Is there a role for cervicography in the detection of premalignant lesions of the cervix uteri?

Coibion, Michel; Autier, Philippe; Vandam, P.; Delobelle, A; Huet, Françoise; Hertens, Dina; Vosse, Marianne; Andry, Martine; Sutter, Ph. De; Heimann, R

doi:10.1038/bjc.1994.260

Cited by 30 publications

(20 citation statements)

References 11 publications

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“…Coibion et al reported 99.1% specificity for cervicography (33), and we found 89.8% in the present study (Table IV). Among single screening methods, cervicography showed the highest sensitivity (94.3%, Table VI), which was improved significantly when combined with cervical cytology (98.1%, Table VI).…”

Section: Discussionsupporting

confidence: 75%

“…Based on recent active molecular biologic studies, many methods of classifying HPV infection and subtypes have been proposed, but the actual application of these methods is limited in actual clinical settings due to their sensitivity and specificity. The recently developed Hybrid Capture System is a non-amplified method and molecular hybridization method, which uses the chemiluminescent characteristic of DNA from smeared cervical cells, to easily determine the presence of HPV, and to distinguish the identified HPV into high-risk subtypes (HPV 16,18,31,33,35,45, 51, 52 and 56) or low-risk subtypes (HPV 6, 11, 42, 43 and 44) quantitatively (25).…”

Section: Discussionmentioning

confidence: 99%

“…Readings were carried out at the Department of Anatomy, College of Medicine, Chosun University. HPV DNA test was performed using probe B, which detects HPV intermediate-and high-risk oncogene HPV DNA types 16,18,31,33,35,45, 51, 52 and 56, using the Hybrid Capture II system (Digene Diagnostics, San Francisco, CA, USA). After inserting a sterilized speculum into the vagina, a Dacron-tipped applicator was used to smear the cervix, transformation zone and posterior fornix.…”

Section: Comparison Of Single-mentioning

confidence: 99%

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Comparison of single-, double- and triple-combined testing, including Pap test, HPV DNA test and cervicography, as screening methods for the detection of uterine cervical cancer

Kim

Park

et al. 2013

Oncology Reports

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Abstract. Cervical cancer is a serious disease that threatens the health of women worldwide. This study compared the sensitivities and false-positive rates of cervical cytology (Pap smear), human papilloma virus (HPV) DNA test, cervicography, first double-combined testing (cervical cytology and HPV DNA test), second double-combined testing (cervical cytology and cervicography) and triple-combined testing (cervical cytology, HPV DNA test and cervicography). The study included 261 patients screened for uterine cervical cancer. All women simultaneously underwent cervical cytology, HPV DNA test and cervicography for uterine cervical cancer screening and colposcopically directed biopsy for diagnostic evaluation. The triple-combined testing was consistently the most sensitive among the cervical screening tests. The second double-combined testing, with a sensitivity rate of 98.1% was more sensitive than the first double-combined test (92.3%). However, cervical cytology was most specific (93.5%) and showed the highest positive predictive value (77.8%). The sensitivity of cervical cytology was markedly improved in combination with HPV DNA test and cervicography. Thus, the triple-combined testing, which improves the high false negativity of cervical cytology, may be an effective tool in uterine cervical cancer screening, pending confirmation of the effectiveness in a mass screening study.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Comparison Of Single-mentioning

confidence: 99%

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Comparison of single-, double- and triple-combined testing, including Pap test, HPV DNA test and cervicography, as screening methods for the detection of uterine cervical cancer

Kim

Park

et al. 2013

Oncology Reports

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“…Cervicography is a technique allowing visual examination of the external part of the cervix in large series of women. During a study to evaluate the relevance of cervicography to screening (Coibion et al, 1994), we used this technique to explore how the location of the transformation zone influenced the detection of premalignant lesions of the cervix.…”

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confidence: 99%

Transformation zone location and intraepithelial neoplasia of the cervix uteri

Autier

Coibion²,

Huet³

et al. 1996

Br J Cancer

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Summary 'ee ;xamined the relationship between the frequency of premalignant lesions of the cervix and location of the transformation zone on the cervix among 8758 women as assessed using cervicography. An endo-and exocervical smear test was performed at the same time. Women with smear test classified CIN I or more were recalled and any abnormal area was biopsied under colposcopy. The transformation zone was located on the exocervix in 94% of women younger than 25 years old; as age increased, the proportion of women with a transformation zone located on the exocervix steadily decreased to reach less than 2% after 64 years old. As compared with women having a transformation zone in the endocervical canal, the age-adjusted likelihood of discovering a histologically proven dysplastic lesion was 1.8 times more frequent among women with a transformation zone located on the exocervix (95% confidence interval 1.1-2.9). This higher frequency seemed not attributable to a lower sensitivity of the smear test when the transformation zone was hidden. The results also showed that deliveries tended significantly to maintain the transformation zone on the exocervix. Parity is a known risk factor for cervix cancer, but the mechanism by which it favours malignant lesions remains unknown. Our results suggest that with increasing numbers of livebirths, the transformation zone is directly exposed for longer periods to external agents involved in dysplastic lesions.Keywords: dysplasia; parity; cervicography Most cancers of the cervix are squamous cell carcinomas originating in the transformation zone within which the junction between squamous and columnar epithelium is located. It has long been known that as age increases, the transformation zone becomes less accessible for cell sampling (Gondos et al., 1972 To explore differences in numbers of lesions detected according to the transformation zone status and to evaluate the influence of parity on the transformation zone status, we fitted logistic regression models using the GLIM software (Numerical Algorithms Group, Oxford, UK, 1977

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“…One of them is cervicography, which is popular in the USA and in some screening clinics in Europe. Although numerous groups have published results on screening with cervicography, wellconducted studies to evaluate cervicography (as compared to cytology) are rare [21]. The principal findings of these studies are that cytology and cervicography detect different pre-malignant lesions of the cervix.…”

Section: Cervical Cancermentioning

confidence: 99%

Screening

Boyle¹

2003

Eur Respir J

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Screening for cancer is currently entering a very promising period as new technologies become available for assessment. However, this great opportunity also presents significant problems, starting with how do you select the likeliest method for evaluation? How do you do trials where the technology will be out-moded by the time the result is known? Indeed, how can all promising technologies be evaluated?There is a need for a renewal of methodological thinking on this topic at present. Randomised trials, which currently rely on death as the primary outcome, are very long and very complicated to undertake and run. There is an urgent need for biological markers, which are true surrogate end-points, to help reduce sample size and make trials more feasible, so that more trials can be done.For those screening modalities of demonstrated effectiveness, the key issue at present is how to maximise the outcome in population screening when the technology is transferred from the research setting to the public health setting. It is essential to remember that screening, per se, has never prevented a cancer nor prevented a cancer death. It is impossible to separate the issues of screening with those of adequate treatment: the best results in a screening programme will come when treatment is excellent.Screening is the first, and sometimes key, stage in a global management programme for the cancer in question. As the aim at present is to strive to maximise the effectiveness of population-based programmes, this aspect should be foremost in all thought processes.

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Is there a role for cervicography in the detection of premalignant lesions of the cervix uteri?

Cited by 30 publications

References 11 publications

Comparison of single-, double- and triple-combined testing, including Pap test, HPV DNA test and cervicography, as screening methods for the detection of uterine cervical cancer

Comparison of single-, double- and triple-combined testing, including Pap test, HPV DNA test and cervicography, as screening methods for the detection of uterine cervical cancer

Transformation zone location and intraepithelial neoplasia of the cervix uteri

Screening

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