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

Vania R. Girianelli, Luiz Claudio S. Thuler, Moyses Szklo, Alexandre Donato, Lucilia M.G. Zardo, José A. Lozana, Olimpio F. Almeida Neto, Aurenice C.L. Carvalho, Jorge H. Matos, Valeska Figueiredo

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)504-510
Number of pages7
JournalEuropean Journal of Cancer Prevention
Volume15
Issue number6
DOIs
StatePublished - Dec 2006
Externally publishedYes

Keywords

  • Cervical cancer
  • Human papillomavirus
  • Hybrid capture
  • Liquid-based cytology
  • Papanicolou
  • Screening

ASJC Scopus subject areas

  • Epidemiology
  • Oncology
  • Public Health, Environmental and Occupational Health
  • Cancer Research

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