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Wiley InterScience

Cytopathology

Cytopathology

Volume 17 Issue 6, Pages 348 - 352

Published Online: 27 Nov 2006

Journal compilation © 2010 Blackwell Publishing Ltd


The Official Journal of the British Society for Clinical Cytology and over 20 National affiliated Societies
British Society for Clinical Cytology (BSCC)
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Test characteristics of various screening modalities for cervical cancer: a feasibility study to develop an alternative strategy for resource-limited settings
P. Sodhani*, S. Gupta*, J. K. Sharma , A. Parashari , K. Halder*, V. Singh § and A. Sehgal
Divisions of  *Cytopathology,  Molecular Genetics,  Epidemiology and  §Clinical Research, Institute of Cytology and Preventive Oncology (ICMR), NOIDA, Uttar Pradesh, India
Correspondence to Dr P. Sodhani, 201-Mavilla Apartments, Mayur Vihar Phase I, Delhi-110091, India.
Tel: +91 120 2579471–72; Fax: +91 120 2579973;
E-mail: psodhani@yahoo.com
Copyright 2006 Blackwell Publishing Ltd
KEYWORDS
cervix • cancer • cytology • Papanicolaou smear • visual inspection • screening • cytodiagnosis • diagnosis • cytological techniques • laboratory diagnosis • cervical screening
P. Sodhani, S. Gupta, J. K. Sharma, A. Parashari, K. Halder, V. Singh and A. Sehgal
Test characteristics of various screening modalities for cervical cancer: a feasibility study to develop an alternative strategy for resource-limited settings

ABSTRACT

Objective: To determine test characteristics – sensitivity, specificity, positive and negative predictive values – of different screening modalities to detect cervical precancerous and cancerous lesions in order to devise an effective alternative strategy for cervical cancer screening in resource-poor settings.

Methods: A total of 472 women presenting with nonspecific gynecologic symptoms were screened by cytology, visual inspection with acetic acid application (VIA), VIA with magnification (VIAM) and human papillomavirus (HPV)-DNA testing. Colposcopic examination was performed in all and on-site biopsy was taken if any grade I and above lesion was detected on colposcopy (230). On histopathological examination, 105 showed cervical intraepithelial neoplasia II and above lesions. Sensitivity, specificity and predictive values for each test were calculated taking colposcopy and or directed biopsy as the gold standard. Comparisons were made with cytology in order to assess the feasibility of alternative strategies in resource-poor settings.

Results: VIA was less sensitive (86.7% versus 91.4%) but more specific (90.7% versus 86.6%) than cytology at low grade squamous intraepithelial lesion (LSIL) threshold but the difference was not statistically significant (P > 0.01). HPV testing improved the sensitivity over cytology (97.1% versus 91.4%) but there was a nonsignificant loss of specificity (84.2% versus 86.6%). Results of VIAM were more or less similar to VIA.

Conclusion: VIA can be used as a mass screening tool for cervical cancer in resource-poor settings.


Accepted for publication 8 December 2005

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1365-2303.2006.00351.x About DOI

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zur HausenProfessor Harald zur Hausen is a 2008 Nobel Laureate in Medicine or Physiology. He was recognized "for his discovery of human papilloma viruses causing cervical cancer". Zur Hausen serves as Editor-in-Chief of the International Journal of Cancer and is the author of the book Infections Causing Human Cancer.

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