Cervical screening by visual inspection, HPV testing, liquid-based and conventional cytology in Amazonian Peru

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dc.contributor.authorAlmonte, Maribel
dc.contributor.authorFerreccio, Catterina
dc.contributor.authorWinkler, Jennifer L.
dc.contributor.authorCuzick, Jack
dc.contributor.authorTsu, Vivien
dc.contributor.authorRobles, Sylvia
dc.contributor.authorTakahashi, Rina
dc.contributor.authorSasieni, Peter
dc.date.accessioned2024-01-10T13:46:37Z
dc.date.available2024-01-10T13:46:37Z
dc.date.issued2007
dc.description.abstractCervical cancer is an important public health problem in many developing countries, where cytology screening has been ineffective. We compared four tests to identify the most appropriate for screening in countries with limited resources. Nineteen midwives screened 5,435 women with visual inspection (VIA) and collected cervical samples for HPV testing, liquid-based cytology (LBC) and conventional cytology (CC). If VIA was positive, a doctor performed magnified VIA. CC was read locally, LBC was read in Lima and HPV testing was done in London. Women with a positive screening test were offered colposcopy or cryotherapy (with biopsy). Inadequacy rates were 5% and 11% for LBC and CC respectively, and less than 0.1% for VIA and HPV. One thousand eight hundred eightyone women (84% of 2,236) accepted colposcopy/cryotherapy: 79 had carcinoma in situ or cancer (CIS+), 27 had severe- and 42 moderate-dysplasia on histology. We estimated a further 6.5 cases of CIS+ in women without a biopsy. Sensitivity for CIS+ (specificity for less than moderate dysplasia) was 41.2% (76.7%) for VIA,95.8% (89.3%) for HPV, 80.3% (83.7%) for LBC, and 42.5% (98.7%) for CC. Sensitivities for moderate dysplasia or worse were better for VIA (54.9%) and less favourable for HPV and cytology. In this setting, VIA and CC missed the majority of high-grade disease. Overall, HPV testing performed best. VIA gives immediate results, but will require investment in regular training and supervision. Further work is needed to determine whether screened-posilive women should all be treated or triaged with a more specific test. (c) 2007 Wiley-Liss, Inc.
dc.fechaingreso.objetodigital05-04-2024
dc.format.extent7 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1002/ijc.22757
dc.identifier.eissn1097-0215
dc.identifier.issn0020-7136
dc.identifier.pubmedidMEDLINE:17437272
dc.identifier.urihttps://doi.org/10.1002/ijc.22757
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/79181
dc.identifier.wosidWOS:000248283300013
dc.information.autorucMedicina;Ferreccio C;S/I;99684
dc.issue.numero4
dc.language.isoen
dc.nota.accesoContenido parcial
dc.pagina.final802
dc.pagina.inicio796
dc.publisherWILEY
dc.revistaINTERNATIONAL JOURNAL OF CANCER
dc.rightsacceso restringido
dc.subjectPap smear
dc.subjecthybrid capture
dc.subjectlow-resource settings
dc.subjectclinical trial
dc.subjectscreening
dc.subjectHYBRID-CAPTURE-II
dc.subjectHUMAN-PAPILLOMAVIRUS
dc.subjectHIGH-RISK
dc.subjectCANCER
dc.subjectWOMEN
dc.subjectDNA
dc.subjectCERVICOGRAPHY
dc.subjectPREVALENCE
dc.subjectPROGRAM
dc.subjectDESIGN
dc.subject.ods03 Good Health and Well-being
dc.subject.ods05 Gender Equality
dc.subject.odspa03 Salud y bienestar
dc.subject.odspa05 Igualdad de género
dc.titleCervical screening by visual inspection, HPV testing, liquid-based and conventional cytology in Amazonian Peru
dc.typeartículo
dc.volumen121
sipa.codpersvinculados99684
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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