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Human papillomavirus testing as an optional screening tool in low-resource settings of Latin America: experience from the Latin American Screening study
  1. A. Longatto-Filho*,,
  2. M. Eržen,
  3. M. Branca§,
  4. C. Roteli-Martins,
  5. P. Naud,
  6. S. F.M. Derchain#,
  7. L. Hammes,
  8. L. O. Sarian#,
  9. J. F. Bragança#,
  10. J. Matos,
  11. R. Gontijo#,
  12. T. Lima,
  13. M. Y.S. Maeda*,
  14. S. Tatti**,
  15. S. Syrjänen#,
  16. G. Dores,,
  17. A. LÖRINCZ§§ and
  18. K. Syrjänen#
  1. * Pathology Division of Adolfo Lutz Institute, São Paulo, Brazil and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
  2. Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
  3. SIZE Diagnostic Center, Ljubljana, Slovenia
  4. § Istituto Superiore di Sanità, Rome, Italy
  5. Cervical Pathology Services, Hospital Leonor Mendes de Barros, São Paulo, Brazil
  6. Department of Gynecology & Obstetrics, Hospital de Clinicas de Porto Alegre, Brazil
  7. # Centro de Atenção Integral à Saúde Da Mulher (CAISM), Universidade Estadual de Campinas, Brazil
  8. ** Department of Gynecology & Obstetrics, Hospital de Clínicas de Porto Alegre, Brazil
  9. ‡‡ Digene Brasil, São Paulo, Brazil
  10. §§ Digen Corporation, Gaithersburg, Maryland
  1. Address correspondence and reprint requests to: Adhemar Longatto-Filho, MSc, PhD, PMIAC, Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal. Email: longatto16{at}hotmail.com

Abstract

Hybrid capture II (HC II) test for oncogenic human papillomaviruses (HPV) was carried out in a cohort of 4284 women at their first clinical visit. Overall prevalence of HPV was 17.1%, decreasing with age from 33.9% among women below 20 years to only 11.0% among those older than 41 years. HPV prevalence was significantly higher among current smokers (odds ratio [OR] = 1.31; 95% CI 1.1–1.6), in women with two or more lifetime sexual partners (OR = 1.9; 95% CI 1.6–2.4), and those women with two or more sexual partners during the past 12 months prior to examination (OR = 1.6; 95% CI 1.2–2.2). HPV detection increased in parallel with increasing cytologic abnormality, being highest in women with high-grade squamous intraepithelial lesion (P = 0.001). Specificity of the HPV test in detecting histologically confirmed cervical disease was 85% (95% CI 83.9–86.1). Sensitivity of the HPV test in detecting histologic abnormalities increased in parallel with disease severity, ranging from 51.5% for cervical intraepithelial neoplasia (CIN) 1 to 96.5% for CIN 3 and 100.0% for cancer, with respective decline of positive predictive value. These data suggest that HPV testing with HC II assay might be a viable screening tool among this population with relatively high prevalence of cervical disease.

  • cervical cancer
  • HPV testing
  • low-resource setting
  • screening

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