Limits...
Performance of alternative strategies for primary cervical cancer screening in sub-Saharan Africa: systematic review and meta-analysis of diagnostic test accuracy studies.

Fokom-Domgue J, Combescure C, Fokom-Defo V, Tebeu PM, Vassilakos P, Kengne AP, Petignat P - BMJ (2015)

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.

View Article: PubMed Central - PubMed

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 fokom.domgue@gmail.com.

Show MeSH

Related in: MedlinePlus

Fig 2 Absolute sensitivity and specificity of VIA, VILI, and HPV testing for CIN2+ detection in sub-Saharan Africa. Diamond=95% confidence interval of the pooled measure computed with a bivariate random effects model. This figure includes only studies where the gold standard (colposcopy and colposcopy directed biopsies) was performed in all women of the study population (that is, GSA group). Heterogeneity across studies was assessed with Cochran’s Q test for each screening test (all P<0.05). DRC=Democratic Republic of Congo
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4490835&req=5

fig2: Fig 2 Absolute sensitivity and specificity of VIA, VILI, and HPV testing for CIN2+ detection in sub-Saharan Africa. Diamond=95% confidence interval of the pooled measure computed with a bivariate random effects model. This figure includes only studies where the gold standard (colposcopy and colposcopy directed biopsies) was performed in all women of the study population (that is, GSA group). Heterogeneity across studies was assessed with Cochran’s Q test for each screening test (all P<0.05). DRC=Democratic Republic of Congo

Mentions: Figure 2 shows the variation of absolute sensitivity and specificity of VIA, VILI, and HPV testing in detecting CIN2+ in the GSA group. The pooled sensitivity for VIA in this group was 82.4% (95% confidence interval 76.3% to 87.3%) and ranged between 65.0% (40.8% to 84.6%) in Mali and 94.4% (90.6% to 97.0%) in Tanzania. The pooled specificity of VIA was 87.4% (77.1% to 93.4%), with the lowest value observed in Zimbabwe (64.1%, 61.9% to 66.2%) and the highest in Tanzania (98.2%, 98.0% to 98.5%).


Performance of alternative strategies for primary cervical cancer screening in sub-Saharan Africa: systematic review and meta-analysis of diagnostic test accuracy studies.

Fokom-Domgue J, Combescure C, Fokom-Defo V, Tebeu PM, Vassilakos P, Kengne AP, Petignat P - BMJ (2015)

Fig 2 Absolute sensitivity and specificity of VIA, VILI, and HPV testing for CIN2+ detection in sub-Saharan Africa. Diamond=95% confidence interval of the pooled measure computed with a bivariate random effects model. This figure includes only studies where the gold standard (colposcopy and colposcopy directed biopsies) was performed in all women of the study population (that is, GSA group). Heterogeneity across studies was assessed with Cochran’s Q test for each screening test (all P<0.05). DRC=Democratic Republic of Congo
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4490835&req=5

fig2: Fig 2 Absolute sensitivity and specificity of VIA, VILI, and HPV testing for CIN2+ detection in sub-Saharan Africa. Diamond=95% confidence interval of the pooled measure computed with a bivariate random effects model. This figure includes only studies where the gold standard (colposcopy and colposcopy directed biopsies) was performed in all women of the study population (that is, GSA group). Heterogeneity across studies was assessed with Cochran’s Q test for each screening test (all P<0.05). DRC=Democratic Republic of Congo
Mentions: Figure 2 shows the variation of absolute sensitivity and specificity of VIA, VILI, and HPV testing in detecting CIN2+ in the GSA group. The pooled sensitivity for VIA in this group was 82.4% (95% confidence interval 76.3% to 87.3%) and ranged between 65.0% (40.8% to 84.6%) in Mali and 94.4% (90.6% to 97.0%) in Tanzania. The pooled specificity of VIA was 87.4% (77.1% to 93.4%), with the lowest value observed in Zimbabwe (64.1%, 61.9% to 66.2%) and the highest in Tanzania (98.2%, 98.0% to 98.5%).

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.

View Article: PubMed Central - PubMed

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 fokom.domgue@gmail.com.

Show MeSH
Related in: MedlinePlus