Clinical determinants of a positive visual inspection after treatment with acetic acid for cervical cancer screening
| Autor: | Pooja Bansil, Melissa Valdez, Wen Chen, Le-Ni Kang, Feng Chen, Xun Zhang, Fang-Hui Zhao, Proma Paul, Jing Li, Roger Peck, Ping Bai, Philip E. Castle, You-Lin Qiao, Jose Jeronimo |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Rural Population China medicine.medical_specialty Population Uterine Cervical Neoplasms Cervical intraepithelial neoplasia Sensitivity and Specificity Specimen Handling Cohort Studies Biopsy medicine Humans Mass Screening Prospective Studies education Prospective cohort study Early Detection of Cancer Acetic Acid Aged Vaginal Smears Colposcopy Gynecology Cervical cancer Human papillomavirus 16 education.field_of_study Human papillomavirus 18 medicine.diagnostic_test Obstetrics business.industry Papillomavirus Infections Obstetrics and Gynecology Odds ratio Middle Aged Uterine Cervical Dysplasia medicine.disease Confidence interval DNA Viral Female Indicators and Reagents business |
| Zdroj: | BJOG: An International Journal of Obstetrics & Gynaecology. 121:739-746 |
| ISSN: | 1470-0328 |
| Popis: | Objective To examine the determinants of a positive visual inspection after acetic acid (VIA), including the relationship of testing positive for high-risk human papillomavirus (HR-HPV), which is the necessary cause of cervical cancer. Design A prospective cohort study. Setting Three clinical sites in rural China. Population A total of 7541 women aged 25–65 years. Methods All women underwent VIA, DNA testing, by two DNA tests performed on both clinician- and self-collected specimens, and HPV E6 oncoprotein testing. Those positive by any test underwent colposcopy and four-quadrant biopsy evaluation. A random sample of women with negative screening results also underwent colposcopy and, if colposcopic abnormalities were observed, four-quadrant biopsy evaluation was performed. Women diagnosed with cervical intraepithelial neoplasia grade 2 (CIN2), or more severe grades (CIN2 + ), underwent treatment. Main outcome measure Testing positive for VIA. Results Overall, 7.6% (95% confidence interval, 95% CI, 7.0–8.2%) had a positive VIA. Women who tested positive for HPV were more likely to have a positive VIA than women who tested negative for HPV (15.0%, 95% CI 12.9–17.2% versus 6.3%, 95% CI 5.7–6.9%; P |
| Databáze: | OpenAIRE |
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