RT info:eu-repo/semantics/article
T1 Performance of visual inspection of the cervix with acetic acid (VIA) for triage of HPV screen-positive women : results from the ESTAMPA study
A1 Baena, Armando
A1 Mesher, David
A1 Salgado, Yuly
A1 Martínez, Sandra
A1 Villalba, Griselda Raquel
A1 Amarilla, María Luisa
A1 Salgado, Brenda
A1 Flores, Bettsy
A1 Bellido Fuentes, Yenny
A1 Álvarez Larraondo, Manuel
A1 Valls, Joan
A1 Lora, Oscar
A1 Virreira Prout, Gonzalo
A1 Figueroa, Jacqueline
A1 Turcios, Elmer
A1 Soilan, Ana María
A1 Ortega, Marina
A1 Celis, Marcela
A1 González, Mauricio
A1 Venegas, Gino
A1 Terán, Carolina
A1 Ferrera, Annabelle
A1 Mendoza Torres, Laura Patricia
A1 Kasamatsu, Elena Satiko
A1 Murillo, Raúl
A1 Wiesner, Carolina
A1 Broutet, Nathalie
A1 Luciani, Silvana
A1 Herrero, Rolando
A1 Almonte, Maribel
A1 ESTAMPA Study Group
A2 Universidad Nacional de Asunción. Instituto de Investigaciones en Ciencias de la Salud
AB VIA is recommended for triage of HPV-positive women attending cervical screening. In the multicentric ESTAMPA study, VIA performance for detection of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) among HPV-positive women was evaluated. Women aged 30-64 years were screened with HPV testing and cytology and referred to colposcopy if either test was positive. At colposcopy visit, study-trained midwives/nurses/GPs performed VIA ahead of colposcopy. VIA was considered positive if acetowhite lesions were observed in or close to the transformation zone. Ablative treatment eligibility was assessed for VIA positives. Performance indicators were estimated. Three thousand one hundred and forty-two HPV-positive women were included. Sensitivity for CIN3+ was 85.9% (95% CI 81.2-89.5) among women <50 years and, although not significant, slightly lower in women 50+ (78.0%, 95% CI 65.9-86.6). Overall specificity was 58.6% (95% CI 56.7-60.5) and was significantly higher among women 50+ (70.3%, 95% CI 66.8-73.5) compared to women <50 (54.3%, 95% CI 52.1-56.5). VIA positivity was lower among women 50+ (35.2%, 95% CI 31.9-38.6) compared to women <50 (53.2, 95% CI 51.1-55.2). Overall eligibility for ablative treatment was 74.5% and did not differ by age. VIA sensitivity, specificity, and positivity, and ablative treatment eligibility varied highly by provider (ranges: 25%-95.4%, 44.9%-94.4%, 8.2%-65.3%, 0%-98.7%, respectively). VIA sensitivity for cervical precancer detection among HPV-positive women performed by trained providers was high with an important reduction in referral rates. However, scaling-up HPV screening triaged by VIA will be challenging due to the high variability of VIA performance and providers' need for training and supervision.
PB WILEY
SN 0020-7136
YR 2022
FD 2022-11-30
LK http://hdl.handle.net/20.500.14066/4517
UL http://hdl.handle.net/20.500.14066/4517
LA eng
NO Baena, A., Mesher, D., Salgado, Y., Martínez, S., Villalba, G. R., Amarilla, M. L., Salgado, B., Flores, B., Bellido Fuentes, Y., Álvarez Larraondo, M., Valls, J., Lora, O., Virreira Prout, G., Figueroa, J., Turcios, E., Soilán, A. M., Ortega, M., Celis, M., González, M., … ESTAMPA Study Group. (2023). Performance of visual inspection of the cervix with acetic acid (VIA) for triage of HPV screen-positive women: results from the ESTAMPA study. International Journal of Cancer, 152(8), 1581–1592. https://doi.org/10.1002/ijc.34384
NO Correspondence: Armando Baena, Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon CEDEX 08, France. Email: baenaa@iarc.who.int
NO Consejo Nacional de Ciencia y Tecnología
DS MINDS@UW
RD 05-feb-2025