Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/199150
Type: Artigo de periódico
Title: Optional Screening Strategies For Cervical Cancer Using Standalone Tests And Their Combinations Among Low- And Medium-income Populations In Latin America And Eastern Europe.
Author: Sarian, Luis Otavio
Derchain, Sophie
Shabalova, Irena
Tatti, Silvio
Naud, Paulo
Longatto-Filho, Adhemar
Syrjänen, Stina
Syrjänen, Kari
,
Abstract: The performance of cervical cancer (CC) screening can be improved by combining Pap smear with human papillomavirus (HPV) testing or visual methods, addressing local demographic, clinical and economic characteristics. To examine the performance of standalone and combined screening tools in populations with variable prevalence of cervical intraepithelial neoplasia (CIN) and CC. Merged data-sets from the Latin American Screening Study and New Independent States cohorts provided results for 15,000 women, screened using Pap smear, HPV testing and visual inspection with acetic acid, in Brazil, Argentina, Russia, Belarus and Latvia. Bayesian correction for verification bias was used. At CIN2+ cut-off, HPV detection alone was the most sensitive technique. There was an improvement (88.5% to 92.7%) in Hybrid Capture 2 (HC2) sensitivity among women ≥35 years old. Using HPV detection alone was the least specific screening tool, regardless of the age group (69.9% [95% CI 66.5-72.8%] and 86.4% [95% CI 84.6-88.2%], in < or ≥35 years, respectively). Of the test combinations, Pap smear (LSIL threshold) with HC2 had the highest specificity (98.7%; 95% CI 98.3-99.0%). However, in women ≥35 years, the sensitivity of Pap alone was superior to that of the combination. The Pap test is a highly specific screening option in populations with medium-range CC prevalence. Combined testing for HPV in this scenario may yield slightly better positive predictive values in women ≥35 years of age with LSIL, but at a high incremental cost.
Subject: Adolescent
Adult
Aged
Aged, 80 And Over
Cervical Intraepithelial Neoplasia
Europe, Eastern
Female
Humans
Latin America
Mass Screening
Middle Aged
Papanicolaou Test
Papillomavirus Infections
Sensitivity And Specificity
Uterine Cervical Neoplasms
Vaginal Smears
Young Adult
Rights: fechado
Identifier DOI: 10.1258/jms.2010.010016
Address: http://www.ncbi.nlm.nih.gov/pubmed/21258130
Date Issue: 2010
Appears in Collections:Unicamp - Artigos e Outros Documentos

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