Parallel Screening with Papanicolaou Smear and Visual Inspection Tests Significantly Reduced False Negative Screening Results in Southern Brazil

Journal Title: Journal of Advances in Medicine and Medical Research - Year 2014, Vol 4, Issue 14

Abstract

Aims: To verify the screening performance of Pap smear and four modalities of visual inspection tests (VIT) in screening for cervical intraepithelial neoplasia CIN of grade 2, 3 or carcinoma in situ, in a low risk population. Study Design: A transversal study validated above tests, both in separate and in combination, against colposcopic and histologic examination as gold standard. Place and Duration of Study: RFCC (Portuguese abbreviation for “Female network against cancer”) in Florianópolis, southern Brazil, between June 2010 and July 2012. Methodology: Among 919 women eligible for the study, 882 completed all clinical and laboratory exams. All screen-positive and a random sample of 18.5% screen-negative specimen were submitted to colposcopy and, if necessary, histologic examination. Results: The prevalence of CIN2 + in this study was 1.7%. Pap smear as the only screening test produced about 1/3 of false negative results. Among those considered normal by Pap smear, 32.1% were diagnosed as CIN1 and 17.1% as CIN2 + by histological examination. The false negative rate reduction from 6/15 for Pap smear test alone to 1/15 for its combination with VIT as a parallel test represents a 5/15 or 33.3% reduction (95% CI = 12-62%). The combination of all four VIT modalities into a parallel test also reduced the false negative fraction significantly. Conclusions: This study has shown that Pap smear alone has its sensitivity too limited to be used as the only test in screening for cervical cancer. Adding VIT as a parallel test significantly improves the screening sensitivity by reducing the false negative results to less than 7% while maintaining the false negative rate at 8%.

Authors and Affiliations

Evandro Russo, Emil Kupek

Keywords

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  • EP ID EP349387
  • DOI 10.9734/BJMMR/2014/8536
  • Views 68
  • Downloads 0

How To Cite

Evandro Russo, Emil Kupek (2014). Parallel Screening with Papanicolaou Smear and Visual Inspection Tests Significantly Reduced False Negative Screening Results in Southern Brazil. Journal of Advances in Medicine and Medical Research, 4(14), 2783-2795. https://europub.co.uk/articles/-A-349387