scholarly journals Performance of clinical screening algorithms comprising point-of-care HPV-DNA testing using self-collected vaginal specimens, and visual inspection of the cervix with acetic acid, for the detection of underlying high-grade squamous intraepithelial lesions in Papua New Guinea

2018 ◽  
Vol 6 ◽  
pp. 70-76 ◽  
Author(s):  
Pamela J. Toliman ◽  
John M. Kaldor ◽  
Steven G. Badman ◽  
Josephine Gabuzzi ◽  
Selina Silim ◽  
...  
Keyword(s):  
Acetic Acid ◽  
Papua New Guinea ◽  
Visual Inspection ◽  
Point Of Care ◽  
High Grade ◽  
Dna Testing ◽  
Clinical Screening ◽  
Hpv Dna ◽  
Hpv Dna Testing ◽  
Intraepithelial Lesions

Can Human Papillomavirus DNA Testing Substitute for Cytology in the Detection of High-Grade Cervical Lesions?

2004 ◽  
Vol 128 (3) ◽  
pp. 298-302
Author(s):  
Kyung-Ju Lee ◽  
Jae-Kwan Lee ◽  
Ho-Suk Saw
Keyword(s):  
Human Papillomavirus ◽  
Cervical Lesion ◽  
High Grade ◽  
Dna Testing ◽  
Cervical Lesions ◽  
Abnormal Cytology ◽  
Hpv Dna ◽  
Conventional Cytology ◽  
Hpv Dna Testing ◽  
Papillomavirus Dna

Abstract Context.—High-risk human papillomaviruses (HPVs) are causal factors of cervical carcinomas. Objective.—To evaluate the sensitivity and efficiency of HPV DNA testing in comparison with conventional cytology for detection of cervical intraepithelial neoplasia (CIN) and cancer. Design.—Both testing procedures were administered to 593 women, aged 14 to 88 years (average, 41.7 years), who were referred for abnormal cytology from January 2000 through December 2001 at Korea University Guro Hospital (Seoul, Korea). After histologic confirmation by either colposcopically directed biopsy or endocervical curettage, the efficiency of the detection methods for high-grade cervical lesion was evaluated for the following 3 data sets: HPV DNA testing, conventional cytology, and the 2 tests combined. Results.—The sensitivity, specificity, and positive predictive, and negative predictive values for the detection of CIN 2 or higher were 92.4%, 52.4%, 49.3%, and 93.2% for HPV DNA testing; 76.3%, 65.8%, 52.8%, and 84.7% for cytology; and 97.8%, 36.7%, 49.2%, and 97.3% for the combined tests. Among the 151 patients diagnosed with CIN 2 or CIN 3, 137 patients (90.7%) were HPV positive, 116 patients (76.8%) were proven to have abnormal cytology, and 147 patients (97.6%) were positive for either HPV DNA testing or cytology. The sensitivity values for HPV DNA testing and cytology were 97.9% (46/47) and 74.5% (35/47), respectively, for invasive cervical cancer detection, and the combined tests showed 100% (47/47) sensitivity. Depending on the patient's age and the grade of the cervical lesion, HPV DNA testing proved to be significantly more sensitive than cytology for the primary detection of cervical abnormalities (P < .001). Conclusion.—Human papillomavirus DNA testing for the detection of high-grade cervical lesions was more sensitive than cytology alone. In addition, the screening sensitivity can be further improved by combining cytology with HPV DNA testing. This approach is especially beneficial in detecting cancer precursors in women older than 60 years.

Human Papillomavirus DNA Testing as an Adjunct to Cytology in Cervical Screening Programs

2003 ◽  
Vol 127 (8) ◽  
pp. 959-968 ◽  
Author(s):  
Attila T. Lörincz ◽  
Ralph M. Richart
Keyword(s):  
High Grade ◽  
Dna Testing ◽  
Papanicolaou Test ◽  
Chain Reaction ◽  
Hpv Dna ◽  
Screening Programs ◽  
Hpv Dna Testing ◽  
Hybrid Capture 2 ◽  
Screening Intervals ◽  
Polymerase Chain

Abstract Our objective was to review current large studies of human papillomavirus (HPV) DNA testing as an adjunct to the Papanicolaou test for cervical cancer screening programs. We analyzed 10 large screening studies that used the Hybrid Capture 2 test and 3 studies that used the polymerase chain reaction test in a manner that enabled reliable estimates of accuracy for detecting or predicting high-grade cervical intraepithelial neoplasia (CIN). Most studies allowed comparison of HPV DNA and Papanicolaou testing and estimates of the performance of Papanicolaou and HPV DNA as combined tests. The studies were selected on the basis of a sufficient number of cases of high-grade CIN and cancer to provide meaningful statistical values. Investigators had to demonstrate the ability to generate reasonably reliable Hybrid Capture 2 or polymerase chain reaction data that were either minimally biased by nature of study design or that permitted analytical techniques for addressing issues of study bias to be applied. Studies had to provide data for the calculation of test sensitivity, specificity, predictive values, odds ratios, relative risks, confidence intervals, and other relevant measures. Final data were abstracted directly from published articles or estimated from descriptive statistics presented in the articles. In some studies, new analyses were performed from raw data supplied by the principal investigators. We concluded that HPV DNA testing was a more sensitive indicator for prevalent high-grade CIN than either conventional or liquid cytology. A combination of HPV DNA and Papanicolaou testing had almost 100% sensitivity and negative predictive value. The specificity of the combined tests was slightly lower than the specificity of the Papanicolaou test alone, but this decrease could potentially be offset by greater protection from neoplastic progression and cost savings available from extended screening intervals. One “double-negative” HPV DNA and Papanicolaou test indicated better prognostic assurance against risk of future CIN 3 than 3 subsequent negative conventional Papanicolaou tests and may safely allow 3-year screening intervals for such low-risk women.

