Sciences, Delta State University, Abraka, Nigeria"},{"name":"Department of Obstetrics and Gynecology, Delta State University Teaching Hospital, Oghara, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayotunde","family":"Adeyinka","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Delta State University Teaching Hospital, Oghara, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"R2-20260423","doi-asserted-by":"crossref","first-page":"839835.","DOI":"10.3389\/fpubh.2022.839835","article-title":"Mapping cancer in Africa: A comprehensive and comparable characterization of 34 cancer types using estimates from GLOBOCAN 2020","volume":"10","author":"Sharma","year":"2022","journal-title":"Front Public Health"},{"key":"R4-20260423","first-page":"10","article-title":"Global burden of cervical cancer: A literature review","volume":"4","author":"Manaf","year":"2017","journal-title":"Int J Public Health Clin Sci"},{"key":"R5-20260423","doi-asserted-by":"crossref","first-page":"744","DOI":"10.5306\/wjco.v5.i4.744","article-title":"Update on prevention and screening of cervical cancer","volume":"5","author":"McGraw","year":"2014","journal-title":"World J Clin Oncol"},{"key":"R6-20260423","doi-asserted-by":"crossref","first-page":"2302.","DOI":"10.1001\/jama.2014.16296","article-title":"JAMA patient page. Screening for cervical cancer","volume":"312","author":"Jin","year":"2014","journal-title":"JAMA"},{"key":"R7-20260423","article-title":"Progress in Cervical Screening in the UK","year":"2016","journal-title":"Scientific Impact Paper No. 7"},{"issue":"Suppl 2","key":"R8-20260423","first-page":"S4","article-title":"A critical assessment of screening methods for cervical neoplasia","volume":"89","author":"Sankaranarayanan","year":"2005","journal-title":"Int J Gynaecol Obstet"},{"key":"R9-20260423","first-page":"115","article-title":"Screening for cervical cancer: An overview","volume":"56","author":"Kerkar","year":"2006","journal-title":"J Obstet Gynecol India"},{"key":"R10-20260423","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1093\/annonc\/mdp471","article-title":"European guidelines for quality assurance in cervical cancer screening. Second edition \u2013 Summary document","volume":"21","author":"Arbyn","year":"2010","journal-title":"Ann Oncol"},{"key":"R11-20260423","first-page":"1","article-title":"Review article screening and diagnostic modalities in carcinoma cervix: A pathologist\u2019s perspective","volume":"1","author":"Mohan","year":"2014","journal-title":"Ann Pathol Lab Med"},{"key":"R12-20260423","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1196\/annals.1429.018","article-title":"The menstrual cycle: Basic biology","volume":"1135","author":"Hawkins","year":"2008","journal-title":"Ann N Y Acad Sci"},{"key":"R14-20260423","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1093\/ajcn\/28.4.333","article-title":"Physiology of the menstrual cycle","volume":"28","author":"Owen","year":"1975","journal-title":"Am J Clin Nutr"},{"key":"R15-20260423","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/S0015-0282(16)36068-X","article-title":"Cyclic changes of cervical mucus in normal and progestin-treated women","volume":"17","author":"Moghissi","year":"1966","journal-title":"Fertil Steril"},{"key":"R16-20260423","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.1038\/sj.bjc.6603151","article-title":"Performance of cytology and human papillomavirus testing in relation to the menstrual cycle","volume":"94","author":"Sherman","year":"2006","journal-title":"Br J Cancer"},{"key":"R17-20260423","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1111\/j.1365-2303.2006.00380.x","article-title":"The cervical smear test: Does timing have an effect on sample adequacy?","volume":"17","author":"Davies","year":"2006","journal-title":"Cytopathology"},{"key":"R18-20260423","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/S1701-2163(16)34958-1","article-title":"Predictors of an unsatisfactory conventional cervical cytology smear","volume":"33","author":"Paulin","year":"2011","journal-title":"J Obstet Gynaecol Can"},{"key":"R19-20260423","first-page":"417","article-title":"Cellular composition of cervical smears in relation to the day of the menstrual cycle and the method of contraception","volume":"31","author":"Vooijs","year":"1987","journal-title":"Acta Cytol"},{"key":"R20-20260423","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.jbi.2014.02.013","article-title":"Sample size estimation in diagnostic test studies of biomedical informatics","volume":"48","author":"Hajian-Tilaki","year":"2014","journal-title":"J Biomed Inform"},{"key":"R21-20260423","first-page":"1","article-title":"Comparison of the accuracy of papanicolaou