title: Human papillomavirus testing as an optional screening tool in low-resource settings of Latin America: experience from the Latin American Screening study.
abstract: Hybrid capture II (HC II) test for oncogenic human papillomaviruses (HPV) was carried out in a cohort of 4284 women at their first clinical visit. Overall prevalence of HPV was 17.1%, decreasing with age from 33.9% among women below 20 years to only 11.0% among those older than 41 years. HPV prevalence was significantly higher among current smokers (odds ratio [OR] = 1.31; 95% CI 1.1-1.6), in women with two or more lifetime sexual partners (OR = 1.9; 95% CI 1.6-2.4), and those women with two or more sexual partners during the past 12 months prior to examination (OR = 1.6; 95% CI 1.2-2.2). HPV detection increased in parallel with increasing cytologic abnormality, being highest in women with high-grade squamous intraepithelial lesion (P= 0.001). Specificity of the HPV test in detecting histologically confirmed cervical disease was 85% (95% CI 83.9-86.1). Sensitivity of the HPV test in detecting histologic abnormalities increased in parallel with disease severity, ranging from 51.5% for cervical intraepithelial neoplasia (CIN) 1 to 96.5% for CIN 3 and 100.0% for cancer, with respective decline of positive predictive value. These data suggest that HPV testing with HC II assay might be a viable screening tool among this population with relatively high prevalence of cervical disease.
authors.affiliation: Pathology Division of Adolfo Lutz Institute, São Paulo, Brazil. longatto16@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Longatto-Filho
authors.forename: M
authors.initials: M
authors.lastname: Erzen
authors.forename: M
authors.initials: M
authors.lastname: Branca
authors.forename: C
authors.initials: C
authors.lastname: Roteli-Martins
authors.forename: P
authors.initials: P
authors.lastname: Naud
authors.forename: S F M
authors.initials: SF
authors.lastname: Derchain
authors.forename: L
authors.initials: L
authors.lastname: Hammes
authors.forename: L O
authors.initials: LO
authors.lastname: Sarian
authors.forename: J F
authors.initials: JF
authors.lastname: Bragança
authors.forename: J
authors.initials: J
authors.lastname: Matos
authors.forename: R
authors.initials: R
authors.lastname: Gontijo
authors.forename: T
authors.initials: T
authors.lastname: Lima
authors.forename: M Y S
authors.initials: MY
authors.lastname: Maeda
authors.forename: S
authors.initials: S
authors.lastname: Tatti
authors.forename: S
authors.initials: S
authors.lastname: Syrjänen
authors.forename: G
authors.initials: G
authors.lastname: Dores
authors.forename: A
authors.initials: A
authors.lastname: Lörincz
authors.forename: K
authors.initials: K
authors.lastname: Syrjänen
mesh_terms: D000328:Adult; D000465:Algorithms; D003430:Cross-Sectional Studies; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D008875:Middle Aged; D018307:Neoplasms, Squamous Cell / Q000453:epidemiology / Q000821:virology*; D027383:Papillomaviridae / Q000302:isolation & purification*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology*; D014626:Vaginal Smears / Q000706:statistics & numerical data; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000821:virology*