Screening for cervical Cancer in high-risk populations: DNA pap test or hybrid capture II test alone?
| Autor: | Adhemar Longatto Filho, Gerson Botacini das Dores, Sérgio Makabe, Celso di Loreto, Maria Lúcia Utagawa, Adauto Castelo, José A Marques, Marina Yoshiê Sakamoto Maeda, Sonia Maria Miranda Pereira, Carmen L.F. Santoro |
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| Přispěvatelé: | Universidade do Minho |
| Jazyk: | angličtina |
| Rok vydání: | 2006 |
| Předmět: |
Adult
Pathology medicine.medical_specialty Adolescent Biopsy Papanicolaou stain Uterine Cervical Neoplasms Context (language use) Pathology and Forensic Medicine 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Positive predicative value medicine Humans Mass Screening Liquid-based cytology Single-Blind Method Pap test Papillomaviridae Aged Cervical cancer Colposcopy Gynecology Vaginal Smears 030219 obstetrics & reproductive medicine Cervical screening Hybrid capture Science & Technology medicine.diagnostic_test business.industry Papillomavirus Infections Obstetrics and Gynecology DCS system Middle Aged medicine.disease Uterine Cervical Dysplasia Papanicolaou test 3. Good health Tumor Virus Infections 030220 oncology & carcinogenesis DNA Viral Female business Papanicolaou Test |
| Zdroj: | Repositório Científico de Acesso Aberto de Portugal Repositório Científico de Acesso Aberto de Portugal (RCAAP) instacron:RCAAP |
| Popis: | This study was designed to evaluate whether Hybrid Capture II (HC2) test alone refer women to colposcopy as appropriately as DNA Papanicolaou (Pap) test, in the context of a high-risk group of women using the recently validated DNACitoliq LBC system. Women with suspected cervical disease were included in this crosssectional study at a tertiary center in São Paulo, Brazil, for further workup. All women had cervical material collected for LBC and HC2 for high-risk human papillomavirus (hrHPV)-DNA test. Irrespective of cytology and HC2 results, colposcopy, and cervical biopsy when applicable, was systematically performed. All tests were performed blindly. Sensitivity, specificity, positive and negative predictive values, and overall accuracy of both methods were computed in relation to histology. A total of 1,080 women were included: 36.4% (393/1080) had ACUS+, 10.2% (110/1080) were high-grade squamous intraepithelial lesions (HSIL) or cancer. Mean age was 33.5 years. All women underwent colposcopy, and cervical biopsies were performed in 38.4% (415/1080): 33% (137/415) of the biopsies were negative, 14.4% (155/415) were low-grade squamous intraepithelial lesions (LSIL), 10.7% (116/415) were HSIL, and 0.6% (7/415) were cancer. HC2 sensitivity to diagnose biopsy-proven HSIL was 100%. Because all HSIL cases had a positive HC2 test, sensitivity could not be improved by adding LBC. Specificity and positive and negative predictive values of DNA Pap were not significantly different from HC2 test alone when considering LSIL+ histology as ‘‘gold standard’’ and HSIL+ histology. As a screening strategy for women with high-risk for cervical cancer, DNA Pap test does not seem to add substantially to HC2 alone in terms of appropriately referring to colposcopy. |
| Databáze: | OpenAIRE |
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