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Testing cervicography and cervicoscopy as screening tests for cervical cancer
S Cecchini1, R Bonardi, A Mazzotta
1Centro per lo Studio e la Prevenzione Oncologica, Florence, Italy.
Tumori
|February 28, 1993
Summary
Cervicoscopy, a naked-eye examination after acetic acid lavage, shows promise for cervical cancer screening. While less specific than cytology, it significantly increases the detection of CIN 2-3 lesions at a lower cost, warranting further evaluation.
Area of Science:
- Gynecology
- Oncology
- Public Health
Background:
- Cervical cancer screening relies on Pap tests, which have suboptimal sensitivity.
- Colposcopy is more sensitive but not feasible for widespread screening due to cost and complexity.
- Cervicography and cervicoscopy are proposed as more feasible screening alternatives.
Purpose of the Study:
- To evaluate the feasibility of cervicography and cervicoscopy as cervical cancer screening methods.
- To compare the positivity rate, CIN 2-3 detection rate, and positive predictive value of cytology, cervicography, and cervicoscopy.
Main Methods:
- Cervicography and cervicoscopy were performed by smear takers in a consecutive screening series.
- Women with abnormal cytology or abnormal cervicography/cervicoscopy results underwent colposcopic assessment.
- Comparison of screening methods based on positivity rate, CIN 2-3 detection, and positive predictive value.
Main Results:
- Cervicoscopy had the highest positivity rate (25.4%) compared to cervicography (15.3%) and cytology (3.8%).
- Cervicoscopy detected 7 out of 8 CIN 2-3 lesions, with a positive predictive value of 2.05%.
- The cost per detected CIN 2-3 lesion was $3,916 for cervicoscopy, significantly lower than cytology ($5,543) or cervicography ($12,947).
Conclusions:
- Cervicoscopy, despite lower specificity, effectively increases CIN 2-3 detection rates at a relatively low cost.
- Cervicography was not found to be cost-effective in this study.
- Cervicoscopy demonstrates potential as a valuable cervical cancer screening tool meriting further investigation.