Evaluation of visual inspection with acetic acid (VIA), Lugol's iodine (VILI), cervical cytology and HPV testing as cervical screening tools in Latin America: This report refers to partial results from the LAMS (Latin AMerican Screening) study

Sarian, Luís Otávio; Derchain, Sophie; Naud, Paulo; Roteli-Martins, Cecília Maria; Longatto‐Filho, Adhemar; Tatti, Sílvio; Branca, Margherita; Erzén, Mojca; Serpa-Hammes, L; Matos, Jean Carlos de; Gontijo, Rodrigo Modesto Gadelha; Bragança, Joana Fróes; Lima, Temístocles Pacheco; Maeda, Marina Yoshiê Sakamoto; Lörincz, A; Dores, G B; Costa, Silvano; Syrjänen, Stina; Syrjänen, Kari

doi:10.1258/0969141054855328

Cited by 129 publications

(115 citation statements)

References 22 publications

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“…The results, however, are very similar to those of the LAMS study carried out in Brazil and Argentina. 14 When follow-up and referral for treatment are difficult, there is a substantial advantage of having an immediate result from screening. This, however, has to be balanced against the overtreatment that would result from offering cryotherapy (or LEEP without prior biopsy) to all women who screen positive.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the Hybrid Capture II test can be automated; the results are not subject to human judgement; they have been successfully implemented in several Latin American laboratories and have shown excellent inter-laboratory agreement. 14,[27][28][29][30][31][32][33][34][35][36] There was only one insufficient sample for testing, a remarkable achievement compared to inadequate rates for cytology (5% for LBC and 11% for CC).…”

Section: Hpv Testingmentioning

confidence: 99%

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Cervical screening by visual inspection, HPV testing, liquid‐based and conventional cytology in Amazonian Peru

Almonte

Ferreccio

Winkler

et al. 2007

Intl Journal of Cancer

110

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Cervical cancer is an important public health problem in many developing countries, where cytology screening has been ineffective. We compared four tests to identify the most appropriate for screening in countries with limited resources. Nineteen midwives screened 5,435 women with visual inspection (VIA) and collected cervical samples for HPV testing, liquid-based cytology (LBC) and conventional cytology (CC). If VIA was positive, a doctor performed magnified VIA. CC was read locally, LBC was read in Lima and HPV testing was done in London. Women with a positive screening test were offered colposcopy or cryotherapy (with biopsy). Inadequacy rates were 5% and 11% for LBC and CC respectively, and less than 0.1% for VIA and HPV. One thousand eight hundred eightyone women (84% of 2,236) accepted colposcopy/cryotherapy: 79 had carcinoma in situ or cancer (CIS1), 27 had severe-and 42 moderate-dysplasia on histology. We estimated a further 6.5 cases of CIS1 in women without a biopsy. Sensitivity for CIS1 (specificity for less than moderate dysplasia) was 41.2% (76.7%) for VIA, 95.8% (89.3%) for HPV, 80.3% (83.7%) for LBC, and 42.5% (98.7%) for CC. Sensitivities for moderate dysplasia or worse were better for VIA (54.9%) and less favourable for HPV and cytology. In this setting, VIA and CC missed the majority of high-grade disease. Overall, HPV testing performed best. VIA gives immediate results, but will require investment in regular training and supervision. Further work is needed to determine whether screened-positive women should all be treated or triaged with a more specific test. ' 2007 Wiley-Liss, Inc.Key words: Pap smear; hybrid capture; low-resource settings; clinical trial; screening Cervical cancer is the commonest female cancer, a major cause of death and an important public health problem in many developing countries. 1 Screening by routine cytology, using Papanicolaou stain (Pap), has had a major impact on cervical cancer rates in many developed countries, but not in any developing country despite its widespread use. 2-4 A number of other cervical screening tests have been proposed. Here, we wanted to identify the most appropriate test for use in developing countries with high rates of cervical cancer and limited resources.In Peru, as in most Latin American countries, cervical cancer is usually detected in an advanced incurable stage, despite widespread use of cytology screening. 5,6 Others have documented numerous problems of screening in Peru. Samples may be poorly collected, slides may be incorrectly labelled and some never reach the laboratory. Cytology results are sometimes wrongly transcribed or are not reported. 6 Cytology laboratories suffer from deficient infrastructure, inadequate training and supervision, staff shortages, lack of followup procedures and lack of internal and external quality control leading to suboptimal reading of cytology for which considerable expertise is required. This study was set up to investigate a variety of screening tests that may be more effective in such a setting.L...

