Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 6/2012

01.06.2012 | Gynecologic Oncology

Is visual inspection with acetic acid better than cervical cytology to screen women ≥40 years of age for carcinoma cervix? A cross-sectional study on proportion of screen-positive women (by VIA and cervical cytology) having CIN II/III lesion on cervical biopsy: difference between two age groups and among screening methods

verfasst von: Subhankar Dasgupta, Sudhindramohan Bhattacharya

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 6/2012

Einloggen, um Zugang zu erhalten

Abstract

Objective

Proportion of CIN II/III lesion on cervical biopsy among screen-positive women of age group <40 years and ≥40 years undergoing screening for carcinoma cervix by Pap smear and visual inspection of cervix with acetic acid (VIA) was determined (both the tests were performed on same population). Difference in proportion of CIN II/III lesion among screen-positive women, between two age groups (for both methods) and between methods (for both age groups) was determined.

Result

In <40 years age group, proportion of screen-positive women with CIN II/III lesion was similar for both cytology or VIA (12.95 vs. 9.8%). For ≥40 year age group, compared to cytology, VIA detected higher proportions of CIN II or III lesion (4.1 vs. 13.3%). Proportion of screen-positive women having CIN II/III lesion was higher in <40 years compared to ≥40 year age group (12.95 vs. 4.1%) with cytology, while for VIA no difference was detected in between age groups (9.8 vs. 13.3%).

