Evaluation of human-papillomavirus testing and visual inspection for cervical cancer screening in Rwanda

Umulisa, Marie Chantal; Franceschi, Silvia; Baussano, Iacopo; Tenet, Vanessa; Uwimbabazi, Mathilde; Rugwizangoga, Belson; Heideman, Daniëlle A.M.; Uyterlinde, Anne M.; Darragh, Teresa M.; Snijders, Peter J.F.; Sayinzoga, Félix; Clifford, Gary M.

doi:10.1186/s12905-018-0549-5

Cited by 20 publications

(23 citation statements)

References 34 publications

(50 reference statements)

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“…Self‐collected samples can be more easily obtained in hard‐to‐reach populations (e.g., younger women and those who will not attend screening programs) . Furthermore, HPV DNA testing has higher detection sensitivity as compared with visual inspection with acetic acid (VIA), the national strategy adopted for cervical cancer screening in Mozambique . Therefore, HPV DNA testing might be a better primary screening method for cervical cancer prevention in low‐resource countries …”

Section: Introductionmentioning

confidence: 99%

Human papillomavirus prevalence and distribution in self‐collected samples from female university students in Maputo

Bule

Silva

Carrilho

et al. 2020

Intl J Gynecology & Obste

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Objective: To characterize human papillomavirus (HPV) prevalence and distribution among female university students in Maputo, Mozambique, and evaluate the determinants of HPV infection. Methods:A cross-sectional study among 504 female university students between February and April 2017. Cervicovaginal self-collected samples were analyzed for HPV genotypes by polymerase chain reaction-restriction fragment length polymorphism and Anyplex TM II HPV28 Detection kit (Seegene ® ). Results:The prevalence of any HPV genotype was 28.6% (144/504). Single and multiple HPV infections were detected in 76 (15.1%) and 68 (13.5%) participants, respectively. Prevalence of high-risk HPV was significantly higher than that of low-risk HPV (P<0.001). HPV16 was the most frequent genotype, followed by HPV58, HPV66, HPV52, HPV18, HPV56, HPV61, and HPV70. The prevalence of genotypes covered by the bivalent, quadrivalent, and nonavalent vaccine was 14.3%, 15.9%, and 23.4%, respectively. Number of sexual partners over lifetime and in the past 12 months was associated with HPV infection (P<0.001 and P=0.039, respectively). Conclusions:Knowledge of HPV genotype-specific prevalence among young women is important to set up strategies for HPV vaccination. The findings suggest that introduction of the nonavalent HPV vaccine might be the way forward in the present lowresource setting. In addition, self-sampling was useful for HPV detection and genotyping. K E Y W O R D SEpidemiology; Human papillomavirus; Mozambique; Self-sampling; Vaccination; Young women SUPPORTING INFORMATIONAdditional supporting information may be found online in the Supporting Information section at the end of the article. Figure S1. Data on HPV PCR detection and genotyping.

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Section: Introductionmentioning

confidence: 99%

Human papillomavirus prevalence and distribution in self‐collected samples from female university students in Maputo

Bule

Silva

Carrilho

et al. 2020

Intl J Gynecology & Obste

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“…Screening with VIA is still the most cost-effective and efficient method of cervical cancer screening in resource-poor countries, however, because it is highly subjective and dependent on training and continued supervision, sensitivity in detecting grade 2 or higher lesions has been reported anywhere from 7.7% to 82.6% compared to care HPV, a low-cost same day testing that has sensitivities above 70%. Screening for HPV offers a more objective approach, and an opportunity to increase screening coverage through self-collection [32,33].…”

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confidence: 99%

Elimination of cervical cancer: challenges for developing countries

Beddoe¹

2019

ecancer

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Cervical cancer is one of the most preventable cancers today, yet over 500,000 new cases are diagnosed globally each year and every 2 minutes a woman dies from cervical cancer. The burden of this disease and the highest mortality from cervical cancer occur in developing countries. High-income countries are poised to eliminate cervical cancer in the 21st century, but despite a global call to eliminate this disease, low-and middleincome countries face many challenges as they strive to answer that call.

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“…Other studies reported similar results with 79% sensitivity and 89% specificity in Africa and India [30], 83% sensitivity and 89% specificity in Mongolia [31], 73% sensitivity and 80% specificity in Kenya [32]. Nevertheless other studies obtained contrasting results with a low sensitivity and high specificity in Rwanda (41% Sensitivity and 96% specificity), [33] or a moderate sensitivity with high specificity in Thailand (67.9% sensitivity and 100% specificity) [34]. This considerable variation between studies on the accuracy of VIA in the detection of high-grade lesions (CIN2 +) is possibly attributable to inter-observer variation, skill levels, light used and acetic acid concentration [35] .In our study, as there was only one observer previously trained in visual screening and colposcopy (2 years) that could explain the 100% sensitivity.…”

Section: Discussionmentioning

confidence: 64%

Evaluation of the effectiveness of high-risk human papilloma self-sampling test for cervical cancer screening in Bolivia

et al. 2020

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Background: In Bolivia the incidence and mortality rates of uterine cervix cancer are the highest in America. The main factor contributing to this situation is the difficulty of establishing and maintaining quality prevention programs based on cytology. We aimed to evaluate the effectiveness of HR-HPV testing on self-collected samples to detect cervical intra-epithelial neoplasia and identify the best combination of screening tests. Methods: A total of 469 women, divided in two groups, were included in this study. The first group included 362 women that underwent three consecutively primary screening tests: self-collected sampling for HR-HPV detection, conventional cervical cytology and visual inspection under acetic acid (VIA). The second group included 107 women referred with a positive HR-HPV test that underwent conventional cervical cytology and VIA. The presence of high grade intraepithelial lesion (CIN 2+) or invasive cancer was verified by colposcopy and biopsy. Result: In the screening group the sensitivity to detect high grade intraepithelial lesion (CIN 2+) or invasive cancer were 100, 76, 44% for the VIA, HR-HPV test and cytology, respectively. In the referred group, the sensitivity to detect high grade intraepithelial lesion (CIN 2+) or invasive cancer by VIA and cytology were 100 and 81%, respectively. Conclusions: VIA and HR-HPV self-sampling were the best combination to detect CIN2+ lesions. Cytology analysis gave the poorest performance.

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Evaluation of human-papillomavirus testing and visual inspection for cervical cancer screening in Rwanda

Cited by 20 publications

References 34 publications

Human papillomavirus prevalence and distribution in self‐collected samples from female university students in Maputo

Human papillomavirus prevalence and distribution in self‐collected samples from female university students in Maputo

Elimination of cervical cancer: challenges for developing countries

Evaluation of the effectiveness of high-risk human papilloma self-sampling test for cervical cancer screening in Bolivia

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