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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: 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.Pooled sensitivity and specificity were similar for HPV testing versus VIA (both P ≥ 0.23) and versus VILI (both P ≥ 0.16).Accuracy of VIA and VILI increased with sample size and time period.

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.

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Fig 3 Absolute accuracy of VIA, VILI and HPV testing for primary cervical cancer screening in sub-Saharan Africa. HSROC=hierarchical summary receiver operating characteristic regression curves. HSROC curves depict the fitted sensitivity as a function of specificity for VIA, VILI, HPV testing, and all three tests combined to detect CIN2+. These curves include only studies where gold standard (colposcopy and colposcopy directed biopsies) was applied to all women (that is, GSA group). Small blue squares, red circles, and green triangles and grey line circles=individual studies and 95% confidence ellipses; large blue squares, red circles, and green triangles and circles=pooled sensitivity and specificity and 95% confidence ellipses
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fig3: Fig 3 Absolute accuracy of VIA, VILI and HPV testing for primary cervical cancer screening in sub-Saharan Africa. HSROC=hierarchical summary receiver operating characteristic regression curves. HSROC curves depict the fitted sensitivity as a function of specificity for VIA, VILI, HPV testing, and all three tests combined to detect CIN2+. These curves include only studies where gold standard (colposcopy and colposcopy directed biopsies) was applied to all women (that is, GSA group). Small blue squares, red circles, and green triangles and grey line circles=individual studies and 95% confidence ellipses; large blue squares, red circles, and green triangles and circles=pooled sensitivity and specificity and 95% confidence ellipses

Mentions: Figure 3 shows the joint variation of observed and pooled sensitivity and specificity by screening test in the GSA group. The wide area of the confidence ellipse for HPV testing reflects the small number of accuracy studies conducted on HPV testing in sub-Saharan Africa. Curves for VILI are closer to the upper left corner of the rectangle than those for VIA, without overlapping ellipses between the two tests (fig 3). These results underpin the better performance of VILI compared with VIA for primary screening of cervical cancer in sub-Saharan Africa.


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 3 Absolute accuracy of VIA, VILI and HPV testing for primary cervical cancer screening in sub-Saharan Africa. HSROC=hierarchical summary receiver operating characteristic regression curves. HSROC curves depict the fitted sensitivity as a function of specificity for VIA, VILI, HPV testing, and all three tests combined to detect CIN2+. These curves include only studies where gold standard (colposcopy and colposcopy directed biopsies) was applied to all women (that is, GSA group). Small blue squares, red circles, and green triangles and grey line circles=individual studies and 95% confidence ellipses; large blue squares, red circles, and green triangles and circles=pooled sensitivity and specificity and 95% confidence ellipses
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig3: Fig 3 Absolute accuracy of VIA, VILI and HPV testing for primary cervical cancer screening in sub-Saharan Africa. HSROC=hierarchical summary receiver operating characteristic regression curves. HSROC curves depict the fitted sensitivity as a function of specificity for VIA, VILI, HPV testing, and all three tests combined to detect CIN2+. These curves include only studies where gold standard (colposcopy and colposcopy directed biopsies) was applied to all women (that is, GSA group). Small blue squares, red circles, and green triangles and grey line circles=individual studies and 95% confidence ellipses; large blue squares, red circles, and green triangles and circles=pooled sensitivity and specificity and 95% confidence ellipses
Mentions: Figure 3 shows the joint variation of observed and pooled sensitivity and specificity by screening test in the GSA group. The wide area of the confidence ellipse for HPV testing reflects the small number of accuracy studies conducted on HPV testing in sub-Saharan Africa. Curves for VILI are closer to the upper left corner of the rectangle than those for VIA, without overlapping ellipses between the two tests (fig 3). These results underpin the better performance of VILI compared with VIA for primary screening of cervical cancer in sub-Saharan Africa.

Bottom Line: 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.Pooled sensitivity and specificity were similar for HPV testing versus VIA (both P ≥ 0.23) and versus VILI (both P ≥ 0.16).Accuracy of VIA and VILI increased with sample size and time period.

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