For the intervention group receiving the modified Pap test, instead of immediately removing the speculum just after rotating back the speculum, an operator still fixes the speculum in the vagina for 15 seconds.

Modified Pap test

Chu-Chun Huang, MD, PhD

Chi-Huan Tsai, MD

Ying-Cheng Chiang, MD, PhD

Chien-Hsieh Chiang, MD, MPH, PhD

Shao-Yi Cheng, MD, MSc, DrPH

Yi-Hsuan Lee, MD, MPH

Ih-Jane Yang, MD

Yi-Hua Lee, RN

Ching-Ming Chiu, MD

Jiun-Yi Sheen, MD

Each patient will participate in both arms of the study on the day of the clinical examination. This arm includes the self-administered Papanicolaou (Pap) smear. They will be compared to each other for congruence and accuracy.

A single cohort of 250 patients will be recruited from among those who need a Papanicolaou (Pap) smear for routine cervical cancer screening, to perform a self-administered Pap smear immediately prior to the traditional Pap smear. Blinded assessment of both tests will be then conducted.

Self-PAP

Each patient will participate in both arms of the study on the day of the clinical examination. This arm includes the traditional, healthcare provider obtained Papanicolaou (Pap) smear specimen. They will be compared to each other for congruence and accuracy.

Traditional Pap smear

Kelsey Price, RN

John B Waits, MD

Claire Ahalt

John Waits, MD

Nikki Savage, CRNP

Intervention: Penfluridol, an oral antipsychotic drug, is used as monotherapy. It targets DRD2, inhibits glycolysis, and induces apoptosis.

Dosing Schedule:

Phase Ib: 3+3 dose-escalation design. Initial dose 20 mg weekly, escalating to 40 mg, then 60 mg until recommended Phase II dose (RP2D) is determined based on 21-day DLT assessment.

Phase II: Expansion cohort at RP2D to further evaluate safety and estimate ORR. Duration: Treatment continues until progression, unacceptable toxicity, withdrawal, or investigator decision.

Monitoring: Regular AE/SAE monitoring using NCI-CTCAE v5.0. Assessments include weekly vital signs, biweekly blood tests, and ECGs every 2 weeks. Tumor response evaluated by RECIST 1.1 criteria with imaging every 2-3 cycles.

Dose Modification: Adjustments made for EPS, QTc prolongation, and proteinuria. Rationale for Single-Arm Design: Chosen due to the ultra-rare patient population and lack of established comparators. Efficient for determining RP2D and ORR.

Penfluridol Monotherapy for Relapsed/Refractory Small-Cell Lung or Cervical Cancer

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

Bai Hu, MD.

Peng Wu, PhD

The intervention group will likely consist of one to two sessions, conducted in-person, coupled with text- or phone-based client navigation.The intervention group will complete three major assessments: baseline (T1), at the conclusion of the intervention (T2), and a three-month follow-up (T3). Until the follow-up assessment, the interventionist will send participants up to 6 SMS messages (one-way) per month. The content of these messages will be developed collaboratively between the participant and the interventionist during the second session; messages could include reminders about follow-ups and/or prompts to use new skills and resources for navigating specific barriers.

Aim 1 data will inform this intervention, however the participant intervention will likely be one or two sessions, conducted in-person, coupled with text- or phone-based client navigation with women who received abnormal high-risk Pap smear results. We anticipate that the intervention may integrate (1) information to improve awareness of cervical cancer susceptibility and treatment, (2) motivational interviewing to assess pros and cons of attending a follow-up appointment and completing treatment; (3) brief cognitive behavioral therapy (CBT) skills to reduce individual-level barriers, (4) problem-solving to increase social support, and (5) patient navigation tools to mitigate clinic-level challenges.

Retention in cervical cancer care intervention

The treatment as usual (TAU) group will receive treatment as usual, including being notified of their abnormal Pap results via SMS and instructed to set up a follow-up appointment, as is typical in routine care. The TAU group will complete the T1 assessment and will complete T2 assessment two-months post-baseline.

Jennifer Smit, PhD

Christina Psaros, PhD

Courtney Yuen, PhD

The study staff will administer to eligible participants the pre-INT and post-INT surveys. The post-INT surveys will be administered approximately 8 months after delivering the INTs. The participants will receive the INT(s) immediately after completing the pre-INT surveys.

Adult men and women will receive age- and gender-specific INTs. Women age 45-75 years will receive the interventions for breast, colorectal, and cervical cancers screening. Men age 45-75 years will receive the intervention for colorectal cancer screening. Women age 21-49 years will receive the intervention for cervical cancer screening. The cognitive-behavioral INTs on age-gender specific cancers will range from 1-2 hours. The study team will utilize a digital flipchart that will cover each cancer's specific risk/protective factors, incidence, mortality, screening methods, and resources. The study team member delivering the INTs will function as a facilitator linking information with practical skills.

Aim 8 (INT, Pilot Test): Breast, Colorectal, and Cervical Cancer Screening Cognitive-Behavioral Interventions

Randomization will allocate women to intervention and control arm in 1:1 ratio; with 6 wards in each group. The intervention arm will consist of 153 women who will receive "Cervical Cancer Stigma Reduction Intervention".

Change in knowledge:

Cervical cancer burden in Nepal, signs and symptoms, preventive measures available, lifestyle modifications, HPV vaccination, early diagnosis, screening, and treatment.

