Cervicography as an adjunctive test to visual inspection with acetic acid in cervical cancer detection screening.
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.
Bomfim-Hyppólito
S
S
Maternal and Child Health Department, Ceara Federal University, Ceara, Brazil. silviabh@secrel.com.br
Franco
E Santana
ES
Franco
R Gomes de Matos Meneses
RG
de Albuquerque
C Matos
CM
Nunes
G C
GC
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*
D019342:Acetic Acid