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Section: Discussionmentioning

confidence: 99%

Section: Hpv Testingmentioning

confidence: 99%

Cervical screening by visual inspection, HPV testing, liquid‐based and conventional cytology in Amazonian Peru

Almonte

Ferreccio

Winkler

et al. 2007

Intl Journal of Cancer

110

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“…The screening process, along with the delays between screening, test results and ultimate treatment are major obstacles to the success of cytology-based programs in low-resource settings. Although cytology screening has been introduced in LMIC over the past 30 years, it has not resulted in the expected decreases in cervical cancer incidence and mortality similar to those observed in the HIC, primarily because of the above mentioned hurdles associated with low coverage of the target population (Dzuba et al, 2005 the CIN2 and CIN 3 (53% in HIC, and 26-65% in LMIC) (Almonte et al, 2007;Cuzick et al, 2006;Sankaranarayanan et al, 2004b;Sarian et al, 2005), repeated screening at regular intervals is necessary for the programmes to be effective. This low sensitivity in developed countries is overcome by organized periodic screening, which is not feasible with the opportunistic screening carried in low-resource setting.…”

Section: Cytologymentioning

confidence: 99%

Evidence-based Screening, Early Diagnosis and Treatment Strategy of Cervical Cancer for National Policy in Low-resource countries: Example of India

Saxena

Sauvaget

Sankaranarayanan³

2012

Asian Pacific Journal of Cancer Prevention

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“…During the last decade, alternatives to cytological screening have been evaluated in low-resource settings (Belinson et al, 2001;Ferreccio et al, 2003;De Vuyst et al, 2005;IARC, 2005;Sarian et al, 2005;Sangwa-Lugoma et al, 2006;Almonte et al, 2007;Pretorius et al, 2007;Sankaranarayanan et al, 2007). Visual inspection with acetic acid (VIA) is a low-cost option that allows the possibility of screening and treatment in one visit (Denny et al, 2005), and has been shown to significantly reduce cervical cancer mortality in a large randomised controlled trial (Sankaranarayanan et al, 2007).…”

mentioning

confidence: 99%

Different cervical cancer screening approaches in a Chinese multicentre study

Shi

Franceschi

et al. 2009

Br J Cancer

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To evaluate alternative cervical cancer screening methods, digital colposcopy and collection of cervical exfoliated cells for liquid-based cytology (LBC) and hybrid capture 2 (HC2) testing were performed among 2562 women aged 15 -59 years in three study sites in the People's Republic of China (rural Shanxi province, Shenyang city in Liaoning province and Shenzhen city in Guangdong province). Visual inspection with acetic acid (VIA) was also evaluated independently from colposcopy. A total of 74 cases of histologically confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2 þ ) were identified, and 16 CIN2 þ cases were imputed among unbiopsied women to correct for verification bias. Corrected sensitivity for CIN2 þ was 37% for VIA, 54% for colposcopy, 87% for LBC with a threshold of atypical cells of undetermined significance (LBCXASCUS), 90% for HC2, 84% for LBC using HC2 to triage ASCUS and 96% for positivity to LBCXASCUS or HC2. For VIA, sensitivity was much lower among women X40 years (12%) than those aged p39 years (50%). Specificity varied from 77% for positivity to LBCXASCUS or HC2, up to 94% for LBC using HC2 to triage ASCUS. In conclusion, LBC, HC2 and their combinations performed well, whereas VIA missed a majority of CIN2 þ , particularly in older women. Digital colposcopy performed better than VIA, but still missed nearly half of CIN2 þ in this study.

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Evaluation of visual inspection with acetic acid (VIA), Lugol's iodine (VILI), cervical cytology and HPV testing as cervical screening tools in Latin America: This report refers to partial results from the LAMS (Latin AMerican Screening) study

Cited by 129 publications

References 22 publications

Cervical screening by visual inspection, HPV testing, liquid‐based and conventional cytology in Amazonian Peru

Cervical screening by visual inspection, HPV testing, liquid‐based and conventional cytology in Amazonian Peru

Evidence-based Screening, Early Diagnosis and Treatment Strategy of Cervical Cancer for National Policy in Low-resource countries: Example of India

Different cervical cancer screening approaches in a Chinese multicentre study

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