Screening strategies of cervical cancer high-risk region compared.

2004 FEB 5 - (NewsRx.com & NewsRx.net) -- Highly accurate screening for cervical cancer and cervical intraepithelial neoplasia grade 3 (CIN 3) is now technically feasible, but the remaining vital issue is to extend improved cervical cancer prevention programs to resource-poor regions.

"According to a study from the United States, "Increased understanding of human papillomavirus (HPV) infection as the central cause of cervical cancer has permitted the development of improved screening techniques. To evaluate their usefulness, we evaluated the performance of multiple screening methods concurrently in a large population-based cohort of >8500 nonvirginal women without hysterectomies, whom we followed prospectively in a high-risk region of Latin America.

"Using Youden's index as a measure of the trade-off between sensitivity and specificity, we estimated the performances of a visual screening method (cervicography), conventional cytology, liquid-based cytology (ThinPrep), and DNA testing for 13 oncogenic HPV types," wrote C. Ferreccio and colleagues, U.S. National Cancer Institute, Division of Cancer Epidemiology.

"The reference standard of disease was neoplasia greater than or equal to CIN 3, defined as histologically confirmed CIN 3 detected within 2 years of enrollment (n=90) or invasive cancer detected within 7 years (n=20). We analyzed each technique alone and in paired combinations (n=112 possible strategies), and evaluated the significance of differences between strategies using a paired Z test that equally weighted sensitivity and specificity," the ...