Evaluation of human-papillomavirus testing and visual inspection for cervical cancer screening in Rwanda
| Autor: | Mathilde Uwimbabazi, Felix Sayinzoga, Teresa M. Darragh, Vanessa Tenet, Daniëlle A.M. Heideman, Iacopo Baussano, M. Chantal Umulisa, Peter J.F. Snijders, Anne M. Uyterlinde, Gary M. Clifford, Silvia Franceschi, Belson Rugwizangoga |
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| Přispěvatelé: | Pathology, CCA - Cancer Treatment and quality of life, AII - Infectious diseases, Amsterdam Neuroscience - Cellular & Molecular Mechanisms |
| Rok vydání: | 2018 |
| Předmět: |
ACCURACY
Uterine Cervical Neoplasms Cervical cancer screening Cervical Cancer CYTOLOGY Visual inspection 0302 clinical medicine Cytology 1114 Paediatrics And Reproductive Medicine Medicine 030212 general & internal medicine Viral Papillomaviridae SUB-SAHARAN AFRICA Early Detection of Cancer Public Environmental & Occupational Health ACETIC-ACID Acetic Acid Cancer Cervical cancer screening and diagnosis biology Obstetrics lcsh:Public aspects of medicine Obstetrics and Gynecology Obstetrics & Gynecology General Medicine Middle Aged Health Services Detection Infectious Diseases 1117 Public Health And Health Services 030220 oncology & carcinogenesis VACCINATION PROGRAM Screening Public Health and Health Services EL SALVADOR Female Squamous Intraepithelial Lesions of the Cervix Life Sciences & Biomedicine Research Article 4.2 Evaluation of markers and technologies Adult medicine.medical_specialty Human papillomavirus Nursing lcsh:Gynecology and obstetrics Sensitivity and Specificity Cervical cell Paediatrics and Reproductive Medicine 03 medical and health sciences Clinical Research CAREHPV Humans Obstetrics & Reproductive Medicine lcsh:RG1-991 Aged Science & Technology business.industry Papillomavirus Infections Rwanda lcsh:RA1-1270 DNA biology.organism_classification medicine.disease Triage PREVENTION Reproductive Medicine INTRAEPITHELIAL NEOPLASIA DNA Viral Sexually Transmitted Infections POSITIVE WOMEN business |
| Zdroj: | BMC women's health, vol 18, iss 1 BMC Women's Health, 18(1). BioMed Central BMC Women's Health BMC Women's Health, Vol 18, Iss 1, Pp 1-8 (2018) Umulisa, M C, Franceschi, S, Baussano, I, Tenet, V, Uwimbabazi, M, Rugwizangoga, B, Heideman, D A M, Uyterlinde, A M, Darragh, T M, Snijders, P J F, Sayinzoga, F & Clifford, G M 2018, ' Evaluation of human-papillomavirus testing and visual inspection for cervical cancer screening in Rwanda ', BMC Women's Health, vol. 18, no. 1, pp. 59 . https://doi.org/10.1186/s12905-018-0549-5 |
| ISSN: | 1472-6874 |
| DOI: | 10.1186/s12905-018-0549-5 |
| Popis: | Background A pilot screening campaign in Rwanda, based on careHPV-testing followed by visual inspection with acetic acid triage (careHPV+VIA triage), was evaluated against other WHO-recommended screening options, namely HPV screen-and-treat and VIA screen-and-treat. Methods 764 women aged 30-69 underwent at visit 1: i) VIA, and cervical cell collection for ii) careHPV in Rwanda, and iii) liquid-based cytology and GP5+/6+ HR-HPV PCR in The Netherlands. All 177 women positive by VIA, careHPV and/or PCR were recalled, of whom 84% attended. At visit 2, VIA was again used to triage screen-positive women for treatment and to obtain biopsies from all women either from visible lesions or at 12 o’clock of the squamocolumnar junction. Cross-sectional screening indices were estimated primarily against histological high-grade squamous intraepithelial lesions or worse (hHSIL+), after imputation of missing histology data, based on 1-visit or 2-visit approaches. Results In a 1-visit screen-and-treat approach, VIA had sensitivity and specificity of 41% and 96%, respectively, versus 71% and 88% for careHPV, and 88% and 86% for PCR. In a 2-visit approach (in which hHSIL+ imputed among women without visit 2 were considered untreated) careHPV sensitivity dropped to 59% due to loss of 13% of hHSIL+. For careHPV+VIA triage, sensitivity dropped further to 35%, as another 24% of hHSIL+ were triaged to no treatment. Conclusions CareHPV was not as sensitive as gold-standard PCR, but detected considerably more hHSIL+ than VIA. However, due to careHPV-positive hHSIL+ women being lost to follow-up and/or triaged to no treatment, 2-visit careHPV+VIA triage did not perform better than VIA screen-and-treat. Electronic supplementary material The online version of this article (10.1186/s12905-018-0549-5) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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