RT info:eu-repo/semantics/article
T1 Performance of cervical cytology and HPV testing for primary cervical cancer screening in Latin America : an analysis within the ESTAMPA study
A1 Ramírez, Arianis Tatiana
A1 Valls, Joan
A1 Baena, Armando
A1 Rojas, Freddy David
A1 Ramírez, Katherine
A1 Álvarez, Rodrigo
A1 Cristaldo, Carmen
A1 Henríquez, Odessa
A1 Moreno, Adrián
A1 Colque Reynaga, Daysi
A1 González Palma, Hans
A1 Robinson, Isabel
A1 Hernández, Diana Carolina
A1 Bardales, Rosa
A1 Cardinal, Lucía
A1 Salgado, Yuly
A1 Martínez, Sandra
A1 González, Emmanuel
A1 Guillén, Diego
A1 Fleider, Laura
A1 Tatti, Silvio
A1 Villagra, Verónica
A1 Venegas, Gino
A1 Cruz Valdez, Aurelio
A1 Valencia, Marleny
A1 Rodríguez, Guillermo
A1 Terán, Carolina
A1 Picconi, María Alejandra
A1 Ferrera, Annabelle
A1 Kasamatsu, Elena Satiko
A1 Mendoza Torres, Laura Patricia
A1 Calderón, Alejandro
A1 Luciani, Silvana
A1 Broutet, Nathalie
A1 Darragh, Teresa M.
A1 Almonte, Maribel
A1 Herrero, Rolando
A2 Universidad Nacional de Asunción. Instituto de Investigaciones en Ciencias de la Salud
AB Background. Cervical cytology remains widely used as the initial tool in cervical cancer screening worldwide. WHO guidelines recommend replacing cytology with primary HPV testing to reach cervical cancer elimination goals. We assessed the performance of cytology and high-risk HPV testing to detect cervical precancer, cervical intraepithelial neoplasia (CIN) grade 3 or worse (CIN3+) among women aged 30–64 years participating in the ESTAMPA study.Methods. Women were screened with cytology and HPV across ESTAMPA study centres in Latin America. Screen-positives were referred to colposcopy with biopsy collection and treatment as needed. Those with no evident precancer were recalled at 18-months for a second HPV test to complete disease ascertainment. Performance indicators for cytology and HPV to detect CIN3+ were estimated.Findings. 30,606 participants with available cytology and HPV results were included in the analysis. A total of 440 histologically confirmed CIN3s and 30 cancers were diagnosed. Cytology sensitivity for CIN3+ was 48.5% (95% CI: 44.0–53.0), whereas HPV testing had a sensitivity of 98.1% (95% CI: 96.3–96.7). Specificity was 96.5% (95% CI: 96.3–96.7) using cytology and 88.7% (95% CI: 88.3–89.0) with HPV. Performance estimates varied substantially by study centre for cytology (ranging from 32.1% to 87.5% for sensitivity and from 89.2% to 99.5% for specificity) while for HPV results were more consistent across sites (96.7%–100% and 83.6–90.8%, respectively).Interpretation. The limited and highly variable sensitivity of cytology strongly supports transition to the more robust and reproducible HPV-based cervical screening to ensure progress towards global cervical cancer elimination targets in Latin America.
PB The Lancet
YR 2023
FD 2023-09-20
LK http://hdl.handle.net/20.500.14066/4423
UL http://hdl.handle.net/20.500.14066/4423
LA eng
NO Ramírez, A. T., Valls, J., Baena, A., Rojas, F. D., Ramírez, K., Álvarez, R., Cristaldo, C., Henríquez, O., Moreno, A., Reynaga, D. C., Palma, H. G., Robinson, I., Hernández, D. C., Bardales, R., Cardinal, L., Salgado, Y., Martínez, S., González, E., Guillén, D., Fleider, L., … ESTAMPA Study Group (2023). Performance of cervical cytology and HPV testing for primary cervical cancer screening in Latin America: an analysis within the ESTAMPA study. The Lancet Regional Health Americas, 26, 100593. https://doi.org/10.1016/j.lana.2023.100593
NO Corresponding author. E-mail address: ramirezt@iarc.who.int (A.T. Ramírez).
NO Consejo Nacional de Ciencia y Tecnología
DS MINDS@UW
RD 11-jul-2024