Comparisons of Papanicolaou Utilization and Cervical Cancer Detection between Rural and Urban Women in Taiwan.

Using the claims data of one million insured residents in Taiwan from 1996-2013, this study identified 12,126 women in an urban city (Taichung) and 7229 women in a rural county (Yunlin), aged 20 and above. We compared Papanicolaou (Pap) test uses and cervical cancer detection rates between urban and rural women. Results showed that the Pap screening rate was slightly higher in rural women than in urban women (86.1 vs. 81.3 percent). The cervical cancer incidence was much greater for women without Pap test than women with the test (35.8 vs. 9.00 per 1000 in rural women and 20.3 vs. 7.00 per 1000 in urban women). Nested case-control analysis showed that Pap test receivers had an adjusted odds ratio (OR) of 0.35 (95% CI = 0.25-0.51) to be diagnosed with cervical cancer as compared to those who did not receive the test. The rural women had an adjusted OR of 1.46 (95% CI = 1.03-2.06) to be diagnosed with cervical cancer as compared to urban women. In conclusion, women in rural area are at higher cancer risk than city women. Women who do not undergo Pap tests deserve timely intervention of Pap test to prevent the onset of cancer, particularly in rural women with low income.

Comparison of labor induction with titrated oral misoprostol solution between nulliparous and multiparous women.

AIM: To compare the outcomes of labor induction with oral misoprostol solution between nulliparous and multiparous women. METHODS: We retrospectively reviewed the medical records of all patients between 37 and 42 weeks of gestation with a Bishop score

Hourly oral misoprostol administration for terminating midtrimester pregnancies: a pilot study.

OBJECTIVE: This pilot study retrospectively evaluated the outcomes of medical induction of termination of midtrimester pregnancies with hourly oral misoprostol administration. MATERIALS AND METHODS: Sixteen women with living fetuses, who had undergone pregnancy termination at 12-25 weeks of gestational age, were reviewed. The method of induction was hourly oral administration of misoprostol, given at doses of 200 µg/hr for the first 12 hours and 400 µg/hr after 12 hours until delivery. Data including the induction-to-delivery interval and total dosage of misoprostol were recorded and analyzed. RESULTS: All 16 women successfully underwent vaginal termination within 36 hours. The median induction-to-delivery interval was 12.0 hours (range, 6.3-30.9 hours), with 13 women (81.3%) undergoing vaginal delivery within 24 hours. The median total dosage of misoprostol was 2,600 µg. The most common side effect was diarrhea, which was easily relieved by medication. CONCLUSION: Our preliminary results show that oral administration of misoprostol at hourly intervals is a promising method for terminating midtrimester pregnancies.