Comparison of pap smear, visual inspection with acetic acid, human papillomavirus DNA-PCR testing and cervicography | ICRH

Authors and affiliation: 

H. De Vuyst (ICRH-Kenya) P. Claeys (ICRH-Ghent), S. Steyaert (ICRH-Ghent) and M. Temmerman (ICRH-Ghent)S. Njiru (University of Nairobi), L. Muchiri (University of Nairobi) and J. Bwayo (University of Nairobi)P. De Sutter (University of Brussels),E. Van Marck (Antwerp University) 

Ranking: 

A1

PubMedID: 

PMID: 15847874

Published: 

International Journal of Gynecology and Obstetrics (2005) 89, 120—126

Publication Date: 

01/05/2005

Objective: To assess the test qualities of four screening methods to detect cervical intra-epithelial neoplasia in an urban African setting. Methods: Six hundred fifty three women, attending a family planning clinic in Nairobi (Kenya), underwent four concurrent screening methods: pap smear, visual inspection with acetic acid (VIA), PCR for high risk human papilloma virus (HR HPV) and cervicography. The presence of cervical intra-epithelial neoplasia (CIN) was verified by colposcopy or biopsy. Results: Sensitivity (for CIN2 or higher) and specificity (to exclude any CIN or cancer) were 83.3% (95% CI [73.6, 93.0]) and 94.6% (95% CI [92.6, 96.5]), respectively, for pap smear; 73.3% (95% CI [61.8, 84.9]) and 80.0% (95% CI [76.6, 83.4]) for VIA; 94.4% (95% CI [84.6, 98.8]) and 73.9% (95% CI [69.7, 78.2]) for HR HPV; and 72.3% (95% CI [59.1, 85.6]) and 93.2% (95% CI [90.8, 95.7]) for cervicography. Conclusions: The pap smear had the highest specificity (94.6%) and HPV testing