TY - JOUR
T1 - Comparison of human papillomavirus DNA tests, liquid-based cytology and conventional cytology for the early detection of cervix uteri cancer
AU - Girianelli, Vania R.
AU - Thuler, Luiz Claudio S.
AU - Szklo, Moyses
AU - Donato, Alexandre
AU - Zardo, Lucilia M.G.
AU - Lozana, José A.
AU - Almeida Neto, Olimpio F.
AU - Carvalho, Aurenice C.L.
AU - Matos, Jorge H.
AU - Figueiredo, Valeska
PY - 2006/12
Y1 - 2006/12
N2 - 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.
AB - 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.
KW - Cervical cancer
KW - Human papillomavirus
KW - Hybrid capture
KW - Liquid-based cytology
KW - Papanicolou
KW - Screening
UR - http://www.scopus.com/inward/record.url?scp=33751069971&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33751069971&partnerID=8YFLogxK
U2 - 10.1097/01.cej.0000220630.08352.7a
DO - 10.1097/01.cej.0000220630.08352.7a
M3 - Article
C2 - 17106330
AN - SCOPUS:33751069971
SN - 0959-8278
VL - 15
SP - 504
EP - 510
JO - European Journal of Cancer Prevention
JF - European Journal of Cancer Prevention
IS - 6
ER -