RT info:eu-repo/semantics/article
T1 Impact of knowledge of human papillomavirus positivity on cervical cytology performance in Latin America
A1 Ramírez, Arianis Tatiana
A1 Mesher, David
A1 Baena, Armando
A1 Salgado, Yuli
A1 Kasamatsu, Elena Satiko
A1 Cristaldo, Carmen
A1 Álvarez, Rodrigo
A1 Rojas, Freddy David
A1 Ramírez, Katherine
A1 Guyot, Julieta
A1 Henríquez, Odessa
A1 González Palma, Hans
A1 Flores, Bettsy
A1 Peñaranda, Jhaquelin
A1 Vero, María José
A1 Robinson, Isabel
A1 Rol, Mary Luz
A1 Rodríguez, Guillermo
A1 Terán, Carolina
A1 Ferrera, Annabelle
A1 Picconi, María Alejandra
A1 Calderón, Alejandro
A1 Mendoza Torres, Laura Patricia
A1 Wiesner, Carolina
A1 Almonte, Maribel Fatima
A1 Herrero, Rolando
A1 ESTAMPA Study Group
A2 Universidad Nacional de Asunción. Instituto de Investigaciones en Ciencias de la Salud
AB Background: Cervical cytology is recommended by the World Health Organization as a triage option in human papillomavirus (HPV)- based cervical cancer screening programs. We assessed the performance of cytology to detect CIN3þ without and with knowledge of HPV positivity. Methods: Women were screened with cytology and HPV across ESTAMPA study centers in Latin America. Screen-positives were referred to colposcopy with biopsy and treatment as needed. Cytology was initially interpreted without knowing HPV results. A subset of cytologies from HPV-positive women were reinterpreted at the same laboratories, with knowledge of HPV status, blinded to previous cytology and histological diagnosis. Performance indicators for cytology to detect CIN3þ without and with knowledge of HPV positivity were estimated. Findings: A total of 4087 women were included, of which 490 had histologically confirmed CIN3þ (455 CIN3 and 35 cancers). Cytology sensitivity without knowledge of HPV positivity for CIN3þ was 47.2% (95% CI ¼ 42.5 to 51.9), whereas with knowledge of HPV positivity, the sensitivity was higher (58.9%, 95% CI ¼ 54.2 to 63.5; P<.0001). The specificity without knowledge of HPV was 89.4% (95% CI ¼ 88.2 to 90.5), whereas with knowledge of HPV positivity was 78.9% (95% CI ¼ 77.4 to 80.4; P<.0001). Performance estimates varied by study center for cytology without knowing the HPV positivity (range ¼ 32.8%-61.5% for sensitivity; range ¼ 80.7%-98.6% for specificity). Similarly, performance varied with knowledge of HPV positivity (36.1%-93.4% for sensitivity; 39.6%-98.6% for specificity). Conclusion: The increase in sensitivity of cytology with HPV knowledge was limited and highly variable, reinforcing the need for alternative triage methods to support cervical cancer elimination goals.
PB Oxford University Press
SN 0027-8874
YR 2024
FD 2024-11-12
LK http://hdl.handle.net/20.500.14066/4496
UL http://hdl.handle.net/20.500.14066/4496
LA eng
NO Ramírez, A. T., Mesher, D., Baena, A., Salgado, Y., Kasamatsu, E., Cristaldo, C., Álvarez, R., Rojas, F. D., Ramírez, K., Guyot, J., Henríquez, O., González Palma, H., Flores, B., Peñaranda, J., Vero, M. J., Robinson, I., Rol, M. L., Rodríguez, G., Terán, C., … Herrero, R. (2024). Impact of knowledge of HPV positivity on cervical cytology performance in latin america. Journal of the National Cancer Institute, Artículo djae283. https://doi.org/10.1093/jnci/djae283
NO Corresponding author: Arianis Tatiana Ramírez, Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, 25 avenue TonyGarnier, 69007 Lyon, France (ramirezt@iarc.who.int).
NO Consejo Nacional de Ciencia y Tecnología
DS MINDS@UW
RD 22-ene-2025