Conclusion

Cytological screening is less sensitive in women ≥40 years while VIA has a uniform sensitivity for both groups.
Literatur
1.
2.
Zurück zum Zitat Directorate General of Health Services (1984) National Cancer Control Program of India. Government of India, New Delhi Directorate General of Health Services (1984) National Cancer Control Program of India. Government of India, New Delhi
3.
Zurück zum Zitat Stjernsward J, Eddy D, Luthra UK, Stanley K (1987) Plotting a new course for cervical cancer in developing countries. World Health Frm 8:42–45 Stjernsward J, Eddy D, Luthra UK, Stanley K (1987) Plotting a new course for cervical cancer in developing countries. World Health Frm 8:42–45
4.
Zurück zum Zitat Sankaranarayanan R, Nene BM, Shastri SS, Jayant K, Muwonge R, Budukh AM et al (2009) HPV screening for cervical cancer in rural India. N Engl J Med 360(14):1385–1394PubMedCrossRef Sankaranarayanan R, Nene BM, Shastri SS, Jayant K, Muwonge R, Budukh AM et al (2009) HPV screening for cervical cancer in rural India. N Engl J Med 360(14):1385–1394PubMedCrossRef
5.
Zurück zum Zitat Sankaranarayanan R, Basu P, Wesley RS, Mahe C, Keita N, Mbalawa CCG, Sharma R, Dolo A, Shastri SS, Nacoulma M, Nayama M, Somanathan T, For the IARC Multicentre Study Group on Cervical Cancer Early Detection (2004) Accuracy of visual screening for cervical neoplasia: Results from an IARC multicentre study in India and Africa. Int J Cancer 110:907–913PubMedCrossRef Sankaranarayanan R, Basu P, Wesley RS, Mahe C, Keita N, Mbalawa CCG, Sharma R, Dolo A, Shastri SS, Nacoulma M, Nayama M, Somanathan T, For the IARC Multicentre Study Group on Cervical Cancer Early Detection (2004) Accuracy of visual screening for cervical neoplasia: Results from an IARC multicentre study in India and Africa. Int J Cancer 110:907–913PubMedCrossRef
6.
Zurück zum Zitat Sankaranarayanan R, Esmy PO, Rajkumar R (2007) Effect of visual screening on cervical cancer incidence and mortality in Tamilnadu, India: a cluster randomized trial. Lancet 370:398–407PubMedCrossRef Sankaranarayanan R, Esmy PO, Rajkumar R (2007) Effect of visual screening on cervical cancer incidence and mortality in Tamilnadu, India: a cluster randomized trial. Lancet 370:398–407PubMedCrossRef
7.
Zurück zum Zitat ASC-US-LSIL Triage Study (ALTS) Group (2003) Results of a randomized trial on the management of cytology interpretations of atypical squamous cells of undetermined significance. Am J Obstet Gynecol 188(6):1383–1392 ASC-US-LSIL Triage Study (ALTS) Group (2003) Results of a randomized trial on the management of cytology interpretations of atypical squamous cells of undetermined significance. Am J Obstet Gynecol 188(6):1383–1392
8.
Zurück zum Zitat Saminathan T, Lahoti C, Kannan V, Kline TS (1994) Postmenopausal squamous-cell atypias: a diagnostic challenge. Diagn Cytopathol 11:226–230PubMedCrossRef Saminathan T, Lahoti C, Kannan V, Kline TS (1994) Postmenopausal squamous-cell atypias: a diagnostic challenge. Diagn Cytopathol 11:226–230PubMedCrossRef
9.
Zurück zum Zitat Keating JT, Wang HH (2001) Significance of a diagnosis of atypical squamous cells of undetermined significance for papanicolaou smears in perimenopausal and postmenopausal women. Cancer 93(2):100–105PubMedCrossRef Keating JT, Wang HH (2001) Significance of a diagnosis of atypical squamous cells of undetermined significance for papanicolaou smears in perimenopausal and postmenopausal women. Cancer 93(2):100–105PubMedCrossRef
10.
Zurück zum Zitat Sankaranarayanan R, Nene BM, Dinshaw KA, Mahe C, Jayant K, Shastri SS, Malvi SG, Chinoy SG, Kelkar R, Budukh AM, Keskar V, Rajeshwarker R, Muwonge R et al on behalf of the Osmanabad District Cervical Screening Study Group (2005) A cluster randomized controlled trial of visual, cytology and human papillomavirus screening for cancer of the cervix in rural India. Int J Cancer 116:617–623 Sankaranarayanan R, Nene BM, Dinshaw KA, Mahe C, Jayant K, Shastri SS, Malvi SG, Chinoy SG, Kelkar R, Budukh AM, Keskar V, Rajeshwarker R, Muwonge R et al on behalf of the Osmanabad District Cervical Screening Study Group (2005) A cluster randomized controlled trial of visual, cytology and human papillomavirus screening for cancer of the cervix in rural India. Int J Cancer 116:617–623
11.
Zurück zum Zitat Arbyn M, Sankaranarayanan R, Muwonge R, Keita N, Dolo A, Mbalawa CG, Nouhou H, Sakande B, Wesley R, Somanathan T, Sharma A, Shastri S, Basu P (2008) Pooled analysis of the accuracy of five cervical cancer screening tests assessed in eleven studies in Africa and India. Int J Cancer 123(1):153–160PubMedCrossRef Arbyn M, Sankaranarayanan R, Muwonge R, Keita N, Dolo A, Mbalawa CG, Nouhou H, Sakande B, Wesley R, Somanathan T, Sharma A, Shastri S, Basu P (2008) Pooled analysis of the accuracy of five cervical cancer screening tests assessed in eleven studies in Africa and India. Int J Cancer 123(1):153–160PubMedCrossRef
