1. Human papillomavirus testing as an optional screening tool in low-resource settings of Latin America: experience from the Latin American Screening study
- Author
-
Attila T. Lorincz, Gerson Botacini das Dores, Margherita Branca, Silvio Tatti, Mojca Eržen, M. Y.S. Maeda, Luis Otávio Sarian, Paulo Naud, Adhemar Longatto-Filho, K Syrjänen, Sophie Françoise Mauricette Derchain, Luciano Serpa Hammes, Renata Clementino Gontijo, C. Roteli-Martins, Jean Carlos de Matos, Joana Froes Bragança, S. Syrjänen, Temístocles P. Lima, and Universidade do Minho
- Subjects
resource setting ,Uterine Cervical Neoplasms ,0302 clinical medicine ,Medicine ,Mass Screening ,030212 general & internal medicine ,Prospective Studies ,Papillomaviridae ,Cervical cancer ,education.field_of_study ,Obstetrics ,Obstetrics and Gynecology ,Middle Aged ,3. Good health ,Squamous intraepithelial lesion ,Sexual Partners ,Oncology ,030220 oncology & carcinogenesis ,Cohort ,Screening ,Health Resources ,Female ,0305 other medical science ,Algorithms ,Adult ,HPV testing ,medicine.medical_specialty ,Sexual Behavior ,Population ,Cervical intraepithelial neoplasia ,low ,03 medical and health sciences ,Predictive Value of Tests ,Humans ,Screening tool ,Neoplasms, Squamous Cell ,education ,Low-resource setting ,Gynecology ,Vaginal Smears ,030505 public health ,Science & Technology ,business.industry ,Cancer ,Odds ratio ,medicine.disease ,Uterine Cervical Dysplasia ,Cross-Sectional Studies ,Latin America ,business - Abstract
Hybrid capture II (HC II) test for oncogenic human papillomaviruses (HPV) was carried out in a cohort of 4284 women at their first clinical visit. Overall prevalence of HPV was 17.1%, decreasing with age from 33.9% among women below 20 years to only 11.0% among those older than 41 years. HPV prevalence was significantly higher among current smokers (odds ratio [OR] = 1.31; 95% CI 1.1–1.6), in women with two or more lifetime sexual partners (OR = 1.9; 95% CI 1.6–2.4), and those women with two or more sexual partners during the past 12 months prior to examination (OR = 1.6; 95% CI 1.2–2.2). HPV detection increased in parallel with increasing cytologic abnormality, being highest in women with high-grade squamous intraepithelial lesion (P = 0.001). Specificity of the HPV test in detecting histologically confirmed cervical disease was 85% (95% CI 83.9–86.1). Sensitivity of the HPV test in detecting histologic abnormalities increased in parallel with disease severity, ranging from 51.5% for cervical intraepithelial neoplasia (CIN) 1 to 96.5% for CIN 3 and 100.0% for cancer, with respective decline of positive predictive value. These data suggest that HPV testing with HC II assay might be a viable screening tool among this population with relatively high prevalence of cervical disease.
- Published
- 2006