Screening for cervical neoplasia in Bangladesh using visual inspection with acetic acid
Screening for cervical neoplasia in Bangladesh using visual inspection with acetic acid
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DOI：
10.1016/j.ijgo.2010.06.004
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发表时间：
2010-11-01
影响因子：
3.8
通讯作者：
Sankaranarayanan, Rengaswamy
中科院分区：
文献类型：
--
作者：
Nessa, Ashrafun;Hussain, Muhammad Anwar;Sankaranarayanan, Rengaswamy
目的：报告孟加拉国预防宫颈癌的醋酸目视检查（VIA）筛查计划的组织和早期结果。方法：由经过培训的医务人员向44个地区的医疗机构的健康妇女提供预防性VIA筛查。在Bangabandhu Sheikh Mujib医科大学（BSMMU）或医学院医院对VIA阳性妇女进行阴道镜检查和/或定向活检。报告了参加BSMMU的筛查和VIA阳性妇女的人数以及阴道镜检查、活检和宫颈上皮内瘤变（CIN）治疗的结果。结果：从2005年1月至2008年6月，104098名妇女接受了VIA筛查。其中，5013例（4.8%）女性为阳性，其中4371例（87.2%）在不同医院的阴道镜门诊就诊。在BSMMU接受阴道镜检查的2188人中，157人被诊断为CIN 2-3，123人被诊断为浸润性癌症。对于2065名女性（不包括癌症病例），VIA检测CIN 2-3病变的敏感性、特异性和阳性预测值分别为93.6%、58.3%、.和15.6%。几乎一半的CIN 2或3病变的妇女接受了治疗。结论：一个基于VIA的计划将促进宫颈肿瘤筛查、诊断和治疗的发展，并提高孟加拉国对宫颈癌预防的认识。(C)2010年国际妇产科联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
Objective: To report the organization and early results of a visual inspection with acetic acid (VIA) screening program for cervical cancer prevention in Bangladesh. Methods: Opportunistic VIA screening was offered by trained medical personnel to healthy women attending healthcare facilities in 44 districts. Colposcopy and/or directed biopsies were performed on VIA-positive women at Bangabandhu Sheikh Mujib Medical University (BSMMU) or medical college hospitals. The numbers of screened and VIA-positive women as well as the results of colposcopy, biopsy, and treatment of those with cervical intraepithelial neoplasia (CIN) attending BSMMU are reported. Results: From January, 2005, to June, 2008, 104 098 women underwent VIA screening. Among them, 5013 (4.8%) women were positive, of whom 4371 (87.2%) attended colposcopy clinics in different hospitals. Of the 2188 who underwent colposcopy at BSMMU, 157 were diagnosed with CIN 2-3 and 123 with invasive cancer. For 2065 women (excluding the cancer cases), results for sensitivity, specificity, and positive predictive value of VIA to detect CIN 2-3 lesions were 93.6%, 58.3%,. and 15.6%, respectively. Almost half the women with CIN 2 or 3 lesions had treatment. Conclusion: A VIA-based program would facilitate the development of screening, diagnosis, and treatment of cervical neoplasia and improve awareness of cervical cancer prevention in Bangladesh. (C) 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.