Performance of cervical cytology and HPV testing for primary cervical cancer screening in Latin America: an analysis within the ESTAMPA study.
Performance of cervical cytology and HPV testing for primary cervical cancer screening in Latin America: an analysis within the ESTAMPA study.
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DOI：
10.1016/j.lana.2023.100593
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发表时间：
2023-10
期刊：
影响因子：
--
通讯作者：
ESTAMPA Study Grp
中科院分区：
文献类型：
--
作者：
Ramirez, Arianis Tatiana;Valls, Joan;Baena, Armando;Rojas, Freddy David;Ramirez, Katherine;Alvarez, Rodrigo;Cristaldo, Carmen;Henriquez, Odessa;Moreno, Adrian;Reynaga, Daysi Colque;Palma, Hans Gonzalez;Robinson, Isabel;Hernandez, Diana Carolina;Bardales, Rosa;Cardinal, Lucia;Salgado, Yuly;Martinez, Sandra;Gonzalez, Emmanuel;Guillen, Diego;Fleider, Laura;Tatti, Silvio;Villagra, Veronica;Venegas, Gino;Cruz-Valdez, Aurelio;Valencia, Marleny;Rodriguez, Guillermo;Teran, Carolina;Picconi, Maria Alejandra;Ferrera, Annabelle;Kasamatsu, Elena;Mendoza, Laura;Calderon, Alejandro;Luciani, Silvana;Broutet, Nathalie;Darragh, Teresa;Almonte, Maribel;ESTAMPA Study Grp
宫颈细胞学仍然被广泛用作全球宫颈癌筛查的初始工具。世卫组织指南建议用初级HPV检测取代细胞学检查，以实现消除宫颈癌的目标。我们评估了细胞学和高危型HPV检测在检测宫颈癌前病变、宫颈上皮内瘤变(CIN)3级或更严重(CIN3+)方面的表现，这些女性年龄在30-之间。拉丁美洲的埃斯塔帕研究中心对女性进行了细胞学和HPV筛查。对筛查阳性的患者进行阴道镜检查，并根据需要进行活检和治疗。那些没有明显癌前病变的人在18个月时被召回进行第二次HPV检测，以完成疾病确定。评估细胞学和人乳头状瘤病毒检测CIN3+的性能指标。有细胞学和HPV结果的30,606名参与者被纳入分析。共有440例经组织学证实的CIN3和30例癌症被诊断出来。细胞学对CIN3+的敏感性为48.5%(95%CI：44.0~53.0)，而HPV检测的敏感性为98.1%(95%CI：96.3~96.7)。细胞学诊断特异度为96.5%(95%CI：96.3~96.7)，HPV特异度为88.7%(95%CI：88.3~89.0)。不同的细胞学研究中心的表现估计有很大的不同(敏感性从32.1%到87.5%，特异性从89.2%到99.5%)，而HPV的结果在不同的地点更一致(分别为96.7%-100%和83.6-90.8%)。细胞学有限且高度可变的敏感性有力地支持向更强大和更可重复性的基于HPV的宫颈筛查过渡，以确保在拉丁美洲实现全球消除宫颈癌的目标取得进展。/、、/、NCI和当地资助者。
Cervical cytology remains widely used as the initial tool in cervical cancer screening worldwide. WHO guidelines recommend replacing cytology with primary HPV testing to reach cervical cancer elimination goals. We assessed the performance of cytology and high-risk HPV testing to detect cervical precancer, cervical intraepithelial neoplasia (CIN) grade 3 or worse (CIN3+) among women aged 30–64 years participating in the ESTAMPA study. Women were screened with cytology and HPV across ESTAMPA study centres in Latin America. Screen-positives were referred to colposcopy with biopsy collection and treatment as needed. Those with no evident precancer were recalled at 18-months for a second HPV test to complete disease ascertainment. Performance indicators for cytology and HPV to detect CIN3+ were estimated. 30,606 participants with available cytology and HPV results were included in the analysis. A total of 440 histologically confirmed CIN3s and 30 cancers were diagnosed. Cytology sensitivity for CIN3+ was 48.5% (95% CI: 44.0–53.0), whereas HPV testing had a sensitivity of 98.1% (95% CI: 96.3–96.7). Specificity was 96.5% (95% CI: 96.3–96.7) using cytology and 88.7% (95% CI: 88.3–89.0) with HPV. Performance estimates varied substantially by study centre for cytology (ranging from 32.1% to 87.5% for sensitivity and from 89.2% to 99.5% for specificity) while for HPV results were more consistent across sites (96.7%–100% and 83.6–90.8%, respectively). The limited and highly variable sensitivity of cytology strongly supports transition to the more robust and reproducible HPV-based cervical screening to ensure progress towards global cervical cancer elimination targets in Latin America. /, , /, NCI and local funders.
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影响因子：
3.7
作者：
Darragh, Teresa M.;Colgan, Terence J.;Wilbur, David C.
通讯作者：
Wilbur, David C.
影响因子：
105.7
作者：
Dijkstra, Maaike G.;van Zummeren, Marjolein;Berkhof, Johannes
通讯作者：
Berkhof, Johannes
DOI：
10.1590/s0036-36342002000500007
发表时间：
2002-09-01
期刊：
Salud Pública de México
影响因子：
--
作者：
Flisser, Ana;García-Malo, Felipe;de la Fuente, Juan Ramón
通讯作者：
de la Fuente, Juan Ramón
影响因子：
120.7
作者：
Stoler, MH;Schiffman, M
通讯作者：
Schiffman, M
影响因子：
2.9
作者：
Almonte, Maribel;Murillo, Raul;Herrero, Rolando
通讯作者：
Herrero, Rolando