title: CareHPV cervical cancer screening demonstration in a rural population of north India.
abstract: OBJECTIVE
  To compare cervical careHPV screening in a rural community setting with other methods of cervical screening for the detection of high-grade cervical intra-epithelial neoplasia (CIN).
  
  
  METHODS
  Cross-sectional study. All ever-married women aged 30-59 years surveyed in an administrative area of Uttar Pradesh, India were targeted for screening by careHPV (cervical and vaginal samples), Pap test and visual inspection of the cervix following application of acetic acid (VIA). Women who screened positive were referred for colposcopy and the results were confirmed histologically. Sensitivity, specificity and predictive values for the detection of histological CINII+ and CINIII+ were assessed for each screening test.
  
  
  RESULTS
  Sixty-five percent (5032/7704) of the women invited for cervical screening agreed to participate in the study. Screen-positive rates for cervical careHPV, vaginal careHPV, Pap test and VIA were 3%, 2%, 3% and 6%, respectively. Data for women who did not complete all screening modes, women lost to follow-up and women with missing histological results were excluded before data analysis, resulting in a final sample size of 4658. Cervical careHPV had high sensitivity (85%) for the detection of CINIII+ lesions and moderate sensitivity (53%) for the detection of CINII+ lesions. Sensitivities for the detection of CINIII+ and CINII+ were 54% and 41% for vaginal careHPV, 62% and 44% for Pap test, and 8% and 22% for VIA, respectively.
  
  
  CONCLUSIONS
  Cervical careHPV testing is superior to VIA and Pap test for the detection of high-grade CIN in a rural community setting.
authors.affiliation: Institute of Cytology and Preventive Oncology, Indian Council of Medical Research, Noida, India. Electronic address: satyanarayanalabani@yahoo.com.
authors.forename: S
authors.initials: S
authors.lastname: Labani
authors.affiliation: Institute of Cytology and Preventive Oncology, Indian Council of Medical Research, Noida, India.
authors.forename: S
authors.initials: S
authors.lastname: Asthana
authors.affiliation: Institute of Cytology and Preventive Oncology, Indian Council of Medical Research, Noida, India.
authors.forename: P
authors.initials: P
authors.lastname: Sodhani
authors.affiliation: Institute of Cytology and Preventive Oncology, Indian Council of Medical Research, Noida, India.
authors.forename: S
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Institute of Cytology and Preventive Oncology, Indian Council of Medical Research, Noida, India.
authors.forename: S
authors.initials: S
authors.lastname: Bhambhani
authors.affiliation: PATH, Seattle, WA, USA.
authors.forename: B
authors.initials: B
authors.lastname: Pooja
authors.affiliation: PATH, Seattle, WA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Lim
authors.affiliation: PATH, Seattle, WA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Jeronimo
mesh_terms: D019342:Acetic Acid; D000328:Adult; D003127:Colposcopy; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D061809:Human Papillomavirus DNA Tests / Q000379:methods*; D006801:Humans; D007194:India / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D065006:Papanicolaou Test; D011237:Predictive Value of Tests; D012424:Rural Population; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000453:epidemiology
chemical_list: D019342:Acetic Acid
keywords: CareHPV screening; Cervical cancer; Cytology; Rural community; VIA