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Multicenter Study
. 2009 Feb 10;100(3):532-7.
doi: 10.1038/sj.bjc.6604840. Epub 2009 Jan 6.

Different cervical cancer screening approaches in a Chinese multicentre study

N Li  1 , J-F Shi, S Franceschi, W-H Zhang, M Dai, B Liu, Y-Z Zhang, L-K Li, R-F Wu, H De Vuyst, M Plummer, Y-L Qiao, G Clifford
Affiliations
Multicenter Study

Different cervical cancer screening approaches in a Chinese multicentre study

N Li et al. Br J Cancer. .

Abstract

To evaluate alternative cervical cancer screening methods, digital colposcopy and collection of cervical exfoliated cells for liquid-based cytology (LBC) and hybrid capture 2 (HC2) testing were performed among 2562 women aged 15-59 years in three study sites in the People's Republic of China (rural Shanxi province, Shenyang city in Liaoning province and Shenzhen city in Guangdong province). Visual inspection with acetic acid (VIA) was also evaluated independently from colposcopy. A total of 74 cases of histologically confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+) were identified, and 16 CIN2+ cases were imputed among unbiopsied women to correct for verification bias. Corrected sensitivity for CIN2+ was 37% for VIA, 54% for colposcopy, 87% for LBC with a threshold of atypical cells of undetermined significance (LBC>or=ASCUS), 90% for HC2, 84% for LBC using HC2 to triage ASCUS and 96% for positivity to LBC>or=ASCUS or HC2. For VIA, sensitivity was much lower among women >or=40 years (12%) than those aged <or=39 years (50%). Specificity varied from 77% for positivity to LBC>or=ASCUS or HC2, up to 94% for LBC using HC2 to triage ASCUS. In conclusion, LBC, HC2 and their combinations performed well, whereas VIA missed a majority of CIN2+, particularly in older women. Digital colposcopy performed better than VIA, but still missed nearly half of CIN2+ in this study.

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Figures

Figure 1
Figure 1
Sensitivity and specificity for different screening tests by age group. LBC⩾ASCUS=liquid-based cytology with a threshold of atypical squamous cells of undetermined significance; HC2=hybrid capture 2; VIA=visual inspection with acetic acid.
See this image and copyright information in PMC

References

    1. Almonte M, Ferreccio C, Winkler JL, Cuzick J, Tsu V, Robles S, Takahashi R, Sasieni P (2007) Cervical screening by visual inspection, HPV testing, liquid-based and conventional cytology in Amazonian Peru. Int J Cancer 121: 796–802 - PubMed
    1. Belinson J, Qiao YL, Pretorius R, Zhang WH, Elson P, Li L, Pan QJ, Fischer C, Lorincz A, Zahniser D (2001) Shanxi Province Cervical Cancer Screening Study: a cross-sectional comparative trial of multiple techniques to detect cervical neoplasia. Gynecol Oncol 83: 439–444 - PubMed
    1. Cronje HS, Cooreman BF, Beyer E, Bam RH, Middlecote BD, Divall PD (2001) Screening for cervical neoplasia in a developing country utilizing cytology, cervicography and the acetic acid test. Int J Gynaecol Obstet 72: 151–157 - PubMed
    1. Cuzick J, Clavel C, Petry KU, Meijer CJ, Hoyer H, Ratnam S, Szarewski A, Birembaut P, Kulasingam S, Sasieni P, Iftner T (2006) Overview of the European and North American studies on HPV testing in primary cervical cancer screening. Int J Cancer 119: 1095–1101 - PubMed
    1. Dai M, Bao YP, Li N, Clifford GM, Vaccarella S, Snijders PJF, Huang RD, Sun LX, Meijer CJLM, Qiao YL, Franceschi S (2006) Human papillomavirus infection in Shanxi Province, People's Republic of China: a population-based study. Br J Cancer 95: 96–101 - PMC - PubMed

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