test cytology, visual inspection with acetic acid, and visual inspection with lugol iodine in screening for cervical neoplasia in Southeast Nigeria","volume":"4","author":"Egede","year":"2018","journal-title":"J Glob Oncol"},{"key":"R23-20260423","doi-asserted-by":"crossref","first-page":"159","DOI":"10.4103\/0970-9371.117654","article-title":"Plastic spatula with narrow long tip provides higher satisfactory smears for Pap test","volume":"30","author":"Kaur","year":"2013","journal-title":"J Cytol"},{"key":"R25-20260423","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1002\/cncy.21521","article-title":"The Pap test and Bethesda 2014","volume":"123","author":"Nayar","year":"2015","journal-title":"Cancer Cytopathol"},{"key":"R26-20260423","first-page":"205","article-title":"The importance of socioeconomic class in voluntary fertility control in a developing country","volume":"4","author":"Olusanya","year":"1985","journal-title":"West Afr J Med"},{"key":"R27-20260423","doi-asserted-by":"crossref","first-page":"16","DOI":"10.9790\/0853-0511619","article-title":"Cervical cancer screening in Benin City, South-South Nigeria","volume":"5","author":"Obaseki","year":"2013","journal-title":"IOSR J Dent Med Sci"},{"key":"R28-20260423","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1080\/01443610802259977","article-title":"Correlation of cervical cytology and visual inspection with acetic acid in HIV-positive women","volume":"28","author":"Akinwuntan","year":"2008","journal-title":"J Obstet Gynaecol"},{"key":"R29-20260423","doi-asserted-by":"crossref","first-page":"161","DOI":"10.4103\/0971-5851.103143","article-title":"Comparative study of effectiveness of Pap smear versus visual inspection with acetic acid and visual inspection with Lugol\u2019s iodine for mass screening of premalignant and malignant lesion of cervix","volume":"33","author":"Consul","year":"2012","journal-title":"Indian J Med Paediatr Oncol"},{"key":"R30-20260423","doi-asserted-by":"crossref","first-page":"99.","DOI":"10.1007\/s40944-020-00447-y","article-title":"A comprarison of the visual based cervical cancer screening tests with Pap smear in a North Indian tertiary centre: A prospective randomised observational study","volume":"18","author":"Yadav","year":"2020","journal-title":"Indian J Gyneoncol"},{"key":"R31-20260423","first-page":"203","article-title":"Measures of diagnostic accuracy: Basic definitions","volume":"19","author":"\u0160imundi\u0107","year":"2009","journal-title":"EJIFCC"},{"key":"R32-20260423","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1097\/JTO.0b013e3181dab122","article-title":"Simple statistical measures for diagnostic accuracy assessment","volume":"5","author":"Mandrekar","year":"2010","journal-title":"J Thorac Oncol"},{"key":"R33-20260423","doi-asserted-by":"crossref","first-page":"45","DOI":"10.4103\/0301-4738.37595","article-title":"Understanding and using sensitivity, specificity and predictive values","volume":"56","author":"Parikh","year":"2008","journal-title":"Indian J Ophthalmol"},{"key":"R34-20260423","doi-asserted-by":"crossref","first-page":"307.","DOI":"10.3389\/fpubh.2017.00307","article-title":"Sensitivity, specificity, and predictive values: Foundations, pliabilities, and pitfalls in research and practice","volume":"5","author":"Trevethan","year":"2017","journal-title":"Front Public Health"},{"key":"R35-20260423","doi-asserted-by":"crossref","first-page":"1508.","DOI":"10.3390\/diagnostics12061508","article-title":"False negative results in cervical cancer screening-risks, reasons and implications for clinical practice and public health","volume":"12","author":"Macios","year":"2022","journal-title":"Diagnostics (Basel)"},{"key":"R36-20260423","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1002\/cncy.22624","article-title":"Inter- and intraobserver agreement in whole-slide digital ThinPrep samples of low-grade squamous lesions of the cervix uteri with known high-risk HPV status: A multicentric international study","volume":"130","author":"Kholov\u00e1","year":"2022","journal-title":"Cancer Cytopathol"}],"container-title":["Nigerian Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/npmj.npmj_296_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:47:05Z","timestamp":1787773625000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/npmj.npmj_296_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/npmj.npmj_296_24","relation":{},"ISSN":["1117-1936","2468-6875"],"issn-type":[{"value":"1117-1936","type":"print"},{"value":"2468-6875","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2024-12-02","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-07","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}