1. Performance of cervical cancer screening and triage strategies among women living with HIV in China
- Author
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Liuye Huang, Le Li, Aihui Wu, Xiaoqian Xu, Hongyun Zhang, Xuelian Zhao, Rufei Duan, Fang-Hui Zhao, and You-Lin Qiao
- Subjects
Adult ,China ,Cancer Research ,medicine.medical_specialty ,cervical cancer ,Uterine Cervical Neoplasms ,HIV Infections ,Acquired immunodeficiency syndrome (AIDS) ,Cytology ,Biopsy ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Genotyping ,Research Articles ,Early Detection of Cancer ,RC254-282 ,Colposcopy ,Cervical cancer ,medicine.diagnostic_test ,business.industry ,Obstetrics ,screening ,virus diseases ,HIV ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Middle Aged ,medicine.disease ,Triage ,female genital diseases and pregnancy complications ,Oncology ,Female ,business ,triage ,Cancer Prevention ,Ascus ,performance ,Research Article - Abstract
Objectives To evaluate the clinical performance of liquid‐based cytology (LBC), HPV tests and visual inspections with acetic acid or Lugol's iodine (VIA/VILI) as primary screening and triage strategies among Chinese women living with HIV (WLHIV). Methods WLHIV aged 18 years and older were recruited from HIV/AIDS treatment clinic in Yunnan, China from 2019 to 2020. Women were screened with self‐ and physician‐sampling for HPV tests, LBC, and VIA/VILI. Women positive for any HPV or with cytological abnormalities were recalled for colposcopy examination and biopsy when necessary. Clinical performance of primary and triage strategies for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was evaluated. Results For primary screening, sensitivity of physician‐HPV tests was 100%, 89.5%, and 100% for hybrid capture 2 (HC2), cobas, and Sansure HPV, and specificity was 80.4%, 85.1%, and 72.0%, respectively. Self‐HPV test achieved considerable performance with physician‐HPV. Sensitivity and specificity were 61.1% and 96.3% for LBC (atypical squamous cells of undetermined significance or worse [ASCUS+]), 40.0% and 77.3% for VIA/VILI. For triaging HPV‐positive women, LBC (ASCUS+), HPV‐16/18 genotyping, and VIA/VILI‐elevated specificity with sensitivity declined 30%–50% compared with HPV screening alone. Restricted HPV genotyping triage (HPV‐16/18/31/33/45/52/58) demonstrated the optimal accuracy (89.5% sensitivity, 81.9% specificity), and was similar to HPV‐16/18 with reflex LBC (ASCUS+). Combination antiretroviral therapies (cARTs)
- Published
- 2021