Comparison of pap smear, visual inspection with acetic acid, human papillomavirus DNA-PCR testing and cervicography
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Date
2005Author
De Vuyst, H
Claeys, P
Njiru, S
Steyaert, S
Muchiri, L
De Sutter, P
Van Marck, E
Bwayo, J
Temmerman, M
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
Objective
To assess the test qualities of four screening methods to detect cervical intra-epithelial neoplasia in an urban African setting.
Method
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.
Result
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.
Conclusion
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.
Keywords
Cervical neoplasia screening;
Papanicolaou smear;
Human papillomavirus testing;
Cervicography;
Visual inspection with acetic acid
URI
http://www.sciencedirect.com/science/article/pii/S0020729205000846http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/36428
http://www.ncbi.nlm.nih.gov/pubmed/15847874
Citation
International Journal of Gynecology & Obstetrics Volume 89, Issue 2, May 2005, Pages 120–126Publisher
Univesity of Nairobi Department of Clinical studies