BACKGROUND: The authors evaluated direct visual inspection of the cervix after the application of 5% acetic acid (DVI) as a cervical cancer screening test for use in low-resource settings. METHODS: Four tests were used to screen 2754 previously unscreened women: DVI with and without x4.5 magnification and differentiating between all lesions and well-circumscribed lesions; testing for high-risk types of human papillomavirus DNA using the Hybrid Capture II assay, cervical cytology, and Cervicography. Women with positive results on any of the four screening tests were referred for colposcopy and histologic sampling. All women were tested for N. gonorrhea, C. trachomatis, T. vaginalis, and human immunodeficiency virus 1. RESULTS: Histologically confirmed carcinoma was diagnosed in 21 women (0.8%), high-grade squamous intraepithelial lesions (SILs) were diagnosed in 96 women (3.5%), and low-grade SILs were diagnosed in 102 women (3.7%). The estimated sensitivity of DVI when performed without magnification for high-grade SILs was 70%, with an estimated specificity of 79%. Magnification did not significantly improve sensitivity for high-grade SILs (74% with magnification) but significantly reduced specificity (77%). Restricting the definition of a positive DVI test to a well-defined acetowhite lesion reduced sensitivity and significantly improved specificity. Infection with T. vaginalis, N. gonorrhea, and C. trachomatis did not alter sensitivity or specificity. CONCLUSIONS: This study confirmed the utility of DVI as a primary screening test. Evaluation of the clinical effectiveness of screening with this low-cost and simple test in low-resource settings is necessary. Copyright 2002 American Cancer Society.
BACKGROUND: The authors evaluated direct visual inspection of the cervix after the application of 5% acetic acid (DVI) as a cervical cancer screening test for use in low-resource settings. METHODS: Four tests were used to screen 2754 previously unscreened women: DVI with and without x4.5 magnification and differentiating between all lesions and well-circumscribed lesions; testing for high-risk types of human papillomavirus DNA using the Hybrid Capture II assay, cervical cytology, and Cervicography. Women with positive results on any of the four screening tests were referred for colposcopy and histologic sampling. All women were tested for N. gonorrhea, C. trachomatis, T. vaginalis, and human immunodeficiency virus 1. RESULTS: Histologically confirmed carcinoma was diagnosed in 21 women (0.8%), high-grade squamous intraepithelial lesions (SILs) were diagnosed in 96 women (3.5%), and low-grade SILs were diagnosed in 102 women (3.7%). The estimated sensitivity of DVI when performed without magnification for high-grade SILs was 70%, with an estimated specificity of 79%. Magnification did not significantly improve sensitivity for high-grade SILs (74% with magnification) but significantly reduced specificity (77%). Restricting the definition of a positive DVI test to a well-defined acetowhite lesion reduced sensitivity and significantly improved specificity. Infection with T. vaginalis, N. gonorrhea, and C. trachomatis did not alter sensitivity or specificity. CONCLUSIONS: This study confirmed the utility of DVI as a primary screening test. Evaluation of the clinical effectiveness of screening with this low-cost and simple test in low-resource settings is necessary. Copyright 2002 American Cancer Society.
Authors: Haripriya Vedantham; Michelle I Silver; B Kalpana; C Rekha; B P Karuna; K Vidyadhari; S Mrudula; Brigitte M Ronnett; K Vijayaraghavan; Gayatri Ramakrishna; Pavani Sowjanya; Shantha Laxmi; Keerti V Shah; Patti E Gravitt Journal: Cancer Epidemiol Biomarkers Prev Date: 2010-05 Impact factor: 4.254
Authors: Patti E Gravitt; Proma Paul; Hormuzd A Katki; Haripriya Vendantham; Gayatri Ramakrishna; Mrudula Sudula; Basany Kalpana; Brigitte M Ronnett; K Vijayaraghavan; Keerti V Shah Journal: PLoS One Date: 2010-10-28 Impact factor: 3.240
Authors: Mark C Pierce; YaoYao Guan; Mary Kate Quinn; Xun Zhang; Wen-Hua Zhang; You-Lin Qiao; Philip Castle; Rebecca Richards-Kortum Journal: Cancer Prev Res (Phila) Date: 2012-08-27
Authors: Alicia C McDonald; Lynette Denny; Chunhui Wang; Wei-Yann Tsai; Thomas C Wright; Louise Kuhn Journal: PLoS One Date: 2012-09-06 Impact factor: 3.240