Cervical cancer screening with naked-eye visual inspection in Colombia
Cervical cancer screening with naked-eye visual inspection in Colombia
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DOI：
10.1016/j.ijgo.2010.01.019
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发表时间：
2010-06-01
影响因子：
3.8
通讯作者：
Cendales, Ricardo
中科院分区：
文献类型：
--
作者：
Murillo, Raul;Luna, Joaquin;Cendales, Ricardo
目的：在哥伦比亚的一个低资源地区，评估护士通过结合醋酸（VIA）和卢戈碘（VILI）进行目视检查的准确性。研究方法：对4957名妇女进行了一项横断面研究，以评估视觉检查技术作为宫颈癌控制中“看和治疗”方法的基础。所有妇女接受常规细胞学检查，由护士进行VIA，以及VIA和VILI的组合。所有女性均接受阴道镜检查，并对任何阳性试验进行活检。结果如下：共有762名妇女接受了活检，4945名妇女被纳入常规细胞学分析，4957名妇女被纳入VIA和VIA-VILI分析。HSIL和LSIL细胞学的阳性率分别为1.3%和4.3%，VIA为7.4%，VIA-VILI为10.1%。LSIL和HSIL阈值的细胞学敏感性分别为52.9%和36.8%，VIA为53.6%，VIA-VILI为68.1%。特异性分别为95.0%、99.2%、93.2%、90.8%。VIA-VILI和细胞学LSIL阈值的平行组合显示了作为筛查策略的最佳性能。结论：使用VIA-VILI模拟阴道镜程序和护士提供的是一个很好的选择，在拉丁美洲实施看和治疗计划。应考虑到方案的限制。(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 assess the accuracy of visual inspection provided by nurses through combining acetic acid (VIA) and Lugol's iodine (VILI) in a low-resource region of Colombia. Methods: A cross-sectional study with 4957 women was conducted to evaluate visual inspection techniques as the basis for see-and-treat approaches in cervical cancer control. All women underwent conventional cytology, VIA performed by nurses, and a combination of VIA and VILI. All women underwent colposcopy and biopsies were obtained for any positive test. Results: A total of 762 women underwent biopsy, 4945 women were included in the analysis of conventional cytology, and 4957 were included in the analysis of VIA and VIA-VILI. Positivity rates were 1.3% and 4.3% for HSIL and LSIL cytology, 7.4% for VIA, and 10.1% for VIA-VILI. Sensitivity for cytology was 52.9% and 36.8% for LSIL and HSIL thresholds, 53.6% for VIA, and 68.1% for VIA-VILI. The corresponding specificity was 95.0%, 99.2%, 93.2%, and 90.8% respectively. The parallel combination of VIA-VILI and cytology LSIL-threshold revealed the best performance as a screening strategy. Conclusion: The use of VIA-VILI simulating colposcopic procedures and provided by nurses represents a good alternative for implementing see-andtreat programs in Latin America. Program constraints should be taken into account. (C) 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.