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

H. De Vuyst, P. Claeys, S. Njiru, L. Muchiri, S. Steyaert, P. De Sutter, E. Van Marck, J. Bwayo, M. Temmerman

Research output: Contribution to journalArticlepeer-review

75 Citations (Scopus)

Abstract

Objective: To assess the test qualities of four screening methods to detect cervical intra-epithelial neoplasia in an urban African setting. Method: 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 papillomavirus (HR HPV) and cervicography. The presence of cervical intra-epithelial neoplasia (CIN) was verified by colposcopy or biopsy. Result: 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. Conclusion: The pap smear had the highest specificity (94.6%) and HPV testing the highest sensitivity (94.4%). The visual methods, VIA and cervicography, were similar and showed an accuracy in between the former two tests.

Original languageEnglish
Pages (from-to)120-126
Number of pages7
JournalInternational Journal of Gynecology and Obstetrics
Volume89
Issue number2
DOIs
Publication statusPublished - May 2005
Externally publishedYes

Keywords

  • Cervical neoplasia screening
  • Cervicography
  • Human papillomavirus testing
  • Papanicolaou smear
  • Visual inspection with acetic acid

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