Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus : results from the ESTAMPA multicentric screening study
Correspondence to: Dr Joan Valls, Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon 69366, France. vallsj@iarc.who.int
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2023
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| Accés en línia: | https://doi.org/10.1016/S2214-109X(22)00545-9 http://hdl.handle.net/20.500.14066/4414 |
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| _version_ | 1870885391025831936 |
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| author | Valls, Joan |
| author2 | Baena, Armando Venegas, Gino Celis, Marcela González, Mauricio Sosa, Carlos Santin, Jorge Luis Ortega, Marina Soilán, Ana Turcios, Elmer Figueroa, Jacqueline Rodríguez de la Peña, Margarita Figueredo, Alicia Beracochea, Andrea Verónica Pérez, Natalia Martínez Better, Josefina Lora, Oscar Jiménez, Julio Yamil Giménez, Diana Fleider, Laura Salgado, Yuly Martínez, Sandra Bellido Fuentes, Yenny Flores, Bettsy Tatti, Silvio Villagra, Verónica Cruz Valdez, Aurelio Terán, Carolina Sánchez, Gloria Inés Rodríguez, Guillermo Picconi, María Alejandra Ferrera, Annabelle Mendoza Torres, Laura Patricia Calderón, Alejandro Murillo, Raúl Wiesner, Carolina Broutet, Nathalie Luciani, Silvana Pérez, Carlos Darragh, Teresa M. Jerónimo, José Herrero, Rolando Almonte, Maribel |
| author2_role | author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| author_browse | Almonte, Maribel Baena, Armando Bellido Fuentes, Yenny Beracochea, Andrea Verónica Broutet, Nathalie Calderón, Alejandro Celis, Marcela Cruz Valdez, Aurelio Darragh, Teresa M. Ferrera, Annabelle Figueredo, Alicia Figueroa, Jacqueline Fleider, Laura Flores, Bettsy Giménez, Diana González, Mauricio Herrero, Rolando Jerónimo, José Jiménez, Julio Yamil Lora, Oscar Luciani, Silvana Martínez Better, Josefina Martínez, Sandra Mendoza Torres, Laura Patricia Murillo, Raúl Ortega, Marina Picconi, María Alejandra Pérez, Carlos Pérez, Natalia Rodríguez de la Peña, Margarita Rodríguez, Guillermo Salgado, Yuly Santin, Jorge Luis Soilán, Ana Sosa, Carlos Sánchez, Gloria Inés Tatti, Silvio Terán, Carolina Turcios, Elmer Valls, Joan Venegas, Gino Villagra, Verónica Wiesner, Carolina |
| author_facet | Valls, Joan Baena, Armando Venegas, Gino Celis, Marcela González, Mauricio Sosa, Carlos Santin, Jorge Luis Ortega, Marina Soilán, Ana Turcios, Elmer Figueroa, Jacqueline Rodríguez de la Peña, Margarita Figueredo, Alicia Beracochea, Andrea Verónica Pérez, Natalia Martínez Better, Josefina Lora, Oscar Jiménez, Julio Yamil Giménez, Diana Fleider, Laura Salgado, Yuly Martínez, Sandra Bellido Fuentes, Yenny Flores, Bettsy Tatti, Silvio Villagra, Verónica Cruz Valdez, Aurelio Terán, Carolina Sánchez, Gloria Inés Rodríguez, Guillermo Picconi, María Alejandra Ferrera, Annabelle Mendoza Torres, Laura Patricia Calderón, Alejandro Murillo, Raúl Wiesner, Carolina Broutet, Nathalie Luciani, Silvana Pérez, Carlos Darragh, Teresa M. Jerónimo, José Herrero, Rolando Almonte, Maribel |
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| dc.contributor.other.es.fl_str_mv | Universidad Nacional de Asunción. Instituto de Investigaciones en Ciencias de la Salud |
| dc.creator.none.fl_str_mv | Valls, Joan Baena, Armando Venegas, Gino Celis, Marcela González, Mauricio Sosa, Carlos Santin, Jorge Luis Ortega, Marina Soilán, Ana Turcios, Elmer Figueroa, Jacqueline Rodríguez de la Peña, Margarita Figueredo, Alicia Beracochea, Andrea Verónica Pérez, Natalia Martínez Better, Josefina Lora, Oscar Jiménez, Julio Yamil Giménez, Diana Fleider, Laura Salgado, Yuly Martínez, Sandra Bellido Fuentes, Yenny Flores, Bettsy Tatti, Silvio Villagra, Verónica Cruz Valdez, Aurelio Terán, Carolina Sánchez, Gloria Inés Rodríguez, Guillermo Picconi, María Alejandra Ferrera, Annabelle Mendoza Torres, Laura Patricia Calderón, Alejandro Murillo, Raúl Wiesner, Carolina Broutet, Nathalie Luciani, Silvana Pérez, Carlos Darragh, Teresa M. Jerónimo, José Herrero, Rolando Almonte, Maribel |
| dc.date.accessioned.none.fl_str_mv | 2024-06-25T16:23:14Z |
| dc.date.available.none.fl_str_mv | 2024-06-25T16:23:14Z |
| dc.date.issued.none.fl_str_mv | 2023-03 |
