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Cervical Visual Inspection with Acetic Acid (VIA) and Oncogenic Human Papillomavirus Screening in Rural Indigenous Guatemalan Women: Time to Rethink VIA

Single-visit “screen-and-treat” strategies using visual inspection with acetic acid (VIA) and cryotherapy (liquid nitrous oxide ablation) in low-resource settings are commonly used to detect and treat precancerous lesions for cervical cancer prevention. This study compared VIA sensitivity and specif...

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Autores principales: Jeffries, Anne, Beck-Sagué, Consuelo M., Marroquin-Garcia, Ariel Bernardo, Dean, Michael, McCoy, Virginia, Cordova-Toma, Diego Aurelio, Fenkl, Eric, Madhivanan, Purnima
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656883/
https://www.ncbi.nlm.nih.gov/pubmed/34886133
http://dx.doi.org/10.3390/ijerph182312406
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author Jeffries, Anne
Beck-Sagué, Consuelo M.
Marroquin-Garcia, Ariel Bernardo
Dean, Michael
McCoy, Virginia
Cordova-Toma, Diego Aurelio
Fenkl, Eric
Madhivanan, Purnima
author_facet Jeffries, Anne
Beck-Sagué, Consuelo M.
Marroquin-Garcia, Ariel Bernardo
Dean, Michael
McCoy, Virginia
Cordova-Toma, Diego Aurelio
Fenkl, Eric
Madhivanan, Purnima
author_sort Jeffries, Anne
collection PubMed
description Single-visit “screen-and-treat” strategies using visual inspection with acetic acid (VIA) and cryotherapy (liquid nitrous oxide ablation) in low-resource settings are commonly used to detect and treat precancerous lesions for cervical cancer prevention. This study compared VIA sensitivity and specificity in rural indigenous Guatemalan communities, to that of oncogenic human papillomavirus (HPV) testing for detection of precancerous changes, using cytology as the reference standard. Between 3–8 September 2017, trained nurses examined 222 women aged 23–58 years with VIA. Specimens for liquid-based cytology and HPV testing were obtained prior to VIA with a cytobrush and transported in PreservCyt to a US clinical laboratory. VIA and HPV test sensitivities were assessed as proportions of women with abnormal cytology that had abnormal VIA or HPV results, respectively, and specificities, as proportions with normal cytology with normal VIA or negative HPV tests. Of 222 women, 18 (8.1%) had abnormal cytology (1 carcinoma in a participant who received VIA-based cryotherapy in 2015, 4 high- and 5 low-grade squamous intraepithelial lesions, and 8 atypical squamous cells of undetermined significance (ASCUS)). Excluding ASCUS, sensitivities of VIA and HPV were 20.0% and 100%, respectively. VIA-based screening may not be acceptable for detecting precancerous lesions, and field cryotherapy for preventing malignancy. The World Health Organization recommended in 2021 “…using HPV DNA detection as the primary screening test rather than VIA or cytology”.
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spelling pubmed-86568832021-12-10 Cervical Visual Inspection with Acetic Acid (VIA) and Oncogenic Human Papillomavirus Screening in Rural Indigenous Guatemalan Women: Time to Rethink VIA Jeffries, Anne Beck-Sagué, Consuelo M. Marroquin-Garcia, Ariel Bernardo Dean, Michael McCoy, Virginia Cordova-Toma, Diego Aurelio Fenkl, Eric Madhivanan, Purnima Int J Environ Res Public Health Article Single-visit “screen-and-treat” strategies using visual inspection with acetic acid (VIA) and cryotherapy (liquid nitrous oxide ablation) in low-resource settings are commonly used to detect and treat precancerous lesions for cervical cancer prevention. This study compared VIA sensitivity and specificity in rural indigenous Guatemalan communities, to that of oncogenic human papillomavirus (HPV) testing for detection of precancerous changes, using cytology as the reference standard. Between 3–8 September 2017, trained nurses examined 222 women aged 23–58 years with VIA. Specimens for liquid-based cytology and HPV testing were obtained prior to VIA with a cytobrush and transported in PreservCyt to a US clinical laboratory. VIA and HPV test sensitivities were assessed as proportions of women with abnormal cytology that had abnormal VIA or HPV results, respectively, and specificities, as proportions with normal cytology with normal VIA or negative HPV tests. Of 222 women, 18 (8.1%) had abnormal cytology (1 carcinoma in a participant who received VIA-based cryotherapy in 2015, 4 high- and 5 low-grade squamous intraepithelial lesions, and 8 atypical squamous cells of undetermined significance (ASCUS)). Excluding ASCUS, sensitivities of VIA and HPV were 20.0% and 100%, respectively. VIA-based screening may not be acceptable for detecting precancerous lesions, and field cryotherapy for preventing malignancy. The World Health Organization recommended in 2021 “…using HPV DNA detection as the primary screening test rather than VIA or cytology”. MDPI 2021-11-25 /pmc/articles/PMC8656883/ /pubmed/34886133 http://dx.doi.org/10.3390/ijerph182312406 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Jeffries, Anne
Beck-Sagué, Consuelo M.
Marroquin-Garcia, Ariel Bernardo
Dean, Michael
McCoy, Virginia
Cordova-Toma, Diego Aurelio
Fenkl, Eric
Madhivanan, Purnima
Cervical Visual Inspection with Acetic Acid (VIA) and Oncogenic Human Papillomavirus Screening in Rural Indigenous Guatemalan Women: Time to Rethink VIA
title Cervical Visual Inspection with Acetic Acid (VIA) and Oncogenic Human Papillomavirus Screening in Rural Indigenous Guatemalan Women: Time to Rethink VIA
title_full Cervical Visual Inspection with Acetic Acid (VIA) and Oncogenic Human Papillomavirus Screening in Rural Indigenous Guatemalan Women: Time to Rethink VIA
title_fullStr Cervical Visual Inspection with Acetic Acid (VIA) and Oncogenic Human Papillomavirus Screening in Rural Indigenous Guatemalan Women: Time to Rethink VIA
title_full_unstemmed Cervical Visual Inspection with Acetic Acid (VIA) and Oncogenic Human Papillomavirus Screening in Rural Indigenous Guatemalan Women: Time to Rethink VIA
title_short Cervical Visual Inspection with Acetic Acid (VIA) and Oncogenic Human Papillomavirus Screening in Rural Indigenous Guatemalan Women: Time to Rethink VIA
title_sort cervical visual inspection with acetic acid (via) and oncogenic human papillomavirus screening in rural indigenous guatemalan women: time to rethink via
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656883/
https://www.ncbi.nlm.nih.gov/pubmed/34886133
http://dx.doi.org/10.3390/ijerph182312406
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