Human papillomavirus testing as an optional screening tool in low-resource settings of Latin America: experience from the Latin American Screening study

Int J Gynecol Cancer. 2006 May-Jun;16(3):955-62. doi: 10.1111/j.1525-1438.2006.00582.x.

Abstract

Hybrid capture II (HC II) test for oncogenic human papillomaviruses (HPV) was carried out in a cohort of 4284 women at their first clinical visit. Overall prevalence of HPV was 17.1%, decreasing with age from 33.9% among women below 20 years to only 11.0% among those older than 41 years. HPV prevalence was significantly higher among current smokers (odds ratio [OR] = 1.31; 95% CI 1.1-1.6), in women with two or more lifetime sexual partners (OR = 1.9; 95% CI 1.6-2.4), and those women with two or more sexual partners during the past 12 months prior to examination (OR = 1.6; 95% CI 1.2-2.2). HPV detection increased in parallel with increasing cytologic abnormality, being highest in women with high-grade squamous intraepithelial lesion (P= 0.001). Specificity of the HPV test in detecting histologically confirmed cervical disease was 85% (95% CI 83.9-86.1). Sensitivity of the HPV test in detecting histologic abnormalities increased in parallel with disease severity, ranging from 51.5% for cervical intraepithelial neoplasia (CIN) 1 to 96.5% for CIN 3 and 100.0% for cancer, with respective decline of positive predictive value. These data suggest that HPV testing with HC II assay might be a viable screening tool among this population with relatively high prevalence of cervical disease.

Publication types

  • Comparative Study
  • Evaluation Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Algorithms
  • Cross-Sectional Studies
  • Female
  • Health Resources / statistics & numerical data
  • Humans
  • Latin America / epidemiology
  • Mass Screening / economics
  • Mass Screening / methods*
  • Middle Aged
  • Neoplasms, Squamous Cell / epidemiology
  • Neoplasms, Squamous Cell / virology*
  • Papillomaviridae / isolation & purification*
  • Predictive Value of Tests
  • Prospective Studies
  • Sexual Behavior / statistics & numerical data
  • Sexual Partners
  • Uterine Cervical Dysplasia / epidemiology
  • Uterine Cervical Dysplasia / virology*
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / virology*
  • Vaginal Smears / statistics & numerical data