Impact of knowledge of HPV positivity on cervical cytology performance in latin america.

Autor:	Ramírez AT; Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France., Mesher D; Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France.; Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency, London, UK., Baena A; Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France., Salgado Y; Instituto Nacional de Cancerología, Bogotá, Colombia., Kasamatsu E; Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay., Cristaldo C; Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay., Álvarez R; Caja Costarricense de Seguro Social (CCSS), Región Pacífico Central, San Jose, Costa Rica., Rojas FD; Caja Costarricense de Seguro Social (CCSS), Región Pacífico Central, San Jose, Costa Rica., Ramírez K; Caja Costarricense de Seguro Social (CCSS), Región Pacífico Central, San Jose, Costa Rica., Guyot J; Sección Citología, Hospital Nacional 'Prof. Posadas', El Palomar, Argentina., Henríquez O; Facultad de Ciencias de la Salud, UNITEC, Tegucigalpa, Honduras., González Palma H; Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia., Flores B; Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia., Peñaranda J; Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia., Vero MJ; ASSE, RIEPS, Laboratorio RAP, Montevideo, Uruguay., Robinson I; ASSE, RIEPS, Laboratorio RAP, Montevideo, Uruguay., Rol ML; Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France., Rodríguez G; Comisión Honoraria de Lucha contra el Cáncer, Montevideo, Uruguay., Terán C; Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia., Ferrera A; Instituto de Investigaciones en Microbiología, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras., Picconi MA; Instituto Nacional de Enfermedades Infecciosas-ANLIS Malbrán, Buenos Aires, Argentina., Calderon A; Caja Costarricense de Seguro Social (CCSS), Región Pacífico Central, San Jose, Costa Rica., Mendoza L; Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay., Wiesner C; Instituto Nacional de Cancerología, Bogotá, Colombia., Almonte M; Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France.; Department of Sexual and Reproductive Health and Research (SRH), World Health Organization, Geneva, Switzerland., Herrero R; Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France.; Agencia Costarricense de Investigaciones Biomédicas (ACIB), Fundación INCIENSA, San Jose, Costa Rica.
Jazyk:	angličtina
Zdroj:	Journal of the National Cancer Institute [J Natl Cancer Inst] 2024 Nov 12. Date of Electronic Publication: 2024 Nov 12.
DOI:	10.1093/jnci/djae283
Abstrakt:	Background: Cervical cytology is recommended by WHO as a triage option in HPV-based cervical cancer screening programmes. We assessed the performance of cytology to detect CIN3+ without and with knowledge of HPV positivity. Methods: Women were screened with cytology and HPV across ESTAMPA study centres in Latin America. Screen-positives were referred to colposcopy with biopsy and treatment as needed. Cytology was initially interpreted without knowing HPV results. A subset of cytologies from HPV-positive women were re-interpreted at the same laboratories, with knowledge of HPV status, blinded to previous cytology and histological diagnosis. Performance indicators for cytology to detect CIN3+ without and with knowledge of HPV positivity were estimated. Findings: A total of 4,087 women were included, of which 490 had histologically confirmed CIN3 + (455 CIN3 and 35 cancers). Cytology sensitivity without knowledge of HPV positivity for CIN3+ was 47.2% (95% CI: 42.5-51.9), whereas with knowledge of HPV positivity, the sensitivity was higher (58.9%, 95% CI: 54.2-63.5), p < .0001. The specificity without knowledge of HPV was 89.4% (95% CI: 88.2-90.5), while with knowledge of HPV positivity was 78.9% (95% CI: 77.4-80.4), p < .0001. Performance estimates varied by study centre for cytology without knowing the HPV positivity, (range from 32.8% to 61.5% for sensitivity; range 80.7% to 98.6% for specificity). Similarly, performance varied with knowledge of HPV positivity (36.1% to 93.4% for sensitivity; 39.6% to 98.6% for specificity). Conclusion: The increase in sensitivity of cytology with HPV knowledge was limited and highly variable, reinforcing the need for alternative triage methods to support cervical cancer elimination goals. (© The Author(s) 2024. Published by Oxford University Press.)
Databáze:	MEDLINE
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