Adjunct screening of cervical or vaginal samples using careHPV testing with Pap and aided visual inspection for detecting high-grade cervical intraepithelial neoplasia

Asthana, Smita; Labani, Satyanarayana

doi:10.1016/j.canep.2014.11.006

Cited by 13 publications

(10 citation statements)

References 24 publications

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“…10,11 The sensitivity and specificity of careHPV are similar to other HPV screening method. 6-9 A significantly higher rate of CINII/CINIII was identified within the 65 patients from the careHPV group after cytology triage than that from the 106 patients in the cytology group. Our result showed that careHPV as a primary screening method with cytology triage resulted in similar detection rate of CINII/CINIII compared with cytology as a primary screening method.…”

Section: Discussionmentioning

confidence: 96%

“…Studies showed that compared with cytology testing and visual inspection of acetic acid, HPVDNA method offers higher specificity and sensitivity. [7][8][9] However, HPVDNA is expensive and requires a relatively advanced laboratory. Thus, HPVDNA testing is mainly used in medical institutes in opportunistic screening and is rarely applied to population screening, especially in rural areas in China.…”

Section: Discussionmentioning

confidence: 99%

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Exploring an Appropriate Method of Cervical Cancer Screening in Rural China

Zhang

Zhao

et al. 2019

Asia Pac J Public Health

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Background. To explore the feasibility of careHPV (human papillomavirus) with cytology triage as a cervical cancer screening in rural areas of China. Methods. A total of 7138 women aged 35 to 64 years were divided into 2 groups. Women in careHPV group (n = 3536) underwent careHPV and 288 positive subjects underwent cytology, of which 65 women were ≥ASC-US (atypical squamous cells of undetermined significance). Women in the cytology group (n = 3602) underwent cytology and 111 women were ≥ASC-US. All subjects with ≥ASC-US were referred to colposcopy and biopsy. Results. The average age of subjects was 48.2 ± 7.8 years. In the careHPV group, the HPV-positive rate was 8.1%. The detection rate of ≥ASC-US was 1.8% in the careHPV group and 3.1% in the cytology group ( P = .001). There was no significant difference in detection rate of ≥CINII (cervical intraepithelial neoplasia) in the careHPV group (0.7%) and the cytology group (0.6%; P = .416). In addition, to identify 1 case ≥CINII, an average of 2.6 colposcopies were needed in the careHPV group, and 5.3 colposcopies were performed to diagnose 1 case ≥CINII in the cytology group. Conclusions. careHPV with cytology triage offered similar efficiency in identifying abnormalities of CINII and above compared with cytology screening. With the reduced requirement for cytology testing and colposcopy, careHPV may be a more favorable cervical cancer screening strategy in areas of China where there is a lack of cytology services.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Exploring an Appropriate Method of Cervical Cancer Screening in Rural China

Zhang

Zhao

et al. 2019

Asia Pac J Public Health

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“…A study by Nawaz et al (2005) from our hospital revealed discordant results in Pap smears and cervical biopsy in 10% of cases [9]. Another group reported an increase in screening sensitivity by 65.6% with the addition of care HPV testing in parallel to Pap smears and to 72% for the combination of CHPV and VIA [10] Blumenthal et al (2001) reported increase in diagnostic sensitivity upon addition of HPV DNA testing to VIA, and Pap smears [11]. Studies from India, South Africa, Thailand [3,12,13] reveal that VIA and HPV DNA testing could be better alternatives to cervical cytology in poor countries.…”

Section: Introductionmentioning

confidence: 93%

HPV Adjunct Testing to VIA as an Alternative to Cytology for Cervical Cancer Screening in Pakistan

FH¹

2015

Gynecol Obstet

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Background: Developing countries often lack sufficient resources to use the Pap smear as a screening tool for cervical abnormalities. Visual inspection with acetic acid (VIA) is similar to Pap smears in terms of sensitivity for highgrade CIN. However, it is not very specific and adjunct testing with HPV can improve the test characteristics of VIA. Aim: To evaluate VIA with adjunct Human Papilloma Virus (HPV) testing as an alternative to routine cervical cytology for cervical cancer screening in a low resource setting. Methods: We conducted a cross-sectional study among the attendees of the gynecology clinics attached to our hospital. Each patient underwent three screening tests, viz., Pap smear, HPV DNA testing and VIA, sequentially. The patients who tested positive by any of these methods underwent colposcopy. Trained colposcopists, blinded to the results of initial screening tests collected biopsies from patients with colposcopic abnormalities. We tested the specimens for HPV by Polymerase Chain Reaction (PCR) using the general primers GP5+/GP6+, and checked for high risk HPV types in positive samples. Results: The median age of participants was 38 years. Out of the 857 patients screened, 46 (5.36%), 4 (0.47%) and 13 (1.53%) tested abnormal/positive by VIA, Pap smear and HPV PCR, respectively. Sequential VIA and HPV PCR yielded a sensitivity and specificity of 80% and 93%, respectively. Conclusions: We propose that sequential testing involving the use of VIA followed by HPV PCR could improve the test characteristics, in low-resource settings. G y n e c o lo gy & O b s te tr ic s

