Poor compliance for screening, diagnosis and treatment due to multiple visits involved is perceived as the single most major barrier for effective cervical cancer programs in resource constrained countries already facing challenges for implementation due to absence of reliable health infrastructure for cytology and HPV testing programs.
Objective: Study was performed to evaluate the efficacy of diagnostic triage by colposcopy compared to conventional cytology and HPV DNA testing in Visual Inspection with 5% Acetic Acid(VIA) based primary screening programs
257 VIA positive women were offered diagnostic triage with Colposcopy, Conventional cytology and HPV DNA testing. Test characteristics and their 95% confidence intervals were compared with that of conventional cytology and HPV DNA test against the reference standard of histopathology. py compared to conventional cytology and HPV DNA testing in Visual Inspection with 5% Acetic Acid(VIA) based primary screening programs
The sensitivity of diagnostic colposcopy, cytology and HPV DNA by Hybrid Capture II was 0.69(95% CI: 0.41 - 0.89), 0.44(95% CI: 0.20 - 0.70) and 0.69(95% CI: 0.41 - 0.89) respectively and that of specificity was 0.76(95% CI: 0.70 - 0.81), 0.97(95% CI: 0.94 - 0.99) and 0.83(95% CI: 0.78 - 0.88) respectively. Colposcopy and HPV DNA had similar false negative rate (FNR) [0.31(95% CI: 0.11 - 0.59)].
Diagnostic triage for VIA positive women by colposcopy was comparable to HPV DNA testing and was more sensitive than conventional cytology. In settings with limitations in establishing diagnostic cytology and molecular facilities and also difficulty in accessing health-care facilities triage by colposcopy should be considered as a possible alternative.
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