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Type: Artigo de periódico
Title: Performance characteristics of Pap test, VIA, VILI, HR-HPV testing, cervicography, and colposcopy in diagnosis of significant cervical pathology
Author: Longatto-Filho, Adhemar
Naud, Paulo
Derchain, Sophie F. M.
Roteli-Martins, Cecilia
Tatti, Silvio
Hammes, Luciano Serpa
Sarian, Luis Otavio
Erzen, Mojca
Branca, Margherita
de Matos, Jean Carlos
Gontijo, Renata
Maeda, Marina Y. S.
Lima, Temistocles
Costa, Silvano
Syrjanen, Stina
Syrjanen, Kari
Abstract: We sought to evaluate the performance of diagnostic tools to establish an affordable setting for early detection of cervical cancer in developing countries. We compared the performance of different screening tests and their feasibility in a cohort of over 12,000 women: conventional Pap smear, liquid-based cytology, visual inspection with acetic acid (VIA), visual inspection with Iodine solution (VILI), cervicography, screening colposcopy, and high-risk human papillomavirus (HPV) testing (HR-HPV) collected by physician and by self-sampling. HR-HPV assay collected by the physician has the highest sensitivity (80 %), but high unnecessary referrals to colposcopy (15.1 %). HR-HPV test in self-sampling had a markedly lower (57.1 %) sensitivity. VIA, VILI, and cervicography had a poor sensitivity (47.4, 55, and 28.6 %, respectively). Colposcopy presented with sensitivity of 100 % in detecting CIN2+, but the lowest specificity (66.9 %). Co-testing with VIA and VILI Pap test increased the sensitivity of stand-alone Pap test from 71.6 to 87.1 % and 71.6 to 95 %, respectively, but with high number of unnecessary colposcopies. Co-testing with HR-HPV importantly increased the sensitivity of Pap test (to 86 %), but with high number of unnecessary colposcopies (17.5 %). Molecular tests adjunct to Pap test seems a realistic option to improve the detection of high-grade lesions in population-based screening programs.
Subject: Cancer prevention
Pap test
Hybrid capture
Screening program
Editor: Springer
Citation: Virchows Archiv. Springer, v.460, n.6, p.577-585, 2012
Rights: fechado
Identifier DOI: 10.1007/s00428-012-1242-y
Date Issue: 2012
Appears in Collections:FCM - Artigos e Outros Documentos

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