Accuracy of visual cervical screening: verification bias revisited

Wentzensen, Nicolas; Litwin, Tamara R.

doi:10.1111/1471-0528.14797

Cited by 5 publications

(6 citation statements)

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“…Hence, it is possible that both sensitivity and specificity of visual inspection were overestimated. 15 A pooled analysis of individual data from 17 studies in China demonstrated that the sensitivity and specificity of VIA for CIN2+ detection were 48.0% and 90.4%, respectively, 13 which decreased reference standard misclassification by requiring several screening tests to be negative and using four-quadrant punch biopsy when no colposcopically suspect lesions were seen. A screening study in Cameroonian peri-urban areas also showed the sensitivity of VIA to be less than 36.4%.…”

Section: Discussionmentioning

confidence: 99%

Implementation of visual inspection with acetic acid and Lugol's iodine for cervical cancer screening in rural China

Zhao

et al. 2022

Intl J Gynecology & Obste

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Objective: To address the value of visual inspection where HPV-based screening is not yet available, we evaluated the real-world effectiveness of visual inspection with acetic acid (VIA) and with Lugol's iodine (VILI) as a primary screening method for cervical cancer in rural China. Methods: A total of 206 133 women aged 30-59 years received two rounds of VIA/ VILI screening for cervical cancer in 2006-2010. Women with positive screening results underwent colposcopy and direct biopsy, and were treated if cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was diagnosed. Clinical effectiveness of VIA/VILI was evaluated by process and outcome measures. Results:The VIA/VILI positivity rate, biopsy rate and detection rate of CIN2+ in the second round were significantly lower than in the first round. The 2-year cumulative detection rate of CIN2+ varied from 0.53% to 0.90% among the four cohorts initiated in 2006, 2007, 2008, and 2009. The first round of screening detected 60%-83% of CIN2, 70%-86% of CIN3, and 88%-100% of cervical cancer. Over 92% of CIN2+ were found at the early stage. Conclusion:Multiple rounds of visual inspection with continuous training and quality assurance could act as a temporary substitutional screening method for cervical cancer in resource-restricted settings.

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Section: Discussionmentioning

confidence: 99%

Implementation of visual inspection with acetic acid and Lugol's iodine for cervical cancer screening in rural China

Zhao

et al. 2022

Intl J Gynecology & Obste

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“…Pemeriksaan dengan inspeksi visual dengan asam asetat (VIA) (Pinder et al, 2020), diikuti dengan pengobatan segera pada perempuan IVA-positif (pendekatan skrining dan pengobatan) dapat mengurangi jumlah kunjungan klinik dan secara signifikan meningkatkan kepatuhan pengobatan (Basu et al, 2018;Maza et al, 2017;WHO, 2013). Program skrining dengan IVA telah terbukti berhasil untuk mendiagnosis positif dan pengobatan lebih awal untuk lesi pra kanker (Abu et al, 2020;Wentzensen & Tamara, 2018). Oleh karena itu, implementasi IVA adalah intervensi yang menjanjikan yang akan membantu mengendalikan penyakit.…”

Section: Pembahasanunclassified

Early Detection of Cervical Cancer by Visual Inspection with Acetic Acid (VIA)

Longulo

Pont

Mangun

et al. 2022

njb

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Background: Breast and cervical cancer is the largest contributor of all types of cancer in women. The second order cancer is cervical cancer. Early detection of Visual Inspection with Acetic Acid (VIA) and immediate action if a positive VIA is found through cryotherapy is an attempt to prevent the morbidity and mortality of cervical cancer. Purpose: evaluation of the results of the IVA examination and management at the Talise Health Center in Palu City. Method: Descriptive research (expatory research) restropektif. The sample number of 678 Women of Childbearing Age who underwent VIA examinations at the Talise Health Center in 2019 to 2021. Univariate analysis uses frequency and percentage distributions. Results: 2019 data on VIA examinations amounted to 474(70%) , VIA negative 461 (68%), VIA positive 13 (2%) and treatment with Cryotherapy. In 2020 the number of IVA checks decreased to 70 people (10%), VIA positive 0% while in 2021 VIA 134 (20%) and VIA positive 0%. Conclusion: VIA examination can be done to detect early cervical cancer, treatment with cryotherapy that can prevent cervical cancer morbidity.

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“…Given that few studies done this, colposcopic verification of disease status would be biased towards confirming the VIA results and therefore give inflated estimates of both sensitivity and specificity. [76] A further consideration is that VIA performance decreases in older women due to the regression of the transformation zone into the endocervix, [77] so the use of VIA needs to account for the age profile of the screening population.…”

Section: Visual Inspectionmentioning

confidence: 99%

Review of HPV testing for primary cervical cancer screening

Dejvis¹

2022

Glas javnog zdr

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Cytology-based cervical cancer screening achieved undisputable success in reducing the incidence and mortality of cervical cancer in many countries of the world, especially high-income countries. However, in lowand middle-income countries substantial reductions in cervical cancer incidence rates have not been achieved, mainly due to the difficulties in realization of complex conditions for implementing high quality cytology-based cervical cancer screening programs. Most international guidelines, including the World Health Organisation (WHO) Global Strategy, now recommend high-risk human papillomavirus (hrHPV) testing as the preferred cervical screening test, for several reasons, primarily due to its sensitivity, less subjectivity in diagnosis and possibility of easier program organization and implementation. The advantages of primary hrHPV screening include higher sensitivity of technology compared to cytology based examinations, and increased specificity in populations where large proportions of women have been vaccinated against the human papillomavirus (HPV), while the high-negative predictive value enables prolongation of screening intervals to 7 to 10 years, which increases the cost effectiveness of the screening programme, when applied at population level. Also, primary hrHPV screening for cervical cancer can be carried out by self-taken samples which increases the feasibility of such cervical cancer screening programme. However, implementing primary hrHPV cervical cancer screening requires at the same time organised system of monitoring the implementation of the program, coordination and quality assurance of all processes within the implementation of cervical cancer screening.Effective hrHPV primary cervical cancer screening programme requires the triage of hrHPV positive women to maximise the detection of clinically relevant cervical lesions for further investigation. Most of the countries that introduced hrHPV primary cervical cancer screening use visual inspection with acetic acid (VIA), cytology based examination or HPV geno-typing with cytology for triage testing. The choice of triage strategy depends on various factors, including availability of resources, effectiveness and cost of procedures to recall women for triage testing as well as the capacity and quality of existing health services to deliver the triage tests. Implementation of self-sampling also requires a number of issues to be addressed, including communication to motivate participation and to inform women about the self-sampling procedure, delivery of the self-sampling kits and return of the samples to the laboratories, laboratory procedures, communication of results, recalling screen-positive women for further examination and triage and motivating them to attend for follow-up and treatment. Finally, the introduction primary screening for HPV on the mucous membrane of the cervix should be accompanied by awareness-raising programs to improve the information and knowledge of women and the entire population about the importance of the cervical cancer screening, which would improve the results of population based cervical cancer screening programs and increase the women's participation.

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Accuracy of visual cervical screening: verification bias revisited

Cited by 5 publications

References 0 publications

Implementation of visual inspection with acetic acid and Lugol's iodine for cervical cancer screening in rural China

Implementation of visual inspection with acetic acid and Lugol's iodine for cervical cancer screening in rural China

Early Detection of Cervical Cancer by Visual Inspection with Acetic Acid (VIA)

Review of HPV testing for primary cervical cancer screening

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