Colposcopic triage methods for detecting cervical intraepithelial neoplasia grade 3 after cytopathological diagnosis of low-grade squamous intraepithelial lesion: a systematic review on diagnostic tests

Corrêa, Flávia de Miranda; Russomano, Fábio Bastos; Oliveira, Caroline Alves de

doi:10.1590/s1516-31802012000100008

Cited by 9 publications

(11 citation statements)

References 19 publications

(30 reference statements)

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“…This rate is higher than that reported in a Brazilian systematic review that included three large studies showing a prevalence of high-grade intraepithelial lesion of 6–12% [17]. However, the present study is in agreement with a study performed in a colposcopy clinic in Rio de Janeiro (19.3%) [18].…”

Section: Discussionsupporting

confidence: 89%

High-Grade Cervical Lesions Among Women Attending A Reference Clinic In Brazil: Associated Factors And Comparison Among Screening Methods

et al. 2014

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BackgroundAlthough screening for cervical cancer is recommended for women in most countries, the incidence of cervical cancer is greater in developing countries. Our goal was to determine the prevalence and factors associated with high-grade lesions/cervical cancer among women attending a reference clinic in Brazil and evaluate the correlation of histology with cytology, colposcopy and the high-risk HPV (HR-HPV) tests.MethodsA cross-sectional study of women attending a colposcopy clinic was carried out. The patients were interviewed to collect demographic, epidemiological and clinical data. Specimens were collected for cervical cytology, Chlamydia trachomatis and HPV testing using the Hybrid Capture (HC) and PCR tests. Colposcopy was performed for all patients and biopsy for histology when cell abnormalities or cervical intraepithelial neoplasia (CIN) were present.ResultsA total of 291 women participated in the study. The median age was 38 years (DIQ: 30–48 years). The prevalence of histologically confirmed high-grade lesions/cervical cancer was 18.2% (95%, CI: 13.8%–22.6%), with 48 (16.5%) cases of CIN-2/CIN-3 and 5 (1.7%) cases of invasive carcinoma. In the final logistic regression model, for ages between 30 and 49 years old [OR = 4.4 (95%: 1.01–19.04), history of smoking [OR = 2.4 (95%, CI: 1.14–5.18)], practice of anal intercourse [OR = 2.4 (95%, CI: 1.10–5.03)] and having positive HC test for HR-HPV [OR = 11.23 (95%, CI: 4 0.79–26, 36)] remained independently associated with high-grade lesions/cervical cancer. A total of 64.7% of the cases CIN-3\Ca in situ were related to HPV-16. Non-oncogenic HPV were only found in CIN-1 biopsy results. Compared to histology, the sensitivity of cytology was 31.8%, the specificity 95.5%; the sensitivity of colposcopy for high-grade lesions/cervical cancer was 51.0%, specificity was 91.4% and the concordance with HPV testing was high.ConclusionsThe results confirm an association of HR-HPV with precursor lesions for cervical cancer. These data emphasize that cytological screening to detect precursor lesions is still important in some regions and that HR-HPV should be included for screening.

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Section: Discussionsupporting

confidence: 89%

High-Grade Cervical Lesions Among Women Attending A Reference Clinic In Brazil: Associated Factors And Comparison Among Screening Methods

et al. 2014

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“…All SRs were on gynecological topics: teriparatide for osteoporosis in post-menopausal women (10), lapatinib for advanced or metastasized breast cancer (11), comparative evaluation of digital mammography and film mammography (12), colposcopic triage methods for grade 3 cervical intraepithelial neoplasia (CIN3) after a cytopathological diagnosis of a low-grade squamous intraepithelial lesion (13) and risk of persistent high-grade squamous intraepithelial lesion after an electrosurgical excision with positive margins (14). Three of the reviews focused on treatment (10,11,14), and two focused on diagnosis (12,13). Three of these SRs presented meta-analyses of their results (10,13,14).…”

Section: Resultsmentioning

confidence: 99%

“…Three of the reviews focused on treatment (10,11,14), and two focused on diagnosis (12,13). Three of these SRs presented meta-analyses of their results (10,13,14). …”

Section: Resultsmentioning

confidence: 99%

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Methodological quality of systematic reviews and clinical trials on women's health published in a Brazilian evidence-based health journal

Macedo¹,

Riera²,

Torloni³

2013

Clinics

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OBJECTIVES:To assess the quality of systematic reviews and clinical trials on women's health recently published in a Brazilian evidence-based health journal.METHOD:All systematic reviews and clinical trials on women's health published in the last five years in the Brazilian Journal of Evidence-based Health were retrieved. Two independent reviewers critically assessed the methodological quality of reviews and trials using AMSTAR and the Cochrane Risk of Bias Table, respectively.RESULTS:Systematic reviews and clinical trials accounted for less than 10% of the 61 original studies on women's health published in the São Paulo Medical Journal over the last five years. All five reviews were considered to be of moderate quality; the worst domains were publication bias and the appropriate use of study quality in formulating conclusions. All three clinical trials were judged to have a high risk of bias. The participant blinding, personnel and outcome assessors and allocation concealment domains had the worst scores.CONCLUSIONS:Most of the systematic reviews and clinical trials on women's health recently published in a Brazilian evidence-based journal are of low to moderate quality. The quality of these types of studies needs improvement.

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“…8 Clinical decision making is a serious challenge because of these limitations of colposcopy-directed multiple biopsy sampling. The incidence of CIN varies greatly among different regions and countries.…”

Section: Distribution Pattern Of Cervical Intraepithelial Neoplasiamentioning

confidence: 99%

Topographical Distribution Pattern of Cervical Intraepithelial Neoplasia Across the Cervix

Hua

et al. 2012

J Int Med Res

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Colposcopic triage methods for detecting cervical intraepithelial neoplasia grade 3 after cytopathological diagnosis of low-grade squamous intraepithelial lesion: a systematic review on diagnostic tests

Abstract: Currently, there is no scientific evidence available that would prove that colposcopic triage using oncogenic HPV-DNA testing to detect CIN3 performs better than repeated cytological tests, among women with LSIL aged 35 years and over.

Cited by 9 publications

References 19 publications

High-Grade Cervical Lesions Among Women Attending A Reference Clinic In Brazil: Associated Factors And Comparison Among Screening Methods

High-Grade Cervical Lesions Among Women Attending A Reference Clinic In Brazil: Associated Factors And Comparison Among Screening Methods

Methodological quality of systematic reviews and clinical trials on women's health published in a Brazilian evidence-based health journal

Topographical Distribution Pattern of Cervical Intraepithelial Neoplasia Across the Cervix

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