Labani S, Asthana S, Sodhani P, Gupta S, Bhambhani S, Pooja B, Lim J, Jeronimo J
Institute of Cytology and Preventive Oncology, Indian Council of Medical Research, Noida, India.
Institute of Cytology and Preventive Oncology, Indian Council of Medical Research, Noida, India.
Eur J Obstet Gynecol Reprod Biol. 2014 May;176:75-9. doi: 10.1016/j.ejogrb.2014.03.006. Epub 2014 Mar 12.
To compare cervical careHPV screening in a rural community setting with other methods of cervical screening for the detection of high-grade cervical intra-epithelial neoplasia (CIN).
Cross-sectional study. All ever-married women aged 30-59 years surveyed in an administrative area of Uttar Pradesh, India were targeted for screening by careHPV (cervical and vaginal samples), Pap test and visual inspection of the cervix following application of acetic acid (VIA). Women who screened positive were referred for colposcopy and the results were confirmed histologically. Sensitivity, specificity and predictive values for the detection of histological CINII+ and CINIII+ were assessed for each screening test.
Sixty-five percent (5032/7704) of the women invited for cervical screening agreed to participate in the study. Screen-positive rates for cervical careHPV, vaginal careHPV, Pap test and VIA were 3%, 2%, 3% and 6%, respectively. Data for women who did not complete all screening modes, women lost to follow-up and women with missing histological results were excluded before data analysis, resulting in a final sample size of 4658. Cervical careHPV had high sensitivity (85%) for the detection of CINIII+ lesions and moderate sensitivity (53%) for the detection of CINII+ lesions. Sensitivities for the detection of CINIII+ and CINII+ were 54% and 41% for vaginal careHPV, 62% and 44% for Pap test, and 8% and 22% for VIA, respectively.
Cervical careHPV testing is superior to VIA and Pap test for the detection of high-grade CIN in a rural community setting.
比较在农村社区环境中使用careHPV进行宫颈癌筛查与其他宫颈癌筛查方法对高级别宫颈上皮内瘤变（CIN）的检测效果。
横断面研究。以印度北方邦一个行政区内所有年龄在30 - 59岁的已婚女性为筛查对象，采用careHPV（宫颈和阴道样本）、巴氏试验以及醋酸涂抹后宫颈视诊（VIA）进行筛查。筛查结果呈阳性的女性被转诊接受阴道镜检查，结果通过组织学检查得以确认。评估每种筛查方法检测组织学CINII + 和CINIII + 的敏感性、特异性及预测值。
受邀参加宫颈癌筛查的女性中有65%（5032/7704）同意参与研究。careHPV宫颈筛查、careHPV阴道筛查、巴氏试验和VIA的筛查阳性率分别为3%、2%、3%和6%。在数据分析前，排除了未完成所有筛查模式的女性、失访女性以及组织学结果缺失的女性，最终样本量为4658。careHPV检测CINIII + 病变的敏感性较高（85%），检测CINII + 病变的敏感性中等（53%）。careHPV阴道筛查检测CINIII + 和CINII + 的敏感性分别为54%和41%，巴氏试验分别为62%和44%，VIA分别为8%和22%。
在农村社区环境中，careHPV检测在检测高级别CIN方面优于VIA和巴氏试验。
