By World Health Organization
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Additional info for Cervical Cancer Screening in Developing Countries
Moreover, PCR-based technology requires additional skills in DNA processing and facilities with safeguards and precautions to avoid specimen contamination. 6. The validity of the currently available HPV tests in identifying HSIL and higher-grade cancers. Standard testing systems have been shown to perform with higher sensitivity than expert cytology in detecting prevalent CIN3 / HSIL or higher-grade cancers. In contrast, the speciﬁcity of the HPV test is lower than cytology in young age groups (<30), though it is comparable in the older age groups.
001) more moderate/severe lesions than cytology, but was signiﬁcantly less speciﬁc. In these studies, the reference investigation by colposcopy was carried out only in test-positive women and a small proportion of test-negative women, with the result that these studies suffered from veriﬁcation bias (36). It is quite likely that sensitivity may have been over-estimated as a result of veriﬁcation bias, although the extent of this bias is difﬁcult to assess because it is a function of the true prevalence of disease in each setting.
Satisfactory accuracy and reproducibility of a screening test in cross-sectional studies cannot be interpreted as evidence for potential effectiveness in reducing disease burden in VIA-based screening programme. The ongoing intervention studies in India, Peru, South Africa and other countries may provide valuable information on its longitudinal (programme) sensitivity, programme effectiveness in detecting high-grade lesions and preventing cervical cancer, as well as on safety issues. CONCLUSION ON VIA The test performance of VIA suggests that it has similar sensitivity to that of cervical cytology in detecting CIN, but has lower speciﬁcity.
Cervical Cancer Screening in Developing Countries by World Health Organization