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- Title
Comparison of pap smear, visual inspection with acetic acid, human papillomavirus DNA-PCR testing and cervicography
- Authors
De Vuyst, H.; Claeys, P.; Njiru, S.; Muchiri, L.; Steyaert, S.; De Sutter, P.; Van Marck, E.; Bwayo, J.; Temmerman, M.
- Abstract
<bold>Objective: </bold>To assess the test qualities of four screening methods to detect cervical intra-epithelial neoplasia in an urban African setting.<bold>Method: </bold>Six hundred fifty-three women, attending a family planning clinic in Nairobi (Kenya), underwent four concurrent screening methods: pap smear, visual inspection with acetic acid (VIA), PCR for high risk human papillomavirus (HR HPV) and cervicography. The presence of cervical intra-epithelial neoplasia (CIN) was verified by colposcopy or biopsy.<bold>Result: </bold>Sensitivity (for CIN2 or higher) and specificity (to exclude any CIN or cancer) were 83.3% (95% CI [73.6, 93.0]) and 94.6% (95% CI [92.6, 96.5]), respectively, for pap smear; 73.3% (95% CI [61.8, 84.9]) and 80.0% (95% CI [76.6, 83.4]) for VIA; 94.4% (95% CI [84.6, 98.8]) and 73.9% (95% CI [69.7, 78.2]) for HR HPV; and 72.3% (95% CI [59.1, 85.6]) and 93.2% (95% CI [90.8, 95.7]) for cervicography.<bold>Conclusion: </bold>The pap smear had the highest specificity (94.6%) and HPV testing the highest sensitivity (94.4%). The visual methods, VIA and cervicography, were similar and showed an accuracy in between the former two tests.
- Subjects
KENYA; PAP test; ACETIC acid; PAPILLOMAVIRUSES; CLINICAL pathology; DNA analysis; CERVIX uteri tumors; CERVICAL intraepithelial neoplasia; CERVIX uteri; CHEMICAL reagents; CLINICS; COLPOSCOPY; COMPARATIVE studies; RESEARCH methodology; MEDICAL cooperation; MEDICAL screening; POLYMERASE chain reaction; RESEARCH; SQUAMOUS cell carcinoma; EVALUATION research; CROSS-sectional method; DIAGNOSIS
- Publication
International Journal of Gynecology & Obstetrics, 2005, Vol 89, Issue 2, p120
- ISSN
0020-7292
- Publication type
journal article
- DOI
10.1016/j.ijgo.2005.01.035