12.
Zurück zum Zitat Solomon D, Davey D, Kurman R, Moriarty A, O’Connor D, Prey M et al (2002) The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA 287(16):2114–2119PubMedCrossRef Solomon D, Davey D, Kurman R, Moriarty A, O’Connor D, Prey M et al (2002) The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA 287(16):2114–2119PubMedCrossRef
13.
Zurück zum Zitat Sankaranarayanan R, Wesley R (2003) A practical manual on visual screening for cervical neoplasia: IARC Technical Publication No. 41. Int Agency for Res Cancer, IARC Press, Lyon Sankaranarayanan R, Wesley R (2003) A practical manual on visual screening for cervical neoplasia: IARC Technical Publication No. 41. Int Agency for Res Cancer, IARC Press, Lyon
14.
Zurück zum Zitat Cytryn A, Russomano FB, de Camargo MJ, Zardo LMG, Horta NMSR, de Paula Fonseca RCS et al (2009) Prevalence of cervical intraepithelial neoplasia grades II/III and cervical cancer in patients with cytological diagnosis of atypical squamous cells when high-grade intraepithelial lesions (ASC-H) cannot be ruled out. Sao Paulo Med J 127(5):283–287PubMedCrossRef Cytryn A, Russomano FB, de Camargo MJ, Zardo LMG, Horta NMSR, de Paula Fonseca RCS et al (2009) Prevalence of cervical intraepithelial neoplasia grades II/III and cervical cancer in patients with cytological diagnosis of atypical squamous cells when high-grade intraepithelial lesions (ASC-H) cannot be ruled out. Sao Paulo Med J 127(5):283–287PubMedCrossRef
15.
Zurück zum Zitat Ali PM, Ali SZ (2003) Atypical squamous cell of undetermined significance- rule out high grade squamous intraepithelial lesion: cytopathological characteristics and clinical correlates. Diagn Cytopathol 28(6):308–312PubMedCrossRef Ali PM, Ali SZ (2003) Atypical squamous cell of undetermined significance- rule out high grade squamous intraepithelial lesion: cytopathological characteristics and clinical correlates. Diagn Cytopathol 28(6):308–312PubMedCrossRef
16.
Zurück zum Zitat Peto J, Gilham C, Fletcher O, Matthews FE (2004) The cervical cancer epidemic that screening has prevented in the UK. Lancet 364:249–256PubMedCrossRef Peto J, Gilham C, Fletcher O, Matthews FE (2004) The cervical cancer epidemic that screening has prevented in the UK. Lancet 364:249–256PubMedCrossRef
17.
Zurück zum Zitat Bray F, Loos AH, McCarron P, Weiderpass E, Arbyn M, Møller H, Hakama M, Parkin DM (2005) Trends in cervical squamous cell carcinoma incidence in 13 European countries: changing risk and the effects of screening. Cancer Epidemiol Biomarkers Prev 14(3):677–686PubMedCrossRef Bray F, Loos AH, McCarron P, Weiderpass E, Arbyn M, Møller H, Hakama M, Parkin DM (2005) Trends in cervical squamous cell carcinoma incidence in 13 European countries: changing risk and the effects of screening. Cancer Epidemiol Biomarkers Prev 14(3):677–686PubMedCrossRef
18.
Zurück zum Zitat Sankaranarayanan R, Budukh AM, Rajkumar R (2001) Effective screening programmes for cervical cancer in low- and middle-income developing countries. Bull World Health Org 79:954–962PubMed Sankaranarayanan R, Budukh AM, Rajkumar R (2001) Effective screening programmes for cervical cancer in low- and middle-income developing countries. Bull World Health Org 79:954–962PubMed
19.
Zurück zum Zitat Sarian LO, Derchain S, Shabalova I, Tatti S, Naud P, Longatto-Filho A, Syrjänen S, Members of the Latin American Screening Study (LAMS), New Independent States of the Former Soviet Union (NIS) Groups (2010) Optional screening strategies for cervical cancer using standalone tests and their combinations among low- and medium-income populations in Latin America and Eastern Europe. J Med Screen 17(4):195–203PubMedCrossRef Sarian LO, Derchain S, Shabalova I, Tatti S, Naud P, Longatto-Filho A, Syrjänen S, Members of the Latin American Screening Study (LAMS), New Independent States of the Former Soviet Union (NIS) Groups (2010) Optional screening strategies for cervical cancer using standalone tests and their combinations among low- and medium-income populations in Latin America and Eastern Europe. J Med Screen 17(4):195–203PubMedCrossRef
20.
