Systematic reviews and meta-analyses of the accuracy of HPV tests, visual inspection with acetic acid, cytology, and colposcopy

Mustafa, Reem A.; Santesso, Nancy; Khatib, Rasha; Mustafa, Ahmad; Wiercioch, Wojtek; Kehar, Rohan; Gandhi, Shreyas; Chen, Yaolong; Cheung, Adrienne; Hopkins, Jessica; Ma, Baochun; Lloyd, Nancy; Wu, Darong; Broutet, Nathalie; Schünemann, Holger J.

doi:10.1016/j.ijgo.2015.07.024

Cited by 142 publications

(151 citation statements)

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“…Canadian randomized controlled trials 11,30 , and international knowledge syntheses 10,14,25,[31][32][33] also support this shift, which has been stressed in recent editorials 6,34,35 , yet some policy-makers feel that the cytology-based programs are "good enough," echoing the World Health Organization suggestion 36 . Researcher respondents were particularly adamant that Canadian cervical cancer screening programs should shift towards primary hpv testing because the increase in sensitivity has the greatest impact on population health and health system spending, in the era of hpv vaccination 6,37 .…”

Section: Discussionmentioning

confidence: 99%

Strategies to Reach Marginalized Women for Cervical Cancer Screening: A Qualitative Study of Stakeholder Perspectives

2018

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Section: Discussionmentioning

confidence: 99%

Strategies to Reach Marginalized Women for Cervical Cancer Screening: A Qualitative Study of Stakeholder Perspectives

2018

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“…[44] Test reliability assesses the degree to which repeated measurements of the test yields the same result, and the accuracy of a test (specificity and sensitivity) is measured using cross-sectional studies with adequate sample size. Previous reviews, not focused on Indian or community-based settings, have reported sensitivity and specificity values of 79–82% and 91–92% by Sauvaget et al [42], 79–83% and 84–85% by Arbyn et al [45], 77% and 82% by Mustafa et al [46], and 71.8% and 79.4% by Sritipsukho et al [47] Compared to previous reviews, the sensitivity values reported in the included studies were lower and for specificity were in the same range when compared to previous reviews. Variation in test providers training, light source when conducting the VIA test in the field settings, and the preparation and storage of diluted acetic acid have previously been reported as possible explanations for wide variations in sensitivity and specificity for VIA conducted in community-based settings.…”

Section: Discussionmentioning

confidence: 99%

Implementing community-based cervical cancer screening programs using visual inspection with acetic acid in India: A systematic review

Adsul

Manjunath

Srinivas

et al. 2017

Cancer Epidemiology

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The objective of this review was to systematically appraise the existing published literature about community-based cervical cancer screening programs that have used visual inspection methods using acetic acid (VIA) in India. All peer reviewed journal articles till December 2015 were searched per PRISMA guidelines. Articles reporting results from cervical cancer screening programs in community-based settings, conducted in India, and using VIA were included in this review. The search resulted in 20 articles to be included in the review with a total of 313,553 women at 12 unique urban and rural sites across India. Seventeen (85%) studies were cross-sectional and three studies were randomized controlled trials; most studies compared accuracy of VIA with other screening tests such as visual inspection using Lugol’s Iodine (VILI), HPV DNA, and cytology. Of studies that reported test accuracy for CIN Grade 2+, the VIA sensitivity values ranged from 16.6 – 82.6% and specificity ranged from 82.1 – 96.8%. Women between age groups of 30–59 years were recruited using motivational one-on-one counseling and local support staff. All studies conducted diagnostic follow-up using colposcopy and guided biopsies, when necessary. Three major themes were identified that facilitated implementation of screening programs in a community-based setting: standardized training that maintained competency of test providers; collaborations with community-based organizations that used health education for recruitment of participants; and employing the screen-and-treat method to reduce loss to follow-up. Summarized evidence presented in this review could substantially influence future implementation and sustainment of cervical cancer screening programs at a national level.

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“…By contrast, small differences in specificity resulted in fairly large absolute differences in overtreatment." 4 …”

Section: Test Sensitivitymentioning

confidence: 99%

Results from a Visual-Based Cervical Cancer Screening Program

Misrahi¹

2018

TMT

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Cervical cancer is the fourth most common cancer in women world-wide and the most common cancer in many low-and middle-income countries. 1 It is estimated that 84% of cervical cancer cases occur in less developed countries, where cervical cancer diagnostic screening and prevention methods are limited. To illustrate this disparity, Over time, the incidence of cervical cancer in developed markets has been reduced thanks to the use of Pap smears (Pap test) and subsequent treatments, but women living in rural areas and low-resource settings (LRS) worldwide lack access to these relatively straightforward lifesaving techniques, and the demands of the test are too complex for many low-resource countries. Based on this background, the critical role for

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Systematic reviews and meta-analyses of the accuracy of HPV tests, visual inspection with acetic acid, cytology, and colposcopy

Abstract: Although differences in sensitivity between tests could be interpreted as large, absolute differences in missed diagnoses were small. By contrast, small differences in specificity resulted in fairly large absolute differences in overtreatment.

Cited by 142 publications

References 35 publications

Strategies to Reach Marginalized Women for Cervical Cancer Screening: A Qualitative Study of Stakeholder Perspectives

Strategies to Reach Marginalized Women for Cervical Cancer Screening: A Qualitative Study of Stakeholder Perspectives

Implementing community-based cervical cancer screening programs using visual inspection with acetic acid in India: A systematic review

Results from a Visual-Based Cervical Cancer Screening Program

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