How can we strengthen pathology services in Cambodia?

Akaba, Hiroki; Fujita, Noriko; Stauch, G.; Matsumoto, Yasuyo; Wakasa, T.; Kawahara, Katsunobu; Sawabe, Motoji; Kawai, Toshiaki

doi:10.35772/ghm.2019.01023

Cited by 5 publications

(6 citation statements)

References 6 publications

(3 reference statements)

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“…Akaba et al reported that only three national hospitals provided pathological service and there were only 9 pathologists and 16 pathological technicians in 2018. 20 All pathologists worked for national hospitals and the national university in Phnom Penh, but they had dual work at private laboratories which provided pathological service. Doctors in provinces may order pathological examination at private laboratories when patients agree to pay the examination fee.…”

Section: Discussionmentioning

confidence: 99%

“…Some participants from provincial hospitals (59.5%), district hospitals (75.0%), and health centers (33.3%) answered that pathological examinations were available at their health facilities. Akaba et al reported that only three national hospitals provided pathological service and there were only 9 pathologists and 16 pathological technicians in 2018 20 . All pathologists worked for national hospitals and the national university in Phnom Penh, but they had dual work at private laboratories which provided pathological service.…”

Section: Discussionmentioning

confidence: 99%

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The current situation of health services for hydatidiform mole in Cambodia

Yamamoto

Kanal²,

Soeung³

et al. 2021

J of Obstet and Gynaecol

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Aim: Management of hydatidiform mole is important to reduce the mortality and morbidity of choriocarcinoma. This study aims to understand the existing health services for hydatidiform mole and to estimate the incidence of gestational trophoblastic disease (GTD) in Cambodia. Methods: A questionnaire was used to collect information on the existing health services for pregnancy and hydatidiform mole at health facilities from attendants of the 16th Annual Conference of the Cambodian Society of Gynecology and Obstetrics in 2017. The incidence of GTD in 2014-2017 was estimated using Health Information System data. Results: A total of 126 attendants, who were from all provinces except three provinces, answered the questionnaire. The work places were national hospitals (n = 29), provincial hospitals (n = 42), district hospitals (n = 20), health centers (n = 6), and others (n = 29). The answers of participants from the public sector suggested the following: Ultrasonography is available at all hospitals but not health centers; Human chorionic gonadotropin (hCG) measurement is only available at national hospitals; Treatment of hydatidiform mole is performed at national hospitals and provincial hospitals; and Treatment of gestational trophoblastic neoplasia (GTN) is provided at national hospitals. The incidence of hydatidiform mole and GTN at health facilities in the public sector in 2014-2017 was 0.95 per 1000 deliveries and 6.58 per 100 000 deliveries, respectively. Conclusions: The results suggest that provincial hospitals are important to detect suspected invasive mole and refer to national hospitals for diagnosis and treatment. Further studies on the management of GTD and development of the guidelines of GTD are needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The current situation of health services for hydatidiform mole in Cambodia

Yamamoto

Kanal²,

Soeung³

et al. 2021

J of Obstet and Gynaecol

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“…Stepby-step training was offered to technicians for quality slide preparation. Five pathology residents, enrolled in the national residency program that started in 2015 to increase the number of pathologists, were also trained for their capacity-building in diagnosis and quality management (17).…”

Section: Phase C (Pathology Service)mentioning

confidence: 99%

“…Under the initiative of the SCGO, a clinicopathological conference (CPC) was introduced to improve case management (17). In the beginning, pathologists and gynecologists tended to criticize each other on discrepancies between clinical and pathological diagnoses, but with close mentoring by Japanese physicians, a mutual learning environment was soon created.…”

Section: Phase C (Pathology Service)mentioning

confidence: 99%

The cooperation between professional societies contributes to the capacity building and system development for prevention and control of cancer in low- and middle-income countries: the practice of Cervical Cancer Prevention and Control Project in Cambodia

Kanal¹,

Fujita

Soeung³

et al. 2020

GHM

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Globally, an estimated 570,000 women are newly diagnosed with cervical cancer, and 311,000 women die every year, with approximately 90% of the cases occurring in low-and middle-income countries (LMICs). Cervical cancer is the most common cancer in women in Cambodia, with age-standard incidence rate of 13.5/100,000 and mortality rate of 10.1/100,000. This paper introduces the educational and managerial interventions of Cambodia Cervical Cancer Project 2015-2018 by two professional societies of Cambodia and Japan. It can be categorized into three phases: health education and screening; diagnosis and treatment of precancerous lesions; and pathology service. Human papillomavirus test-based cancer screening and treatment of precancerous lesions were successfully initiated. Key factors contributed to optimal outcomes are partnership between two professional societies with strong commitment, and a comprehensive and stepwise quality-focused approach. A complementary role and joint society initiatives is a novel approach and substantial in sustainability for developing a system of cervical cancer management. This effort might serve as a good example how professional societies can contribute to capacity building and system development for prevention and control of cancer in LMICs.

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“…There are a number of ways to improve the situation through multinational support such as lectures and hands-on assistance in the field. Regular telemedical consultations based on microphotographic images of tissue samples and cytological smears make a particularly important contribution [8,9]. However, experience at institutes in Germany shows that telemedical communication based on such images also requires some practice [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Artificial intelligence assisted diagnoses of fine-needle aspiration of breast diseases: a single-center experience

Fritz

Raoufi

Dalquen³

et al. 2023

JDH

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Purpose: Since 2010, physicians from Afghanistan have been uploading images of histological and cytological specimens to a telemedicine internet platform (iPath network) for expert evaluation. From this collective work, all cases with fine-needle aspirations (FNA) of mammary gland diseases were extracted and analyzed. The aim of the present retrospective feasibility study is to investigate the utility of artificial intelligence assisted diagnoses in fine-needle aspiration (FNA) of breast diseases.Material and Methods: A total of 3304 microphotographic images from 438 patients of smears from FNA of the mammary gland were available for this study. Telemedical expert diagnoses from 4 experienced cytopathologists were available in all 438 cases. Their diagnosis (malignant tumor of the mammary gland or benign mammary gland disease) was set as the gold standard. AI analysis was performed using i) clinical context data and ii) two different image recognition methods to determine the probability values for the presence of malignant breast tumor. Youden index and AUC (area under the curve) were used to evaluate test performance. Results: A score for invasive breast cancer (IBC) calculated from contextual variables agreed with the expert diagnosis (accuracy) in 85.2% and with the two image recognition systems in 78.4% and 65.2%. This simplifies health healthcare management of breast diseases in low income countries as in many patients the less expensive and less time-consuming technique of FNA may replace a histological examination.Conclusion: Image classification and analysis of context variables can be used to test the validity and plausibility of cytologic diagnoses, especially when cytologic interpretation has to be performed by people who are inexperienced in cytopathology.

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How can we strengthen pathology services in Cambodia?

Cited by 5 publications

References 6 publications

The current situation of health services for hydatidiform mole in Cambodia

The current situation of health services for hydatidiform mole in Cambodia

The cooperation between professional societies contributes to the capacity building and system development for prevention and control of cancer in low- and middle-income countries: the practice of Cervical Cancer Prevention and Control Project in Cambodia

Artificial intelligence assisted diagnoses of fine-needle aspiration of breast diseases: a single-center experience

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