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A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya.

Publication ,  Journal Article
Huchko, MJ; Sneden, J; Leslie, HH; Abdulrahim, N; Maloba, M; Bukusi, E; Cohen, CR
Published in: Bull World Health Organ
March 1, 2014

OBJECTIVE: To determine the optimal strategy for cervical cancer screening in women with human immunodeficiency virus (HIV) infection by comparing two strategies: visual inspection of the cervix with acetic acid (VIA) and VIA followed immediately by visual inspection with Lugol's iodine (VIA/VILI) in women with a positive VIA result. METHODS: Data from a cervical cancer screening programme embedded in two HIV clinic sites in western Kenya were evaluated. Women at a central site underwent VIA, while women at a peripheral site underwent VIA/VILI. All women positive for cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) on VIA and/or VILI had a confirmatory colposcopy, with a biopsy if necessary. Overall test positivity, positive predictive value (PPV) and the CIN 2+ detection rate were calculated for the two screening methods, with biopsy being the gold standard. FINDINGS: Between October 2007 and October 2010, 2338 women were screened with VIA and 1124 with VIA/VILI. In the VIA group, 26.4% of the women tested positive for CIN 2+; in the VIA/VILI group, 21.7% tested positive (P < 0.01). Histologically confirmed CIN 2+ was detected in 8.9% and 7.8% (P = 0.27) of women in the VIA and VIA/VILI groups, respectively. The PPV of VIA for biopsy-confirmed CIN 2+ in a single round of screening was 35.2%, compared with 38.2% for VIA/VILI (P = 0.41). CONCLUSION: The absence of any differences between VIA and VIA/VILI in detection rates or PPV for CIN 2+ suggests that VIA, an easy testing procedure, can be used alone as a cervical cancer screening strategy in low-income settings.

Duke Scholars

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Published In

Bull World Health Organ

DOI

EISSN

1564-0604

Publication Date

March 1, 2014

Volume

92

Issue

3

Start / End Page

195 / 203

Location

Switzerland

Related Subject Headings

  • Young Adult
  • Vaginal Smears
  • Uterine Cervical Neoplasms
  • Tropical Medicine
  • Papanicolaou Test
  • Neoplasm Staging
  • Middle Aged
  • Logistic Models
  • Kenya
  • Iodides
 

Citation

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Huchko, M. J., Sneden, J., Leslie, H. H., Abdulrahim, N., Maloba, M., Bukusi, E., & Cohen, C. R. (2014). A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya. Bull World Health Organ, 92(3), 195–203. https://doi.org/10.2471/BLT.13.122051
Huchko, Megan J., Jennifer Sneden, Hannah H. Leslie, Naila Abdulrahim, May Maloba, Elizabeth Bukusi, and Craig R. Cohen. “A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya.Bull World Health Organ 92, no. 3 (March 1, 2014): 195–203. https://doi.org/10.2471/BLT.13.122051.
Huchko MJ, Sneden J, Leslie HH, Abdulrahim N, Maloba M, Bukusi E, et al. A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya. Bull World Health Organ. 2014 Mar 1;92(3):195–203.
Huchko, Megan J., et al. “A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya.Bull World Health Organ, vol. 92, no. 3, Mar. 2014, pp. 195–203. Pubmed, doi:10.2471/BLT.13.122051.
Huchko MJ, Sneden J, Leslie HH, Abdulrahim N, Maloba M, Bukusi E, Cohen CR. A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya. Bull World Health Organ. 2014 Mar 1;92(3):195–203.

Published In

Bull World Health Organ

DOI

EISSN

1564-0604

Publication Date

March 1, 2014

Volume

92

Issue

3

Start / End Page

195 / 203

Location

Switzerland

Related Subject Headings

  • Young Adult
  • Vaginal Smears
  • Uterine Cervical Neoplasms
  • Tropical Medicine
  • Papanicolaou Test
  • Neoplasm Staging
  • Middle Aged
  • Logistic Models
  • Kenya
  • Iodides