title: [Human papillomavirus testing in cervical cancer screening at a public health service of Santiago, Chile].
abstract: BACKGROUND
  Molecular techniques for human papillomavirus (HPV) detection have a good performance as screening tests and could be included in cervical cancer early detection programs. We conducted a population-based trial comparing HPV detection and Papanicolaou as primary screening tests, in a public health service in Santiago, Chile.
  
  
  OBJECTIVE
  To describe the experience of implementing this new molecular test and present the main results of the study.
  
  
  METHODS
  Women aged 25 to 64 enrolled in three public health centers were invited to participate. In all women, samples were collected for Papanicolaou and HPV DNA testing, and naked-eye visual inspection of the cervix with acetic acid was performed. Women with any positive screening test were referred to the local area hospital for diagnostic confirmation with colposcopy and biopsy of suspicious lesions.
  
  
  RESULTS
  Screening results were obtained for 8265 women, of whom 931 (11.3%) were positive to any test. The prevalence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was 1.1%; nine women had invasive cervical cancer. Sensitivities for the detection of CIN2+ were 22.1% (95% confidence interval (CI) 16.4-29.2) for Papanicolaou and 92.7% (95% CI 84.4-96.8) for HPV testing; specificities were 98.9% (95% CI 98.7-99.0) and 92.0% (95% CI 91.4-92.6) respectively.
  
  
  CONCLUSIONS
  This experience showed that the implementation of a molecular test for cervical cancer screening is not a major challenge in Chile: it was well accepted by both the health team and the participants, and it may improve the effectiveness of the screening program.
authors: Solana
authors: S
authors: Terrazas
authors: Carolina
authors: C
authors: Ibáñez
authors: Marcela
authors: M
authors: Lagos
authors: Helena
authors: H
authors: Poggi
authors: Jorge
authors: J
authors: Brañes
authors: María Isabel
authors: MI
authors: Barriga
authors: Jaime
authors: J
authors: Cartagena
authors: Felipe
authors: F
authors: Núñez
authors: Francisca
authors: F
authors: González
authors: Paz
authors: P
authors: Cook
authors: Vanessa
authors: V
authors: Van De Wyngard
authors: Catterina
authors: C
authors: Ferreccio
mesh_terms: D000328:Adult; D052685:Alphapapillomavirus / Q000235:genetics / Q000302:isolation & purification*; D002677:Chile; D004279:DNA, Viral / Q000302:isolation & purification; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D065006:Papanicolaou Test; D011634:Public Health; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control* / Q000821:virology; D014626:Vaginal Smears
chemical_list: D004279:DNA, Viral