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Semantic Scholar Open Access 2023 62 sitasi

Performance of cervical cytology and HPV testing for primary cervical cancer screening in Latin America: an analysis within the ESTAMPA study

Arianis Tatiana Ramírez Joan Valls A. Baena Freddy David Rojas Katherine Ramírez +50 lainnya
Lihat Sumber DOI

Abstrak

Summary Background Cervical cytology remains widely used as the initial tool in cervical cancer screening worldwide. WHO guidelines recommend replacing cytology with primary HPV testing to reach cervical cancer elimination goals. We assessed the performance of cytology and high-risk HPV testing to detect cervical precancer, cervical intraepithelial neoplasia (CIN) grade 3 or worse (CIN3+) among women aged 30–64 years participating in the ESTAMPA study. Methods Women were screened with cytology and HPV across ESTAMPA study centres in Latin America. Screen-positives were referred to colposcopy with biopsy collection and treatment as needed. Those with no evident precancer were recalled at 18-months for a second HPV test to complete disease ascertainment. Performance indicators for cytology and HPV to detect CIN3+ were estimated. Findings 30,606 participants with available cytology and HPV results were included in the analysis. A total of 440 histologically confirmed CIN3s and 30 cancers were diagnosed. Cytology sensitivity for CIN3+ was 48.5% (95% CI: 44.0–53.0), whereas HPV testing had a sensitivity of 98.1% (95% CI: 96.3–96.7). Specificity was 96.5% (95% CI: 96.3–96.7) using cytology and 88.7% (95% CI: 88.3–89.0) with HPV. Performance estimates varied substantially by study centre for cytology (ranging from 32.1% to 87.5% for sensitivity and from 89.2% to 99.5% for specificity) while for HPV results were more consistent across sites (96.7%–100% and 83.6–90.8%, respectively). Interpretation The limited and highly variable sensitivity of cytology strongly supports transition to the more robust and reproducible HPV-based cervical screening to ensure progress towards global cervical cancer elimination targets in Latin America. Funding 10.13039/100008700IARC/10.13039/100004423WHO, 10.13039/100016195UNDP, HRP/10.13039/100004423WHO, NCI and local funders.

Topik & Kata Kunci

Medicine

Penulis (55)

A

Arianis Tatiana Ramírez

J

Joan Valls

A

A. Baena

F

Freddy David Rojas

K

Katherine Ramírez

R

Rodrigo Álvarez

C

Carmen Cristaldo

O

Odessa Henríquez

A

A. Moreno

D

Daysi Colque Reynaga

H

Hans González Palma

I

Isabel Robinson

D

D. C. Hernández

R

R. Bardales

L

L. Cardinal

Y

Yuly Salgado

S

Sandra Martínez

E

Emmanuel González

D

Diego Guillén

L

L. Fleider

S

S. Tatti

V

Verónica Villagra

G

Gino Venegas

A

A. Cruz-Valdez

M

M. Valencia

G

Guillermo Rodríguez

C

Carolina Terán

M

M. Picconi

A

Annabelle Ferrera

E

Elena Kasamatsu

L

L. Mendoza

A

Alejandro Calderón

S

S. Luciani

N

N. Broutet

T

T. Darragh

M

M. Almonte

R

Rolando Herrero

M

Mary-Luz Rol

E

Eric Lucas

M

M. Hernández

G

G. I. Sánchez

R

Raúl Murillo

J

J. Jeronimo

C

C. Ferreccio

M

M. I. Rodríguez

Y

Yessy Cabrera

B

Brenda Salgado

M

María Celeste Colucci

M

M. Saino

M

Margarita Rodríguez de la Peña

D

D. Fernández

L

L. García

B

B. Caserta

F

Franco Doimi

E

E. Lazcano‐Ponce

Format Sitasi

APA MLA BibTeX
Ramírez, A.T., Valls, J., Baena, A., Rojas, F.D., Ramírez, K., Álvarez, R. et al. (2023). Performance of cervical cytology and HPV testing for primary cervical cancer screening in Latin America: an analysis within the ESTAMPA study. https://doi.org/10.1016/j.lana.2023.100593

Akses Cepat

Lihat di Sumber doi.org/10.1016/j.lana.2023.100593
Informasi Jurnal
Tahun Terbit
2023
Bahasa
en
Total Sitasi
62×
Sumber Database
Semantic Scholar
DOI
10.1016/j.lana.2023.100593
Akses
Open Access ✓