Role of HPV DNA testing in predicting cervical intraepithelial lesions: Comparison of HC HPV and ISH HPV

2003 ◽  
Vol 29 (3) ◽  
pp. 149-155 ◽  
Author(s):  
M. Nasar Qureshi ◽  
Raoul D. Rudelli ◽  
Raymond R. Tubbs ◽  
Charles V. Biscotti ◽  
Lester J. Layfield
Keyword(s):  
Dna Testing ◽  
Hpv Dna ◽  
Hpv Dna Testing ◽  
Cervical Intraepithelial Lesions ◽  
Intraepithelial Lesions

scholarly journals Visual inspection with acetic acid for detection of high grade lesion in atypical squamous cells and low grade squamous intraepithelial lesions from cervical Pap smear

2011 ◽  
Vol 22 (3) ◽  
pp. 145 ◽  
Author(s):  
Methasinee Pothisuwan ◽  
Kamol Pataradool ◽  
Siriwan Tangjitgamol ◽  
Sunamchok Srijaipracharoen ◽  
Sumonmal Manusirivithaya ◽  
...  
Keyword(s):  
Acetic Acid ◽  
Visual Inspection ◽  
Pap Smear ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Squamous Cells ◽  
High Grade Lesion ◽  
Intraepithelial Lesions

Findings to Date From the ASCUS-LSIL Triage Study (ALTS)

2003 ◽  
Vol 127 (8) ◽  
pp. 946-949 ◽  
Author(s):  
Mark Schiffman ◽  
Diane Solomon
Keyword(s):  
Intraepithelial Neoplasia ◽  
The United States ◽  
Alternative Methods ◽  
Low Grade ◽  
High Grade ◽  
Dna Testing ◽  
Squamous Intraepithelial Lesion ◽  
Hpv Dna ◽  
Hpv Dna Testing ◽  
Intraepithelial Lesion

Abstract Controversy exists in the United States regarding the proper evaluation and management of low-grade squamous intraepithelial lesion (LSIL) and equivocal (atypical squamous cells of undetermined significance [ASCUS, now ASC-US]) cervical cytologic interpretations. To address this issue, the National Cancer Institute initiated the ASCUS-LSIL Triage Study (ALTS). ALTS is a multicenter, randomized clinical trial designed to evaluate 3 alternative methods of management, namely, immediate colposcopy, cytologic follow-up, and triage by human papillomavirus (HPV) DNA testing. This article summarizes the major findings of ALTS that have been published to date. Patients with ASCUS (n = 3488) or LSIL (n = 1572) were randomly assigned to research arms between November 1996 and December 1998, and were monitored for 2 years. The disease outcome was histologic cervical intraepithelial neoplasia (CIN) 3/cancer. The prevalence of oncogenic HPV was too high to permit effective triage of LSIL using HPV DNA testing by Hybrid Capture 2. However, for the women referred with a cytologic interpretation of ASCUS, HPV triage proved useful, with sensitivity equivalent to immediate colposcopy and a halving of colposcopic referrals. Among older women with ASCUS, HPV testing remained sensitive for detecting CIN 3 and cancer, but the referral percentage was dramatically lower compared to younger women. ALTS yielded insight into the performance of cytology and histopathology; experienced pathologists differed significantly in their interpretations of cervical abnormalities, especially histologic CIN 1 and cytologic ASCUS. Nonetheless, it was possible to distinguish a relatively uncommon type of ASCUS, equivocal for high-grade squamous intraepithelial lesion, that has a high positive predictive value for identifying women with underlying high-grade CIN. Many additional analyses are underway.

Performance of p16INK4a-cytology, HPV mRNA, and HPV DNA testing to identify high grade cervical dysplasia in women with abnormal screening results

2010 ◽  
Vol 119 (1) ◽  
pp. 98-105 ◽  
Author(s):  
Miriam Reuschenbach ◽  
Andreas Clad ◽  
Christina von Knebel Doeberitz ◽  
Nicolas Wentzensen ◽  
Janina Rahmsdorf ◽  
...  
Keyword(s):  
Cervical Dysplasia ◽  
High Grade ◽  
Dna Testing ◽  
Hpv Dna ◽  
Hpv Dna Testing ◽  
Hpv Mrna
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