| dc.identifier.doi.es.fl_str_mv | 10.1016/S2214-109X(22)00545-9 |
| dc.identifier.essn.es.fl_str_mv | 2214-109X |
| dc.identifier.other.none.fl_str_mv | https://doi.org/10.1016/S2214-109X(22)00545-9 |
| dc.identifier.uri.none.fl_str_mv | http://hdl.handle.net/20.500.14066/4414 |
| dc.language.iso.es.fl_str_mv | eng |
| dc.publisher.es.fl_str_mv | The Lancet |
| dc.rights.*.fl_str_mv | Atribución 3.0 Organización Intergubernamental |
| dc.rights.accessRights.es.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.rights.uri.*.fl_str_mv | http://creativecommons.org/licenses/by/3.0/igo/deed.es |
| dc.subject.classification.es.fl_str_mv | 7. Salud 7.2. Abarca desde medicina preventiva, incluyendo todos los aspectos de tratamientos médicos y quirúrgicos, tanto para individuos como para grupos, y las provisiones de hospitales y cuidado domiciliario, medicina social e investigación pediátrica y geriátrica |
| dc.subject.ocde.es.fl_str_mv | 3. Ciencias Médicas y de la Salud 3.3. Ciencias de la Salud (salud pública, medicina social, higiene, enfermería, epidemiología) |
| dc.subject.other.es.fl_str_mv | Colposcopía Detección precoz del cáncer/métodos Displasia del cuello del útero/diagnóstico Embarazo Estudios transversales Frotis vaginal Infecciones por papillomavirus/diagnóstico Neoplasias del cuello uterino/diagnóstico Tamizaje masivo/métodos Triaje Virus del papiloma humano Colposcopy Early detection of cancer/methods Uterine cervical dysplasia/diagnosis Pregnancy Cross-sectional studies Vaginal smears Papillomavirus infections/diagnosis Uterine cervical neoplasms/diagnosis Mass screening/methods Triage Human papillomavirus viruses |
| dc.title.es.fl_str_mv | Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus : results from the ESTAMPA multicentric screening study |
| dc.type.es.fl_str_mv | info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
| description | Correspondence to: Dr Joan Valls, Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon 69366, France. vallsj@iarc.who.int |
| eu_rights_str_mv | openAccess |
| format | article |
| id | CONACYT_d6082b18e93a4df7ca38fb614075a14f |
| identifier_str_mv | 10.1016/S2214-109X(22)00545-9 2214-109X |
| language | eng |
| network_acronym_str | CONACYT |
| network_name_str | Repositorio Institucional CONACYT |
| oai_identifier_str | oai:repositorio.conacyt.gov.py:20.500.14066/4414 |
| publishDate | 2023 |
| publishDateSort | 2023 |
| repository.mail.fl_str_mv | repositorio.institucional@conacyt.gov.py |
| repository.name.fl_str_mv | Repositorio Institucional CONACYT |
| repository_id_str | |
| rights_invalid_str_mv | Atribución 3.0 Organización Intergubernamental http://creativecommons.org/licenses/by/3.0/igo/deed.es |
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Instituto de Investigaciones en Ciencias de la Salud2024-06-25T16:23:14Z2024-06-25T16:23:14Z2023-03https://doi.org/10.1016/S2214-109X(22)00545-9http://hdl.handle.net/20.500.14066/441410.1016/S2214-109X(22)00545-92214-109XCorrespondence to: Dr Joan Valls, Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon 69366, France. vallsj@iarc.who.intBackground. Colposcopy, currently included in WHO recommendations as an option to triage human papillomavirus (HPV)-positive women, remains as the reference standard to guide both biopsy for confirmation of cervical precancer and cancer and treatment approaches. We aim to evaluate the performance of colposcopy to detect cervical precancer and cancer for triage in HPV-positive women. Methods. This cross-sectional, multicentric screening study was conducted at 12 centres (including primary and secondary care centres, hospitals, laboratories, and universities) in Latin America (Argentina, Bolivia, Colombia, Costa Rica, Honduras, Mexico, Paraguay, Peru, and Uruguay). Eligible women were aged 30–64 years, sexually active, did not have a history of cervical cancer or treatment for cervical precancer or a hysterectomy, and were not planning to move outside of the study area. Women were screened with HPV DNA testing and cytology. HPV-positive women were referred to colposcopy using a standardised protocol, including biopsy collection of observed lesions, endocervical sampling for transformation zone (TZ) type 3, and treatment as needed. Women with initial normal colposcopy or no high-grade cervical lesions on histology (less than cervical intraepithelial neoplasia [CIN] grade 2) were recalled after 18 months for another HPV test to complete disease ascertainment; HPV-positive women were referred for a second colposcopy with biopsy and treatment as needed. Diagnostic accuracy of colposcopy was assessed by considering a positive test result when the colposcopic impression at the initial colposcopy was positive minor, positive major, or suspected cancer, and was considered negative otherwise. The main study outcome was histologically confirmed CIN3+ (defined as grade 3 or worse) detected at the initial visit or 18-month visit. Findings. Between Dec 12, 2012, and Dec 3, 2021, 42 502 women were recruited, and 5985 (14·1%) tested positive for HPV. 4499 participants with complete disease ascertainment and follow-up were included in the analysis, with a median age of 40·6 years (IQR 34·7–49·9). CIN3+ was detected in 669 (14·9%) of 4499 women at the initial visit or 18-month visit (3530 [78·5%] negative or CIN1, 300 [6·7%] CIN2, 616 [13·7%] CIN3, and 53 [1·2%] cancers). Sensitivity was 91·2% (95% CI 88·9–93·2) for CIN3+, whereas specificity was 50·1% (48·5–51·8) for less than CIN2 and 47·1% (45·5–48·7) for less than CIN3. Sensitivity for CIN3+ significantly decreased in older women (93·5% [95% CI 91·3–95·3] in those aged 30–49 years vs 77·6% [68·6–85·0] in those aged 50–65 years; p<0·0001), whereas specificity for less than CIN2 significantly increased (45·7% [43·8–47·6] vs 61·8% [58·7–64·8]; p<0·0001). Sensitivity for CIN3+ was also significantly lower in women with negative cytology than in those with abnormal cytology (p<0·0001). Interpretation. Colposcopy is accurate for CIN3+ detection in HPV-positive women. These results reflect ESTAMPA efforts in an 18-month follow-up strategy to maximise disease detection with an internationally validated clinical management protocol and regular training, including quality improvement practices. We showed that colposcopy can be optimised with proper standardisation to be used as triage in HPV-positive women.Consejo Nacional de Ciencia y TecnologíaPrograma Paraguayo para el Desarrollo de la Ciencia y Tecnología. Proyectos de investigación y desarrollo14-INV-036PINV18-256engThe LancetAtribución 3.0 Organización Intergubernamentalhttp://creativecommons.org/licenses/by/3.0/igo/deed.esinfo:eu-repo/semantics/openAccess© 2023 World Health Organization; licensee Elsevier. This is an Open Access article published under the CC BY 3.0 IGO license which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any use of this article, there should be no suggestion that WHO endorses any specific organisation, products, or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article’s original URL.7. Salud7.2. Abarca desde medicina preventiva, incluyendo todos los aspectos de tratamientos médicos y quirúrgicos, tanto para individuos como para grupos, y las provisiones de hospitales y cuidado domiciliario, medicina social e investigación pediátrica y geriátricaColposcopíaDetección precoz del cáncer/métodosDisplasia del cuello del útero/diagnósticoEmbarazoEstudios transversalesFrotis vaginalInfecciones por papillomavirus/diagnósticoNeoplasias del cuello uterino/diagnósticoTamizaje masivo/métodosTriajeVirus del papiloma humanoColposcopyEarly detection of cancer/methodsUterine cervical dysplasia/diagnosisPregnancyCross-sectional studiesVaginal smearsPapillomavirus infections/diagnosisUterine cervical neoplasms/diagnosisMass screening/methodsTriageHuman papillomavirus viruses3. Ciencias Médicas y de la Salud3.3. Ciencias de la Salud (salud pública, medicina social, higiene, enfermería, epidemiología)Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus : results from the ESTAMPA multicentric screening studyinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion3The Lancet Global Healthe350e36011Valls, JoanBaena, ArmandoVenegas, GinoCelis, MarcelaGonzález, MauricioSosa, CarlosSantin, Jorge LuisOrtega, MarinaSoilán, AnaTurcios, ElmerFigueroa, JacquelineRodríguez de la Peña, MargaritaFigueredo, AliciaBeracochea, Andrea