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HPV DNA Test Alone and HPV DNA Test Combined with VIA as Screening Test for Cervical Cancer
Shabnom Mostofa Purobi1, Ashrafunnesa1, Shirin Akter Begum1
1Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Background:
Cervical cancer (CC) remains a leading cause of cancer-related deaths among women globally. Persistent infection with high-risk human papillomavirus (HPV) is the primary risk factor. This study aims to compare the diagnostic accuracy of the HPV DNA test alone versus in combination with visual inspection with acetic acid (VIA) for CC screening in Bangladesh.
Methodology:
A cross-sectional analytical study was conducted at the National Centre for Cervical and Breast Cancer Screening and Training, Bangabandhu Sheikh Mujib Medical University, Dhaka, from September 2023 to August 2024. A total of 400 women underwent HPV DNA testing, VIA, and colposcopy. Data were analyzed using SPSS version 26.0 (IBM Corp., Armonk, NY, USA).
Results:
The mean participant age was 39.9 ± 7.4 years. The HPV DNA test identified 9 positive cases (2.25%), VIA identified 44 (11%), and the combined test detected 8 cases (2%). Colposcopy confirmed 10 cases (2.5%). VIA showed 100% sensitivity but a low positive predictive value (PPV) (22.7%). HPV DNA had 80% sensitivity, 99.7% specificity, and 88.8% PPV. The combined approach showed 80% sensitivity, 100% specificity, and 100% PPV, with 99.5% accuracy.
Conclusion:
Combining HPV DNA and VIA improves specificity and predictive value, making it a highly effective CC screening strategy in low-resource settings.
