A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya
Objective To determine the optimal strategy for cervical cancer screening in women with human immunodeficiency virus (HIV) infection by comparing two strategies: visual inspection of the cervix with acetic acid (VIA) and VIA followed immediately by visual inspection with Lugol's iodine (VIA/VIL...
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| Format: | Article |
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The World Health Organization
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| Series: | Bulletin of the World Health Organization |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862014000300195&lng=en&tlng=en |
| _version_ | 1797288739191390208 |
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| author | Megan J Huchko Jennifer Sneden Hannah H Leslie Naila Abdulrahim May Maloba Elizabeth Bukusi Craig R Cohen |
| author_facet | Megan J Huchko Jennifer Sneden Hannah H Leslie Naila Abdulrahim May Maloba Elizabeth Bukusi Craig R Cohen |
| author_sort | Megan J Huchko |
| collection | DOAJ |
| description | Objective To determine the optimal strategy for cervical cancer screening in women with human immunodeficiency virus (HIV) infection by comparing two strategies: visual inspection of the cervix with acetic acid (VIA) and VIA followed immediately by visual inspection with Lugol's iodine (VIA/VILI) in women with a positive VIA result. Methods Data from a cervical cancer screening programme embedded in two HIV clinic sites in western Kenya were evaluated. Women at a central site underwent VIA, while women at a peripheral site underwent VIA/VILI. All women positive for cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) on VIA and/or VILI had a confirmatory colposcopy, with a biopsy if necessary. Overall test positivity, positive predictive value (PPV) and the CIN 2+ detection rate were calculated for the two screening methods, with biopsy being the gold standard. Findings Between October 2007 and October 2010, 2338 women were screened with VIA and 1124 with VIA/VILI. In the VIA group, 26.4% of the women tested positive for CIN 2+; in the VIA/VILI group, 21.7% tested positive (P < 0.01). Histologically confirmed CIN 2+ was detected in 8.9% and 7.8% (P = 0.27) of women in the VIA and VIA/VILI groups, respectively. The PPV of VIA for biopsy-confirmed CIN 2+ in a single round of screening was 35.2%, compared with 38.2% for VIA/VILI (P = 0.41). Conclusion The absence of any differences between VIA and VIA/VILI in detection rates or PPV for CIN 2+ suggests that VIA, an easy testing procedure, can be used alone as a cervical cancer screening strategy in low-income settings. |
| first_indexed | 2024-03-07T18:53:49Z |
| format | Article |
| id | doaj.art-edcb5923b3474ad6b10a039602b295db |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T18:53:49Z |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-edcb5923b3474ad6b10a039602b295db2024-03-02T01:01:22ZengThe World Health OrganizationBulletin of the World Health Organization0042-968692319520310.2471/BLT.13.122051S0042-96862014000300195A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in KenyaMegan J HuchkoJennifer SnedenHannah H LeslieNaila AbdulrahimMay MalobaElizabeth BukusiCraig R CohenObjective To determine the optimal strategy for cervical cancer screening in women with human immunodeficiency virus (HIV) infection by comparing two strategies: visual inspection of the cervix with acetic acid (VIA) and VIA followed immediately by visual inspection with Lugol's iodine (VIA/VILI) in women with a positive VIA result. Methods Data from a cervical cancer screening programme embedded in two HIV clinic sites in western Kenya were evaluated. Women at a central site underwent VIA, while women at a peripheral site underwent VIA/VILI. All women positive for cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) on VIA and/or VILI had a confirmatory colposcopy, with a biopsy if necessary. Overall test positivity, positive predictive value (PPV) and the CIN 2+ detection rate were calculated for the two screening methods, with biopsy being the gold standard. Findings Between October 2007 and October 2010, 2338 women were screened with VIA and 1124 with VIA/VILI. In the VIA group, 26.4% of the women tested positive for CIN 2+; in the VIA/VILI group, 21.7% tested positive (P < 0.01). Histologically confirmed CIN 2+ was detected in 8.9% and 7.8% (P = 0.27) of women in the VIA and VIA/VILI groups, respectively. The PPV of VIA for biopsy-confirmed CIN 2+ in a single round of screening was 35.2%, compared with 38.2% for VIA/VILI (P = 0.41). Conclusion The absence of any differences between VIA and VIA/VILI in detection rates or PPV for CIN 2+ suggests that VIA, an easy testing procedure, can be used alone as a cervical cancer screening strategy in low-income settings.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862014000300195&lng=en&tlng=en |
| spellingShingle | Megan J Huchko Jennifer Sneden Hannah H Leslie Naila Abdulrahim May Maloba Elizabeth Bukusi Craig R Cohen A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya Bulletin of the World Health Organization |
| title | A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya |
| title_full | A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya |
| title_fullStr | A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya |
| title_full_unstemmed | A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya |
| title_short | A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya |
| title_sort | comparison of two visual inspection methods for cervical cancer screening among hiv infected women in kenya |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862014000300195&lng=en&tlng=en |
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