OBJECTIVES: We sought to determine the clinical performance of visual inspection with acetic acid (VIA), digital cervicography (DC), Xpert human papillomavirus (HPV), and OncoE6 for cervical cancer screening in an HIV-infected population. MATERIALS AND METHODS: HIV-infected women 18 years or older were included in this cross-sectional validation study conducted in Lusaka, Zambia. The screening tests were compared against a histological gold standard. We calculated sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and odds ratios using cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) and grade 3 or worse (CIN 3+) thresholds. RESULTS: Between January and June 2015, a total of 200 women were enrolled. Fifteen percent were screen positive by VIA, 20% by DC, 47% by Xpert HPV, and 6% by OncoE6. Using a CIN 2+ threshold, the sensitivity and specificity of VIA were 48% (95% CI = 30%-67%) and 92% (95% CI = 86%-95%), respectively. Similarly, the sensitivity and specificity of DC were 59% (95% CI = 41%-76%) and 88% (95% CI = 82%-93%), respectively. The sensitivity and specificity of Xpert HPV were 88% (95% CI = 71%-97%) and 60% (95% CI = 52%-68%), respectively. Finally, the sensitivity and specificity of OncoE6 were 31% (95% CI = 16%-50%) and 99% (95% CI = 97%-100%), respectively. CONCLUSIONS: VIA and DC displayed moderate sensitivity and high specificity. Xpert HPV performed equivalently to currently approved HPV DNA tests, with high sensitivity and moderate specificity. OncoE6 displayed excellent specificity but low sensitivity. These results confirm an important role for VIA, DC, and Xpert HPV in screen-and-treat cervical cancer prevention in low- and middle-income countries, such as Zambia.
OBJECTIVES: We sought to determine the clinical performance of visual inspection with acetic acid (VIA), digital cervicography (DC), Xpert human papillomavirus (HPV), and OncoE6 for cervical cancer screening in an HIV-infected population. MATERIALS AND METHODS:HIV-infectedwomen 18 years or older were included in this cross-sectional validation study conducted in Lusaka, Zambia. The screening tests were compared against a histological gold standard. We calculated sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and odds ratios using cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) and grade 3 or worse (CIN 3+) thresholds. RESULTS: Between January and June 2015, a total of 200 women were enrolled. Fifteen percent were screen positive by VIA, 20% by DC, 47% by Xpert HPV, and 6% by OncoE6. Using a CIN 2+ threshold, the sensitivity and specificity of VIA were 48% (95% CI = 30%-67%) and 92% (95% CI = 86%-95%), respectively. Similarly, the sensitivity and specificity of DC were 59% (95% CI = 41%-76%) and 88% (95% CI = 82%-93%), respectively. The sensitivity and specificity of Xpert HPV were 88% (95% CI = 71%-97%) and 60% (95% CI = 52%-68%), respectively. Finally, the sensitivity and specificity of OncoE6 were 31% (95% CI = 16%-50%) and 99% (95% CI = 97%-100%), respectively. CONCLUSIONS: VIA and DC displayed moderate sensitivity and high specificity. Xpert HPV performed equivalently to currently approved HPV DNA tests, with high sensitivity and moderate specificity. OncoE6 displayed excellent specificity but low sensitivity. These results confirm an important role for VIA, DC, and Xpert HPV in screen-and-treat cervical cancer prevention in low- and middle-income countries, such as Zambia.
Authors: Nicole G Campos; Jane J Kim; Philip E Castle; Jesse D Ortendahl; Meredith O'Shea; Mireia Diaz; Sue J Goldie Journal: Int J Cancer Date: 2011-08-24 Impact factor: 7.396
Authors: Groesbeck P Parham; Mulindi H Mwanahamuntu; Vikrant V Sahasrabuddhe; Andrew O Westfall; Kristin E King; Carla Chibwesha; Krista S Pfaendler; Gracilia Mkumba; Victor Mudenda; Sharon Kapambwe; Sten H Vermund; Michael L Hicks; Jeffrey Sa Stringer; Benjamin H Chi Journal: HIV Ther Date: 2010
Authors: V V Sahasrabuddhe; M H Mwanahamuntu; S H Vermund; W K Huh; M D Lyon; J S A Stringer; G P Parham Journal: Br J Cancer Date: 2007-04-17 Impact factor: 7.640
Authors: Cynthia Firnhaber; Lu Mao; Simon Levin; Mark Faesen; David A Lewis; Bridgette J Goeieman; Avril J Swarts; Ntombiyenkosi Rakhombe; Pam M Michelow; Sophie Williams; Jennifer S Smith Journal: J Low Genit Tract Dis Date: 2015-01 Impact factor: 1.925
Authors: Elkanah Omenge Orang'o; Tao Liu; Astrid Christoffersen-Deb; Peter Itsura; John Oguda; Sierra Washington; David Chumba; Latha Pisharodi; Susan Cu-Uvin; Anne F Rositch Journal: AIDS Date: 2017-01-14 Impact factor: 4.177
Authors: Manuela Viviano; Pierre DeBeaudrap; Pierre-Marie Tebeu; Jovanny T Fouogue; Pierre Vassilakos; Patrick Petignat Journal: Int J Womens Health Date: 2017-02-02
Authors: Margot Kunckler; Fanny Schumacher; Bruno Kenfack; Rosa Catarino; Manuela Viviano; Eveline Tincho; Pierre-Marie Tebeu; Liliane Temogne; Pierre Vassilakos; Patrick Petignat Journal: Cancer Med Date: 2017-06-04 Impact factor: 4.452