C A Ngelangel1, G M Limson, C P Cordero, A D Abelardo, J M Avila, M R Festin. 1. University of the Philippines Department of Health, Cervical Cancer Screening Health Operations Study Group, National Institutes of Health, Pedro Gil, Ermita, Manila, Philippines.
Abstract
OBJECTIVES: To compare the validity and acceptability of acetic-acid visualization (VIA), magnified acetic-acid visualization (VIAM), spatula+cotton swab-Papanicolaou (Pap) smear (SS), and cervical brush-Pap smear (CB) in the detection of precursor/early cervical cancer lesions. METHODS: A total of 12992 women aged between 25 and 65 years from 14 Philippine centers were randomly allocated to the four tests. The gold standard was colposcopy with biopsy for positive/suspicious cases. RESULTS:Sensitivity rates [95% confidence intervals (CIs)] were 37 (CI, 26.8-48.5), 34.1 (CI, 24.8-44.8), 14.3 (CI, 6.4-27.8), and 19.1 (CI, 9.2-34.6) for VIA, VIAM, SS, and CB, respectively. Specificity rates were 90.7 (CI, 89.6-91.7), 90.7 (CI, 89-91.1), 97.5 (CI, 96.8-98), and 97.9 (CI, 97.3-98.4), respectively. Kappa for the Pap smear (PS) within centers ranged from -0.154 to 0.783, and between centers from -0.028 to 0.364. Screeners preferred CB; screened-women preferred VIA. CONCLUSIONS: The acetic-acid visualization and VIAM methods are recommended for initial cervical cancer screening in the Philippines.
RCT Entities:
OBJECTIVES: To compare the validity and acceptability of acetic-acid visualization (VIA), magnified acetic-acid visualization (VIAM), spatula+cotton swab-Papanicolaou (Pap) smear (SS), and cervical brush-Pap smear (CB) in the detection of precursor/early cervical cancer lesions. METHODS: A total of 12992 women aged between 25 and 65 years from 14 Philippine centers were randomly allocated to the four tests. The gold standard was colposcopy with biopsy for positive/suspicious cases. RESULTS: Sensitivity rates [95% confidence intervals (CIs)] were 37 (CI, 26.8-48.5), 34.1 (CI, 24.8-44.8), 14.3 (CI, 6.4-27.8), and 19.1 (CI, 9.2-34.6) for VIA, VIAM, SS, and CB, respectively. Specificity rates were 90.7 (CI, 89.6-91.7), 90.7 (CI, 89-91.1), 97.5 (CI, 96.8-98), and 97.9 (CI, 97.3-98.4), respectively. Kappa for the Pap smear (PS) within centers ranged from -0.154 to 0.783, and between centers from -0.028 to 0.364. Screeners preferred CB; screened-women preferred VIA. CONCLUSIONS: The acetic-acid visualization and VIAM methods are recommended for initial cervical cancer screening in the Philippines.
Authors: Jessica Chubak; Carolyn M Rutter; Aruna Kamineni; Eric A Johnson; Natasha K Stout; Noel S Weiss; V Paul Doria-Rose; Chyke A Doubeni; Diana S M Buist Journal: Am J Prev Med Date: 2013-05 Impact factor: 5.043
Authors: Michael H Chung; Kevin P McKenzie; Hugo De Vuyst; Barbra A Richardson; Farzana Rana; Ritesh Pamnani; Julia W Njoroge; Evans Nyongesa-Malava; Samah R Sakr; Grace C John-Stewart; Nelly R Mugo Journal: AIDS Date: 2013-11-28 Impact factor: 4.177
Authors: Anna Melissa Guerrero; Anne Julienne Genuino; Melanie Santillan; Naiyana Praditsitthikorn; Varit Chantarastapornchit; Yot Teerawattananon; Marissa Alejandria; Jean Anne Toral Journal: BMC Public Health Date: 2015-07-30 Impact factor: 3.295