Human papillomavirus testing as an optional screening tool in low-resource settings of Latin America: experience from the Latin American Screening study.
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.
Longatto-Filho
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Pathology Division of Adolfo Lutz Institute, São Paulo, Brazil. longatto16@hotmail.com
Erzen
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Branca
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Roteli-Martins
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Naud
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Derchain
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Hammes
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Sarian
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Bragança
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Matos
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Gontijo
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Lima
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Maeda
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Tatti
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Syrjänen
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Dores
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Lörincz
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Syrjänen
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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*