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Virchows Archiv
Published in: Virchows Archiv 6/2012

01-06-2012 | Original Article

Performance characteristics of Pap test, VIA, VILI, HR-HPV testing, cervicography, and colposcopy in diagnosis of significant cervical pathology

Authors: Adhemar Longatto-Filho, Paulo Naud, Sophie FM Derchain, Cecília Roteli-Martins, Sílvio Tatti, Luciano Serpa Hammes, Luis Otavio Sarian, Mojca Eržen, Margherita Branca, Jean Carlos de Matos, Renata Gontijo, Marina Y. S. Maeda, Temístocles Lima, Silvano Costa, Stina Syrjänen, Kari Syrjänen

Published in: Virchows Archiv | Issue 6/2012

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Abstract

We sought to evaluate the performance of diagnostic tools to establish an affordable setting for early detection of cervical cancer in developing countries. We compared the performance of different screening tests and their feasibility in a cohort of over 12,000 women: conventional Pap smear, liquid-based cytology, visual inspection with acetic acid (VIA), visual inspection with Iodine solution (VILI), cervicography, screening colposcopy, and high-risk human papillomavirus (HPV) testing (HR-HPV) collected by physician and by self-sampling. HR-HPV assay collected by the physician has the highest sensitivity (80 %), but high unnecessary referrals to colposcopy (15.1 %). HR-HPV test in self-sampling had a markedly lower (57.1 %) sensitivity. VIA, VILI, and cervicography had a poor sensitivity (47.4, 55, and 28.6 %, respectively). Colposcopy presented with sensitivity of 100 % in detecting CIN2+, but the lowest specificity (66.9 %). Co-testing with VIA and VILI Pap test increased the sensitivity of stand-alone Pap test from 71.6 to 87.1 % and 71.6 to 95 %, respectively, but with high number of unnecessary colposcopies. Co-testing with HR-HPV importantly increased the sensitivity of Pap test (to 86 %), but with high number of unnecessary colposcopies (17.5 %). Molecular tests adjunct to Pap test seems a realistic option to improve the detection of high-grade lesions in population-based screening programs.
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Metadata
Title
Performance characteristics of Pap test, VIA, VILI, HR-HPV testing, cervicography, and colposcopy in diagnosis of significant cervical pathology
Authors
Adhemar Longatto-Filho
Paulo Naud
Sophie FM Derchain
Cecília Roteli-Martins
Sílvio Tatti
Luciano Serpa Hammes
Luis Otavio Sarian
Mojca Eržen
Margherita Branca
Jean Carlos de Matos
Renata Gontijo
Marina Y. S. Maeda
Temístocles Lima
Silvano Costa
Stina Syrjänen
Kari Syrjänen
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
Virchows Archiv / Issue 6/2012
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI
https://doi.org/10.1007/s00428-012-1242-y

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