Visual inspection methods for cervical cancer prevention
Visual inspection methods for cervical cancer prevention
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DOI：
10.1016/j.bpobgyn.2011.08.003
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发表时间：
2012-04-01
影响因子：
5.5
通讯作者：
Dangou, Jean-Marie
中科院分区：
文献类型：
--
作者：
Sankaranarayanan, Rengaswamy;Nessa, Ashrafun;Dangou, Jean-Marie
在资源匮乏的国家，为了预防宫颈癌，需要采用简单、成本效益高的筛查方法，因此对3-5%醋酸目视筛查进行了评估。低再现性和准确度的广泛变化反映了测试的主观性。检测宫颈上皮内瘤变2级及以上病变的敏感性、特异性、阳性预测值和阴性预测值分别为80%、92%、10%和99%。有质量保证的醋酸单次目视检查的实际灵敏度约为50%。在随机对照试验中，单轮醋酸筛查目视检查与宫颈癌发病率和宫颈上皮内瘤变2级或更严重病变频率降低25-35%相关。尽管存在种种局限性，但在资源匮乏的国家实施醋酸筛查目视检查可能为建立人力资源和基础设施提供一种务实的方法，这可能有助于在不久的将来进行备受期待的低成本、快速的人乳头瘤病毒检测。(C) 2011 Elsevier Ltd.版权所有。
The need for simple, cost-effective screening approaches for cervical cancer prevention in low-resource countries has led to the evaluation of visual screening with 3-5% acetic acid. The low reproducibility and wide variation in accuracy reflect the subjective nature of the test. Pooled sensitivity, specificity, positive and negative predictive values were 80%, 92%, 10% and 99%, respectively, for detecting cervical intraepithelial neoplasia grade 2 or worse lesions. Realistic sensitivity of a quality- assured single visual inspection with acetic acid is around 50%. A single round of visual inspection with acetic acid screening has been associated with a 25-35% reduction in cervical cancer incidence and the frequency of cervical intraepithelial neoplasia grade 2 or worse lesions in randomised-controlled trials. Despite all its limitations, implementing visual inspection with acetic acid screening in low-resource countries may provide a pragmatic approach to building up human resources and infrastructure that may facilitate the highly anticipated low-cost, rapid human papilloma virus testing in the near future. (C) 2011 Elsevier Ltd. All rights reserved.