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Comparison of pap smear, visual inspection with acetic acid, human papillomavirus DNA‐PCR testing and cervicography
Author(s) -
De Vuyst H.,
Claeys P.,
Njiru S.,
Muchiri L.,
Steyaert S.,
De Sutter P.,
Van Marck E.,
Bwayo J.,
Temmerman M.
Publication year - 2005
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2005.01.035
Subject(s) - colposcopy , medicine , hybrid capture , cervical cancer , human papillomavirus , gynecology , biopsy , visual inspection , cervical cancer screening , cervical intraepithelial neoplasia , obstetrics , cancer , statistics , mathematics
Objective To assess the test qualities of four screening methods to detect cervical intra‐epithelial neoplasia in an urban African setting. Method Six hundred fifty‐three women, attending a family planning clinic in Nairobi (Kenya), underwent four concurrent screening methods: pap smear, visual inspection with acetic acid (VIA), PCR for high risk human papillomavirus (HR HPV) and cervicography. The presence of cervical intra‐epithelial neoplasia (CIN) was verified by colposcopy or biopsy. Result Sensitivity (for CIN2 or higher) and specificity (to exclude any CIN or cancer) were 83.3% (95% CI [73.6, 93.0]) and 94.6% (95% CI [92.6, 96.5]), respectively, for pap smear; 73.3% (95% CI [61.8, 84.9]) and 80.0% (95% CI [76.6, 83.4]) for VIA; 94.4% (95% CI [84.6, 98.8]) and 73.9% (95% CI [69.7, 78.2]) for HR HPV; and 72.3% (95% CI [59.1, 85.6]) and 93.2% (95% CI [90.8, 95.7]) for cervicography. Conclusion The pap smear had the highest specificity (94.6%) and HPV testing the highest sensitivity (94.4%). The visual methods, VIA and cervicography, were similar and showed an accuracy in between the former two tests.