Performance characteristics of Pap test, VIA, VILI, HR-HPV testing, cervicography, and colposcopy in diagnosis of significant cervical pathology.

Virchows Archiv : an International Journal of Pathology
Adhemar Longatto-FilhoKari Syrjänen

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 unnece...Continue Reading

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Citations

Mar 23, 2013·Journal of Lower Genital Tract Disease·Atef M DarwishNermat A Abdel-Fattah
Mar 17, 2015·Asian Pacific Journal of Cancer Prevention : APJCP·Li-Ju ZongKeng Shen
Jul 22, 2017·Expert Review of Vaccines·Didik SetiawanMaarten J Postma
Aug 11, 2017·The Cochrane Database of Systematic Reviews·George KoliopoulosMarc Arbyn
Dec 7, 2018·BMJ : British Medical Journal·Marc ArbynUNKNOWN Collaboration on Self-Sampling and HPV Testing

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