VerónicaPérez, NataliaMartínez Better, JosefinaLora, OscarJiménez, Julio YamilGiménez, DianaFleider, LauraSalgado, YulyMartínez, SandraBellido Fuentes, YennyFlores, BettsyTatti, SilvioVillagra, VerónicaCruz Valdez, AurelioTerán, CarolinaSánchez, Gloria InésRodríguez, GuillermoPicconi, María AlejandraFerrera, AnnabelleMendoza Torres, Laura PatriciaCalderón, AlejandroMurillo, RaúlWiesner, CarolinaBroutet, NathalieLuciani, SilvanaPérez, CarlosDarragh, Teresa M.Jerónimo, JoséHerrero, RolandoAlmonte, MaribelORIGINALPerformance of standardised colposcopy to detect cervical.pdfPerformance of standardised colposcopy to detect cervical.pdfArtículo científicoapplication/pdf666703http://repositorio.conacyt.gov.py/bitstream/20.500.14066/4414/1/Performance%20of%20standardised%20colposcopy%20to%20detect%20cervical.pdf4c5de93b058de054916b6f1f29ac361cMD51Performance of standardised colposcopy_Supplementary Material.pdfPerformance of standardised colposcopy_Supplementary Material.pdfMaterial Suplementarioapplication/pdf216628http://repositorio.conacyt.gov.py/bitstream/20.500.14066/4414/4/Performance%20of%20standardised%20colposcopy_Supplementary%20Material.pdfdbb05f8edb2f2d071daa3c07fdc72b7cMD54LICENSElicense.txtlicense.txttext/plain; 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| spellingShingle | Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus : results from the ESTAMPA multicentric screening study Valls, Joan 7. Salud 7.2. Abarca desde medicina preventiva, incluyendo todos los aspectos de tratamientos médicos y quirúrgicos, tanto para individuos como para grupos, y las provisiones de hospitales y cuidado domiciliario, medicina social e investigación pediátrica y geriátrica Colposcopía Detección precoz del cáncer/métodos Displasia del cuello del útero/diagnóstico Embarazo Estudios transversales Frotis vaginal Infecciones por papillomavirus/diagnóstico Neoplasias del cuello uterino/diagnóstico Tamizaje masivo/métodos Triaje Virus del papiloma humano Colposcopy Early detection of cancer/methods Uterine cervical dysplasia/diagnosis Pregnancy Cross-sectional studies Vaginal smears Papillomavirus infections/diagnosis Uterine cervical neoplasms/diagnosis Mass screening/methods Triage Human papillomavirus viruses 3. Ciencias Médicas y de la Salud 3.3. Ciencias de la Salud (salud pública, medicina social, higiene, enfermería, epidemiología) |
| status_str | publishedVersion |
| title | Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus : results from the ESTAMPA multicentric screening study |
| title_full | Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus : results from the ESTAMPA multicentric screening study |
| title_fullStr | Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus : results from the ESTAMPA multicentric screening study |
| title_full_unstemmed | Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus : results from the ESTAMPA multicentric screening study |
| title_short | Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus : results from the ESTAMPA multicentric screening study |
| title_sort | Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus : results from the ESTAMPA multicentric screening study |
| topic | 7. Salud 7.2. Abarca desde medicina preventiva, incluyendo todos los aspectos de tratamientos médicos y quirúrgicos, tanto para individuos como para grupos, y las provisiones de hospitales y cuidado domiciliario, medicina social e investigación pediátrica y geriátrica Colposcopía Detección precoz del cáncer/métodos Displasia del cuello del útero/diagnóstico Embarazo Estudios transversales Frotis vaginal Infecciones por papillomavirus/diagnóstico Neoplasias del cuello uterino/diagnóstico Tamizaje masivo/métodos Triaje Virus del papiloma humano Colposcopy Early detection of cancer/methods Uterine cervical dysplasia/diagnosis Pregnancy Cross-sectional studies Vaginal smears Papillomavirus infections/diagnosis Uterine cervical neoplasms/diagnosis Mass screening/methods Triage Human papillomavirus viruses 3. Ciencias Médicas y de la Salud 3.3. Ciencias de la Salud (salud pública, medicina social, higiene, enfermería, epidemiología) |
| url | https://doi.org/10.1016/S2214-109X(22)00545-9 http://hdl.handle.net/20.500.14066/4414 |