Co-Testing of Cervical Screening Tests in Detection of High Grade Cervical Intraepithelial Neoplasia
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 10
Abstract
Introduction: Co-testing performance for detection of high grade Cervical Intraepithelial Neoplasia (CIN) has not been adequately addressed from Low Resource Countries (LRCs). Where isolated tests do not have adequate performance, further explorations are recommended. Aim: To evaluate the co-testing of conventional cervical screening tests such as Papanicolaou (Pap) and Visual Inspection Cervix with Acetic Acid (VIA), with care HPV on Cervical Samples (CHPV) or on Vaginal Samples (VHPV) in the detection of high grade CIN. Materials and Methods: The cross-sectional study was conducted on ever married women of age 30 to 59 years in a rural community of Dadri. Women were screened by CHPV, VHPV, and Pap and VIA methods. Confirmation of screen positives was done by histology. Sensitivity, Specificity and likelihood ratios of different combinations of test determined to evaluate the performance. Results: Total eligible women, 66.2% (5032/7604) responded for screening. Analysis was performed on 4658, after excluding those who did not complete all screenings. Co-testing of CHPV (OR=246) or VHPV (OR=278) with Pap had highest association. Positive likelihood ratios of CHPV and VHPV with Pap in CIN II+ detection rates were 13.0 and 11.8 and in CIN III+ the detection rates were 18.0 and 16.0 respectively. Higher sensitivities and specificities were observed in co-testing for CIN III+ detection as against CIN II+ lesions. Conclusion: Choice of co-testing in a pair of tests for detection of high grade CIN is likely to depend on whether screening is targeted for developed or low resource country. VIA in isolation might not yield optimal results for LRCs.
Authors and Affiliations
Smita Asthana, Satyanarayana Labani, Pushpa Sodhani, Sanjay Gupta
Keywords
Related Articles
- EP ID EP365661
- DOI 10.7860/JCDR/2017/26260.10757
- Views 36
- Downloads 0
Iris Positioning Using a Grid Attached to a Spring Bow for a Custom Ocular Prosthesis
Eyes are among the first features of the face to be noticed. Loss of an eye due to congenital, traumatic or pathologic aetiologies causes disfigurement and loss of sensory feedback. It leaves a psychological impact on th...
A1 and A2 Sub-Types of Blood Group ‘A’: A Reflection of their Prevalence in North Karnataka Region
Introduction: Landsteiner ABO system of blood groups is most important for transfusion medicine and has subtypes of A Antigen, A1 and A2, upon which further groups of A and AB have been classified. Of individuals with A...
Review of Ayuvedic Strategies to Overcome Nidranasha and Improve Quality of Life
ABSTRACT Introduction: Insomnia is the most commonly reported sleep problem, which profoundly affects the person’s quality of life. In Ayurveda various non-pharmacological methods related with dietary modifications, phys...
Effect and Mechanisms of Medicinal Plants on Dry Eye Disease: A Systematic Review
ABSTRACT Introduction: Dry Eye Disease (DED) is one of the most common problems and reasons for referring to ophthalmology clinics, which has been exacerbated by the increased use of computers and mobile phones. Aim: The...
RPR (Red Cell Distribution Width to Platelet Ratio): As a Prognostic Marker in Acute Pancreatitis
ABSTRACT Introduction: Acute pancreatitis is an inflammatory disease of the pancreas with grade of severity ranging from very mild indolent course to severely fatal necrotising pancreatitis. Early detection of the diseas...