Cytology versus HPV testing for the detection of high-grade cervical lesions in women found positive on visual inspection in Mumbai, India.
OBJECTIVE
To compare the utility of cytology and HPV testing in women from Mumbai, India, suspected of having cervical intraepithelial neoplasia (CIN) on visual inspection with acetic acid (VIA), Lugol's iodine (VILI), or both.


METHODS
The sensitivity, specificity, and predictive values of these tests for the detection of CIN 2 and/or 3 were evaluated in this cross-sectional study with 756 women suspected of having CIN on visual inspection.


RESULTS
There were 25 women with CIN 2, 20 with CIN 3, and 21 with invasive cancer. The sensitivity to detect CIN 3 lesions was 85.0% (95% CI, 62.1-96.8) and 70.0% (95% CI, 45.7-88.1) for cytology testing at the ASCUS and LSIL thresholds, respectively, and it was 89.5% (95% CI, 66.9-98.7) for HPV testing. The specificity to detect CIN 3 lesions was 94.5% (95% CI, 92.5-96.1) and 96.1% (95% CI, 94.4-97.5) for cytology testing at the ASCUS and LSIL thresholds, and it was 91.1% (95% CI, 88.5-93.2) for HPV testing.


CONCLUSIONS
Cytology and HPV testing were both found to be accurate triaging methods for women suspected of having CIN on visual inspection, especially for those with CIN 3 lesions.
Pimple
Sharmila
S
Department of Preventive Oncology, Tata Memorial Hospital, Mumbai, India.
Muwonge
Richard
R
Amin
Geetanjali
G
Goswami
Smriti
S
Sankaranarayanan
Rengaswamy
R
Shastri
Surendra S
SS
D000328:Adult; D003430:Cross-Sectional Studies; D015344:DNA Probes, HPV; D005260:Female; D006801:Humans; D007194:India; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*
D015344:DNA Probes, HPV