title: Cervicography as an adjunctive test to visual inspection with acetic acid in cervical cancer detection screening.
abstract: OBJECTIVE
  Validate Digital Cervicography as adjunctive cervical cancer screening test to VIA and Cytology.
  
  
  METHODS
  Women (1292) were submitted to both cytological and VIA tests to obtain a sample of 301 positive VIA cases (23.3%) which have had the Digital Cervicography (DC) taken and evaluated. Just cases considered positive by DC (149/301 cases--49.5%) and/or positive Pap smear tests were referred to colposcopy and biopsy whenever indicated.
  
  
  RESULTS
  Cervical smear was positive in 5.4%, including LGSIL (4%), HGSIL (1%) and one case of invasive cancer (0.4%), and 1.6% of ASCUS or AGUS). DC identified 81 positive cases (74 LGSIL; 5 HGSIL; 2 cancers). The sensitivity of cytology was 14.8%, and the DC was 100%. Corresponding specificities were 95.4% and 69.1%, respectively. The NPV and PPV for DC were 100% and 54.4%.
  
  
  CONCLUSIONS
  DC increases sensitivity, specificity and positive predictive value of VIA, becoming a valid adjunctive screening test for cervical cancer in low resource settings.
authors.affiliation: Maternal and Child Health Department, Ceara Federal University, Ceara, Brazil. silviabh@secrel.com.br
authors.forename: S
authors.initials: S
authors.lastname: Bomfim-Hyppólito
authors.forename: E Santana
authors.initials: ES
authors.lastname: Franco
authors.forename: R Gomes de Matos Meneses
authors.initials: RG
authors.lastname: Franco
authors.forename: C Matos
authors.initials: CM
authors.lastname: de Albuquerque
authors.forename: G C
authors.initials: GC
authors.lastname: Nunes
mesh_terms: D019342:Acetic Acid; D000293:Adolescent; D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000166:cytology / Q000000981:diagnostic imaging*; D003127:Colposcopy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D065006:Papanicolaou Test; D010808:Physical Examination; D011237:Predictive Value of Tests; D011856:Radiographic Image Enhancement / Q000592:standards*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*
chemical_list: D019342:Acetic Acid