Zurück zum Zitat Ronco G, Giorgi-Rossi P, Carozzi F, Confortini M, Dalla Palma P, Del Mistro A, Ghiringhello B, Girlando S, Gillio-Tos A, De Marco L, Naldoni C, Pierotti P, Rizzolo R, Schincaglia P, Zorzi M, Zappa M, Segnan N, Cuzick J, New Technologies for Cervical Cancer screening (NTCC) Working Group (2010) Efficacy of human papillomavirus testing for the detection of invasive cervical cancers and cervical intraepithelial neoplasia: a randomised controlled trial. Lancet Oncol 11(3):249–257PubMedCrossRef Ronco G, Giorgi-Rossi P, Carozzi F, Confortini M, Dalla Palma P, Del Mistro A, Ghiringhello B, Girlando S, Gillio-Tos A, De Marco L, Naldoni C, Pierotti P, Rizzolo R, Schincaglia P, Zorzi M, Zappa M, Segnan N, Cuzick J, New Technologies for Cervical Cancer screening (NTCC) Working Group (2010) Efficacy of human papillomavirus testing for the detection of invasive cervical cancers and cervical intraepithelial neoplasia: a randomised controlled trial. Lancet Oncol 11(3):249–257PubMedCrossRef
21.
Zurück zum Zitat Leinonen M, Nieminen P, Kotaniemi-Talonen L, Malila N, Tarkkanen J, Laurila P, Anttila A (2009) Age-specific evaluation of primary human papillomavirus screening versus conventional cytology in a randomized setting. J Natl Cancer Inst 101(23):1612–1623PubMedCrossRef Leinonen M, Nieminen P, Kotaniemi-Talonen L, Malila N, Tarkkanen J, Laurila P, Anttila A (2009) Age-specific evaluation of primary human papillomavirus screening versus conventional cytology in a randomized setting. J Natl Cancer Inst 101(23):1612–1623PubMedCrossRef
22.
Zurück zum Zitat Schiffman M, Castle PE, Jeronimo J, Rodriguez AC, Wacholder S (2007) Human papilloma virus and cervical cancer. Lancet 370:890–907PubMedCrossRef Schiffman M, Castle PE, Jeronimo J, Rodriguez AC, Wacholder S (2007) Human papilloma virus and cervical cancer. Lancet 370:890–907PubMedCrossRef
23.
Zurück zum Zitat Cibas ES, Browne TJ, Bassichis MHM, Lee KR (2005) Enlarged squamous cell nuclei in cervical cytologic specimens from perimenopausal women (“PM Cells”) a cause of ASC overdiagnosis. Am J Clin Pathol 124:58–61PubMedCrossRef Cibas ES, Browne TJ, Bassichis MHM, Lee KR (2005) Enlarged squamous cell nuclei in cervical cytologic specimens from perimenopausal women (“PM Cells”) a cause of ASC overdiagnosis. Am J Clin Pathol 124:58–61PubMedCrossRef
24.
Zurück zum Zitat Kainz C, Tempfer C, Gitsch G, Heinz H, Reinthaller A, Breitenecker G (1995) Influence of age and human papillomavirus-infection on reliability of cervical cytopathology. Arch Gynecol Obstet 256:23–28PubMedCrossRef Kainz C, Tempfer C, Gitsch G, Heinz H, Reinthaller A, Breitenecker G (1995) Influence of age and human papillomavirus-infection on reliability of cervical cytopathology. Arch Gynecol Obstet 256:23–28PubMedCrossRef
25.
Zurück zum Zitat McGrath CM (2002) ASCUS in papanicolaou smears problems, controversies, and potential future directions. Am J Clin Pathol 117(Suppl 1):62–75 McGrath CM (2002) ASCUS in papanicolaou smears problems, controversies, and potential future directions. Am J Clin Pathol 117(Suppl 1):62–75
26.
Zurück zum Zitat Autier P, Coibion M, Huet F, Grivegneel AR (1996) Transformation zone location and intraepithelial neoplasia of the cervix uteri. Br J Cancer 74:488–490PubMedCrossRef Autier P, Coibion M, Huet F, Grivegneel AR (1996) Transformation zone location and intraepithelial neoplasia of the cervix uteri. Br J Cancer 74:488–490PubMedCrossRef
Metadaten
Titel
Is visual inspection with acetic acid better than cervical cytology to screen women ≥40 years of age for carcinoma cervix? A cross-sectional study on proportion of screen-positive women (by VIA and cervical cytology) having CIN II/III lesion on cervical biopsy: difference between two age groups and among screening methods
verfasst von
Subhankar Dasgupta
Sudhindramohan Bhattacharya
Publikationsdatum
01.06.2012
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 6/2012
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-012-2228-3

Weitere Artikel der Ausgabe 6/2012

Archives of Gynecology and Obstetrics 6/2012 Zur Ausgabe

Hirsutismus bei PCOS: Laser- und Lichttherapien helfen

26.04.2024 Hirsutismus Nachrichten

Laser- und Lichtbehandlungen können bei Frauen mit polyzystischem Ovarialsyndrom (PCOS) den übermäßigen Haarwuchs verringern und das Wohlbefinden verbessern – bei alleiniger Anwendung oder in Kombination mit Medikamenten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

22.04.2024 DGIM 2024 Kongressbericht

Durch die Häufung nach der COVID-19-Pandemie sind Infektionen mit dem Respiratorischen Synzytial-Virus (RSV) in den Fokus gerückt. Fachgesellschaften empfehlen eine Impfung inzwischen nicht nur für Säuglinge und Kleinkinder.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.