Validation of cervical cancer screening methods in HIV positive women from Johannesburg South Africa

 

Show simple item record

dc.contributor.author Firnhaber, Cynthia en_ZA
dc.contributor.author Mayisela, Nomtha en_ZA
dc.contributor.author Mao, Lu en_ZA
dc.contributor.author Williams, Sophie en_ZA
dc.contributor.author Swarts, Avril en_ZA
dc.contributor.author Faesen, Mark en_ZA
dc.contributor.author Levin, Simon en_ZA
dc.contributor.author Michelow, Pam en_ZA
dc.contributor.author Omar, Tanvier en_ZA
dc.contributor.author Hudgens, Michael G en_ZA
dc.date.accessioned 2015-11-18T07:05:00Z
dc.date.available 2015-11-18T07:05:00Z
dc.date.issued 2013 en_ZA
dc.identifier.citation Firnhaber, C., Mayisela, N., Mao, L., Williams, S., Swarts, A., Faesen, M., ... & Smith, J. S. (2013). Validation of cervical cancer screening methods in HIV positive women from Johannesburg South Africa. PloS one, 8(1), e53494. doi:10.1371/journal.pone.0053494 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/15114
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0053494
dc.description.abstract BACKGROUND: HIV-infected women are at increased risk for developing cervical cancer. Women living in resource-limited countries are especially at risk due to poor access to cervical cancer screening and treatment. We evaluated three cervical cancer screening methods to detect cervical intraepithelial neoplasia grade 2 and above (CIN 2+) in HIV-infected women in South Africa; Pap smear, visual inspection with 5% acetic acid (VIA) and human papillomavirus detection (HPV). METHODS: HIV-infected women aged 18-65 were recruited in Johannesburg. A cross-sectional study evaluating three screening methods for the detection of the histologically-defined gold standard CIN-2 + was performed. Women were screened for cervical abnormalities with the Digene HC2 assay (HPV), Pap smear and VIA. VIA was performed by clinic nurses, digital photographs taken and then later reviewed by specialist physicians. The sensitivity, specificity and predictive valves for CIN-2 + were calculated using maximum likelihood estimators. RESULTS: 1,202 HIV-infected women participated, with a median age of 38 years and CD4 counts of 394 cells/mm 3 . One third of women had a high grade lesion on cytology. VIA and HPV were positive in 45% and 61% of women respectively. Estimated sensitivity/specificity for HPV, Pap smear and VIA for CIN 2+ was 92%/51.4%, 75.8%/83.4% and 65.4/68.5% (nurse reading), respectively. Sensitivities were similar, and specificities appeared significantly lower for the HPV test, cytology and VIA among women with CD4 counts ≤200 cells/mm 3 as compared to CD4 counts >350 cells/mm 3 . CONCLUSIONS: Although HPV was the most sensitive screening method for detecting CIN 2+, it was less specific than conventional cytology and VIA with digital imaging review. Screening programs may need to be individualized in context of the resources and capacity in each area. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other Cytology en_ZA
dc.subject.other HIV en_ZA
dc.subject.other HIV infections en_ZA
dc.subject.other Cancer screening en_ZA
dc.subject.other Nurses en_ZA
dc.subject.other Cervical cancer en_ZA
dc.subject.other Histology en_ZA
dc.subject.other Human papillomavirus en_ZA
dc.title Validation of cervical cancer screening methods in HIV positive women from Johannesburg South Africa en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2013 Firnhaber et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Division of Virology en_ZA
uct.type.filetype Text
uct.type.filetype Image


Files in this item

This item appears in the following Collection(s)

Show simple item record

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.