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Evaluation of human-papillomavirus testing and visual inspection for cervical cancer screening in Rwanda
- Source :
- 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
- Publication Year :
- 2018
- Publisher :
- eScholarship, University of California, 2018.
-
Abstract
- 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.
- Subjects :
- 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
Subjects
Details
- ISSN :
- 14726874
- Database :
- OpenAIRE
- Journal :
- 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
- Accession number :
- edsair.doi.dedup.....44337d046c76fde14de72267fe1ab1fd