Evaluation of adjunctive tests for cervical cancer screening in low resource settings.

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dc.contributor.authorBhatla, Neerjaen_US
dc.contributor.authorMukhopadhyay, Asimaen_US
dc.contributor.authorKriplani, Alkaen_US
dc.contributor.authorPandey, R Men_US
dc.contributor.authorGravitt, Patti Een_US
dc.contributor.authorShah, K Ven_US
dc.contributor.authorIyer, V Ken_US
dc.contributor.authorVerma, Kusumen_US
dc.date.accessioned2009-05-28T06:05:24Z
dc.date.available2009-05-28T06:05:24Z
dc.date.issued2007-04-17en_US
dc.description.abstractBACKGROUND: Visual inspection of cervix after application of acetic acid (VIA) is an effective screening tool for cervical cancer in low resource settings, but its low specificity leads to high referral rates. Adjunctive testing may overcome this drawback. AIMS: This pilot study was aimed to assess test performances of VIA, human papillomavirus (HPV) testing and Pap smear, individually and in simulated combinations, to determine the probable best screening option. SETTING AND DESIGN: Gynecology outpatient department (OPD); cross-sectional study. MATERIALS AND METHODS: One hundred women with complaints of irregular vaginal bleeding or discharge, post coital bleeding or unhealthy cervix on examination underwent Pap smear, HPV testing, VIA, colposcopy and biopsy, if indicated, in this screening order. STATISTICAL ANALYSIS: Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each of the tests with a biopsy result of > or =HSIL taken as the gold standard. Simulated parallel and sequential combinations for VIA/Pap, VIA/HPV and HPV/Pap were calculated and compared with individual test performance. RESULTS: Prevalence of abnormal Pap smears was 5%, VIA positive 51% and HPV positive 16%. Sensitivity and specificity of VIA were 100% and 53.3% respectively. For HPV and Pap tests corresponding figures were 85.7%, 89.7% and 50%, 98.9% respectively. The best simulated combination with a balance of sensitivity and specificity was of VIA followed by HPV testing (sensitivity 85.7%, specificity 95.4%). CONCLUSION: Addition of HPV testing to VIA can increase the specificity of VIA, thereby reducing the referral rates without compromising the sensitivity of the test.en_US
dc.description.affiliationDepartment of Obstetrics and Gynaecology, AIIMS, New Delhi, India. nbhatla@aiims.ac.inen_US
dc.identifier.citationBhatla N, Mukhopadhyay A, Kriplani A, Pandey RM, Gravitt PE, Shah KV, Iyer VK, Verma K. Evaluation of adjunctive tests for cervical cancer screening in low resource settings. Indian Journal of Cancer. 2007 Apr-Jun; 44(2): 51-5en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/49291
dc.language.isoengen_US
dc.source.urihttps://www.indianjcancer.comen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshBiopsyen_US
dc.subject.meshCarcinoma, Squamous Cell --diagnosisen_US
dc.subject.meshColposcopyen_US
dc.subject.meshCross-Sectional Studiesen_US
dc.subject.meshDNA Probes, HPVen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshIndiaen_US
dc.subject.meshMass Screening --methodsen_US
dc.subject.meshMetrorrhagia --diagnosisen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMonitoring, Ambulatoryen_US
dc.subject.meshPhysical Examinationen_US
dc.subject.meshPilot Projectsen_US
dc.subject.meshPredictive Value of Testsen_US
dc.subject.meshQuestionnairesen_US
dc.subject.meshUterine Cervical Neoplasms --diagnosisen_US
dc.subject.meshVaginal Discharge --diagnosisen_US
dc.subject.meshVaginal Smears --standardsen_US
dc.titleEvaluation of adjunctive tests for cervical cancer screening in low resource settings.en_US
dc.typeJournal Articleen_US
dc.typeResearch Support, Non-U.S. Gov'ten_US
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