Is magnification necessary to confirm visual inspection of cervical abnormalities? A randomized trial in Peru

Autor: John Sellors, Kristen D.C. Lewis, Jennifer L. Winkler, Roberto del Aguila, Vivien Tsu, Jose Manuel Delgado, Miguel Gonzales
Jazyk: angličtina
Rok vydání: 2008
Předmět:
Adult
medicine.medical_specialty
Time Factors
lcsh:Arctic medicine. Tropical medicine
lcsh:RC955-962
Biopsy
Uterine Cervical Neoplasms
Magnification
lcsh:Medicine
Physical examination
Cervix Uteri
Cervical intraepithelial neoplasia
Sensitivity and Specificity
law.invention
Perú
Randomized controlled trial
Predictive Value of Tests
law
Peru
Confidence Intervals
Humans
Mass Screening
Medicine
Physical Examination
Mass screening
Acetic Acid
Lenses
Colposcopy
Cervical cancer
cribado
medicine.diagnostic_test
business.industry
Obstetrics
lcsh:Public aspects of medicine
lcsh:R
Public Health
Environmental and Occupational Health
lcsh:RA1-1270
Middle Aged
Reference Standards
Uterine Cervical Dysplasia
medicine.disease
Neoplasmas del cuello uterino
Surgery
diagnóstico
Visual inspection
Female
business
Follow-Up Studies
Zdroj: Revista Panamericana de Salud Pública, Vol 23, Iss 1, Pp 1-6 (2008)
ISSN: 1020-4989
Popis: OBJECTIVES: Cervical cancer is the leading cause of cancer death among women in developing countries. This study was designed to evaluate whether visual inspection with acetic acid and magnification (VIAM) improved confirmation of cervical lesions as compared to confirmation with visual inspection with acetic acid (VIA) without magnification when used by physicians. METHODS: From April-December 2004, women in San Martin, Peru, who were referred as VIA-positive by an "obstetriz" (a professional midwife with 6 years of university training) were randomized into two groups for confirmatory screening by a physician using either VIA or VIAM with an AviScope,TM a hand-held 4x magnification scope with a green light source. The reference standard for the presence or absence of cervical neoplasia was colposcopy and directed biopsy, as required. RESULTS: A total of 358 women participated in the study; 161 had a confirmatory examination with VIAM and 159 with VIA. Sensitivity for low- or high-grade lesions was 68% with VIA and 77% with VIAM, and specificity was 62% with VIA and 63% with VIAM; however, these differences were not statistically significant. CONCLUSIONS: For settings where physician confirmation of cervical abnormalities identified through visual inspection is required and available, this study demonstrates that VIAM had no significant advantage over VIA.
Databáze: OpenAIRE
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