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“…On these grounds, care HPV (Qiagen), a rapid and less expensive derivative of HC2, has been developed. It has been documented that the care HPV test performs well in clinical trials conducted by well‐trained lab personnel 12‐15 . However, the performance of the test in resource‐constrained settings has not been thoroughly documented.…”

Section: Introductionmentioning

confidence: 99%

“…It has been documented that the careHPV test performs well in clinical trials conducted by well-trained lab personnel. [12][13][14][15] However, the performance of the test in resource-constrained settings has not been thoroughly documented. Further, in the evaluation of screening programs relying on careHPV testing, it should be acknowledged that the various high-risk HPV genotypes included in the test have different carcinogenic potentials.…”

Section: Introductionmentioning

confidence: 99%

Agreement between careHPV and hybrid capture 2 in detecting high‐risk HPV in women in Tanzania

Katanga

Kjær

Manongi

et al. 2021

Acta Obstet Gynecol Scand

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Introduction Visual inspection of the cervix with acetic acid is used to control the burden of cervical cancer in low‐ and middle‐income countries. This method has some limitations and HPV DNA testing may be an alternative, but it is expensive and requires a laboratory setup. Cheaper and faster HPV tests have been developed. This study describe the agreement between a fast HPV test (careHPV) and hybrid capture 2 (HC2) in detection of high‐risk HPV among Tanzanian women. Material and methods The study involved women attending routine cervical cancer screening at the Ocean Road Cancer Institute and Kilimanjaro Christian Medical Centre in Tanzania. The women were offered HIV testing. Two cervical samples were subsequently obtained; the first sample was processed at the clinics using careHPV and the second sample was transported to Denmark and Germany for cytology and HC2 analysis. Kappa statistic was calculated to assess the agreement between careHPV and HC2. The sensitivity, specificity and predictive values of careHPV were calculated using HC2 as reference. The analyses were done for the overall study population and stratified by testing site and HIV status. Results A total of 4080 women were enrolled, with 437 being excluded due to invalid information, lack of careHPV or HC2 results. Overall agreement between the tests was substantial with a kappa value of 0.69 (95% confidence interval [CI] 0.66‐0.72). The sensitivity and specificity of careHPV was 90.7% (95% CI 89.6‐91.8) and 84.2% (95% CI 81.2–86.8), respectively. The agreement was similar in the stratified analyses where the kappa values were 0.75 (95% CI 0.70‐0.79) in women aged 25‐34, 0.66 (95% CI 0.62‐0.70) in women aged 35–60, 0.73 (95% CI 0.70‐0.77) at the Ocean Road Cancer Institute, 0.64 (95% CI 0.60‐0.69) at the Kilimanjaro Christian Medical Center, 0.73 (95% CI 0.68‐0.79) in HIV‐positive and 0.66 (95% CI 0.63‐0.70) in HIV‐negative women. The kappa value of 0.64 (95% CI 0.39‐0.88) for cervical high‐grade lesions indicates a substantial agreement between careHPV and HC2 in detecting HPV among women with cervical high‐grade lesions. Conclusions A substantial agreement was found between careHPV and HC2 in detecting HPV overall as well as detecting HPV among women with cervical high‐grade lesions. However, given the limited resources available in low and middle‐income countries, the HPV testing assay should be weighed against the cost‐effectiveness of the test.

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Adjunct screening of cervical or vaginal samples using careHPV testing with Pap and aided visual inspection for detecting high-grade cervical intraepithelial neoplasia

Cited by 13 publications

References 24 publications

Exploring an Appropriate Method of Cervical Cancer Screening in Rural China

Exploring an Appropriate Method of Cervical Cancer Screening in Rural China

HPV Adjunct Testing to VIA as an Alternative to Cytology for Cervical Cancer Screening in Pakistan

Agreement between careHPV and hybrid capture 2 in detecting high‐risk HPV in women in Tanzania

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