Change in Stigma

1. Para-social contact

   * Video of a person facing cervical cancer what symptoms she got, how she dealt with it, and how she overcame it.
   * Experiences of a cervical cancer survivor so that women personalize the information by relating it to their own life experiences by changing their attitude and behavior.
2. Participatory learning techniques

   * Personal stories: Voluntary self-reflection of any stigma they perceive on cervical cancer or their community perceives cervical cancer.
   * Group Discussion: Discuss the drivers of stigma, facilitators of sigma, types of stigma prevalent in your community, and consequences of stigma.
3. Myths vs facts: Negative attitudes, myths, and misconceptions about cervical cancer will be contraindicated by factual information.

"Cervical Cancer Stigma Reduction Intervention"

The control arm will consist of 153 women who would not be given any intervention.

Kathmandu University School of Medical Sciences

The study population will be women aged 30-60 years which is the recommended age group by National Guideline for Cervical Cancer Screening and Prevention in Nepal

Women will receive an awareness letter explaining the importance of cervical cancer screening, the Swiss recommendations and an invitation to schedule an appointment.

Sensitization to Cervical Cancer (CC) screening

Women will receive a free-of-charge vaginal self-sampling kit for HPV infection.

Home-based HPV self-sampling

Patrick Petignat, MD

Women aged 50 to 65 years with no cervical smear or no gynecological examination for more than three years, attending the mobile unit for breast cancer screening in the Department of Hérault, or the Medical and Social Care Center in the Department of Aude.

* Direct offer of a vaginal self-sampling kit with information to perform at home and send back to the laboratory for HR-HPV testing
* The psychosocial determinants involved in decision-making process and compliance to cervical cancer screening will be collected from open questionnaires and by semi-directive phone interviews
* Control ; Receive reminder to send the self-sample to the laboratory : After 3 and 6 months without "return", women receive a remind letter to send the vaginal self-sample to the laboratory. We call "return" the receipt of the vaginal self-sample at the laboratory.
* Control ; Receive reminder to perform cervical smear in case of positive HR-HPV test : In case of a positive HR-HPV test, women are asked to perform a control cervical smear. After 3, 6 months and 12 months without "return", women and their health-care professional will receive a remind letter or a call to perform a cervical smear for control. We call "return" the performance of a pap smear.

Proximity-incentive strategy based on vaginal self-sampling for women 50 to 65 years who do not participate to cervical cancer screening

Participants will be provided the opportunity to self- sample for HPV during their ED visit. Participants will be (1) briefly instructed by study staff on how to self-sample using a defined instructional script written at an elementary reading level, (2) provided with a packaged swab, and (3) invited to self- sample privately in their ED room or in one of the private ED restrooms. Once self sampling has been completed, the study staff will then transfer the swab to a vial of transport media and forward the specimens to the laboratory for analysis. Participants recruited to the intervention arm that subsequently decline to or are unable to self-sample in the ED will remain in the study and will receive referral for clinic-based screening.

Subjects will perform self sampling for cervical cancer.

Cervical Cancer Screening

Beau Abar, PHD MS

Peter MacDowell

Women enrolled in this study will receive HPV testing for cervical cancer screening. They will be offered self-sampling. And also they will be offered voluntary Family Planning services, as appropriate.

HPV testing of women for cervical cancer screening

6 weekly group sessions of advocacy training for cervical cancer screening

The peer advocacy training sessions focus on reduction of internalized stigma, disclosure decision making, education on cervical cancer facts and myths, and building skills for cervical cancer prevention advocacy.

Game Changers for Cervical Cancer Prevention

usual care (no intervention); control participants will be offered the chance to receive the intervention at the conclusion of month 12 follow-up data collection

Participants will attend the workshops in a mosque or community centre.

The intervention includes a two-hour workshop, delivered in-person, that aims to improve the uptake of cancer screening among Muslim women.

The workshop consists of four parts:

* A peer-led discussion on barriers and facilitators to breast, cervical and colorectal cancer screening
* A health information session led by a health professional
* Videos of Muslim women talking about their experiences with cancer screening
* A religious perspective on cancer screening led by a female religious scholar

In-person peer-led faith-based intervention to encourage breast, bowel, and cervical screening uptake among Muslim women

Participants will join the workshops via a web conferencing platform The content of the online workshops is identical to the content of in-person workshops.

The intervention includes a two-hour workshop, delivered online, that aims to improve the uptake of cancer screening among Muslim women.

The workshop consists of four parts:

* A peer-led discussion on barriers and facilitators to breast, cervical and colorectal cancer screening
* A health information session led by a health professional
* Videos of Muslim women talking about their experiences with cancer screening
* A religious perspective on cancer screening led by a female religious scholar

변형된 자궁경부암 검사

자가 자궁경부암 검사, 전통적인 자궁경부 세포진 검사

재발/난치성 소세포 폐암 또는 자궁경부암에 대한 펜플루리돌 단독 요법

자궁경부암 치료 개입에서의 유지

목표 8(INT, 파일럿 테스트): 유방암, 대장암, 자궁경부암 검진을 위한 인지행동적 개입

"자궁경부암에 대한 사회적 낙인 감소 개입 프로그램"

자궁경부암 검진에 대한 인식 제고 및 가정용 HPV 자가 채취

자궁경부암 검진에 참여하지 않는 50~65세 여성을 대상으로 질 자가 채취를 기반으로 한 근접성 인센티브 전략

자궁경부암 검진

자궁경부암 검진을 위한 여성 대상 HPV 검사

자궁경부암 예방을 위한 획기적인 변화