Performance of alternative strategies for primary cervical cancer screening in sub-Saharan Africa: systematic review and meta-analysis of diagnostic test accuracy studies.
Bottom Line: Inclusion criteria for studies were: alternative methods to cytology used as a standalone test for primary screening; study population not at particular risk of cervical cancer (excluding studies focusing on HIV positive women or women with gynaecological symptoms); women screened by nurses; reference test (colposcopy and directed biopsies) performed at least in women with positive screening results.Prevalence of CIN2+ did not vary by screening test and ranged from 2.3% (95% confidence interval 1.5% to 3.3%) in VILI studies to 4.9% (2.7% to 7.8%) in HPV testing studies.Implementation studies are needed to assess the effect of these screening strategies on the incidence and outcomes of cervical cancer in the region.
Affiliation: Department of Gynecology and Obstetrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals, 1211 Geneva 14, Switzerland email@example.com.Show MeSH
Related in: MedlinePlus
Mentions: Of 1049 entries identified via searches, 15 papers (eight in the GSA group, seven in the GSP group) fulfilled the inclusion criteria193334353637383940414243444546 (fig 1). Two thirds of included papers were from southern (six papers) or eastern (four) Africa. One article reported data from five countries in western and middle Africa;40 we considered them separately. Therefore, the meta-analyses included 15 reports (10 in the GSA group; five in the GSP group) of 61 381 women screened by VIA, eight reports (all GSA) of 46 435 women screened by VILI, and six reports (three GSA; three GSP) of 11 322 women screened by HPV testing (four on second generation hybrid capture assays, one on careHPV, and one on PCR).
Affiliation: Department of Gynecology and Obstetrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals, 1211 Geneva 14, Switzerland firstname.lastname@example.org.