Comparison of human papillomavirus DNA tests, liquid-based cytology and conventional cytology for the early detection of cervix uteri cancer

To compare the performance of human papillomavirus DNA tests (samples collected by a healthcare professional and self-collected) and liquid-based cytology with conventional cytology in the detection of cervix uteri cancer and its precursor lesions. A cross-sectional study was carried out in 1777 wom...

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Published in:	European journal of cancer prevention Vol. 15; no. 6; pp. 504 - 510
Main Authors:	Girianelli, Vania R., Thuler, Luiz Claudio S., Szklo, Moyses, Donato, Alexandre, Zardo, Lucilia M.G., Lozana, José A., Neto, Olimpio F. Almeida, Carvalho, Aurenice C.L., Matos, Jorge H., Figueiredo, Valeska
Format:	Journal Article
Language:	English
Published:	England Lippincott Williams & Wilkins 01-12-2006
Subjects:	Adult Cervical Intraepithelial Neoplasia - diagnosis Cervix Uteri - cytology Cervix Uteri - virology DNA, Viral - analysis Female Humans Mass Screening - methods Middle Aged Other Cancers Papillomaviridae - isolation & purification Sensitivity and Specificity Uterine Cervical Neoplasms - diagnosis Uterine Cervical Neoplasms - pathology Vaginal Smears
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Summary:	To compare the performance of human papillomavirus DNA tests (samples collected by a healthcare professional and self-collected) and liquid-based cytology with conventional cytology in the detection of cervix uteri cancer and its precursor lesions. A cross-sectional study was carried out in 1777 women living in poor communities in Rio de Janeiro State, Brazil. Eligibility criteria included ages 25-59 years and not having had a Papanicolau test within at least 3 years prior to the study. Cytology (conventional or liquid-based) and human papillomavirus DNA (collected by a healthcare professional or self-collected) tests were performed using samples collected in a single visit. Women with abnormalities in at least one test and a systematic sample of 70 women with negative test results were referred to a colposcopic examination. Test readings were double-masked, and the outcome of interest was high-grade squamous intraepithelial lesion or worse. The pathology report was used as the gold standard. The prevalence of high-grade squamous intraepithelial lesion or worse was 2.0%. Human papillomavirus DNA test collected by a health professional alone or combined with conventional cytology had the highest sensitivity (91.4 and 97.1%, respectively). The highest specificity was found for conventional cytology (91.6%) and for a human papillomavirus DNA test collected by a healthcare professional (90.2%). On the basis of only test performance, the use of human papillomavirus DNA tests, alone or combined with cytology, would seem to be recommended. Its population-wide implementation, however, is conditional on a cost-effectiveness analysis.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0959-8278 1473-5709
DOI:	10.1097/01.cej.0000220630.08352.7a