Cervical cancer classification from Pap-smears using an enhanced fuzzy C-means algorithm

Wasswa William*, Andrew Ware, Annabella Habinka Basaza-Ejiri, Johnes Obungoloch

*Corresponding author for this work

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Globally, cervical cancer ranks as the fourth most prevalent cancer affecting women. However, it can be successfully treated if detected at an early stage. The Pap smear is a good tool for initial screening of cervical cancer, but there is the possibility of error due to human mistake. Moreover, the process is tedious and time-consuming. The objective of this study was to mitigate the risk of mistake by automating the process of cervical cancer classification from Pap smear images. In this research, contrast local adaptive histogram equalization was used for image enhancement. Cell segmentation was achieved through a Trainable Weka Segmentation classifier, and a sequential elimination approach was used for debris rejection. Feature selection was achieved using simulated annealing integrated with a wrapper filter, while classification was achieved using a fuzzy c-means algorithm. The evaluation of the classifier was carried out on three different datasets (single cell images, multiple cell images and Pap smear slide images from a pathology unit). An overall classification accuracy, sensitivity and specificity of ‘98.88%, 99.28% and 97.47%‘, ‘97.64%, 98.08% and 97.16%’ and ‘96.80%, 98.40% and 95.20%’ were obtained for each dataset respectively. The higher accuracy and sensitivity of the classifier was attributed to the robustness of the feature selection method that was utilized to select cell features that would improve the classification performance, and the number of clusters used during defuzzification and classification. The evaluation and testing conducted confirmed the rationale of the approach taken, which is based on the premise that the selection of salient features embeds sufficient discriminatory information that leads to an increase in the accuracy of cervical cancer classification. Results show that the method outperforms many of the existing algorithms in terms of the false negative rate (0.72%), false positive rate (2.53%), and classification error (1.12%), when applied to the DTU/Herlev benchmark Pap smear dataset. The approach articulated in this paper is applicable to many Pap smear analysis systems, but is particularly pertinent to low-cost systems that should be of significant benefit to developing economies.

Original languageEnglish
Pages (from-to)23-33
Number of pages11
JournalInformatics in Medicine Unlocked
Early online date12 Feb 2019
Publication statusPublished - 2019


  • Cervical cancer
  • Fuzzy-C means
  • Pap-smear


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