You are here

Article Text

Article menu

Download PDFPDF

Original Article
Evaluation of portable colposcopy and human papillomavirus testing for screening of cervical cancer in rural China
  1. Haley Newman1,2,
  2. Jilin Hu3,
  3. Xiao Li4,
  4. Jing He3,4,
  5. Leslie Bradford5,
  6. Songmei Shan4,
  7. Xiaomei Wu3,4,
  8. Bin Zhu6,
  9. Wenyang Yang6,
  10. Bingqin Fu6,
  11. Baosheng Zhu3,4 and
  12. Guangping Gao7
  1. 1 Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
  2. 2 Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
  3. 3 Kunming University of Science and Technology, Kunming, China
  4. 4 Department of Obstetrics and Gynecology, National Health Commission’s Key Laboratory for Healthy Births in Western China, First People's Hospital of Yunnan Province, Yunnan, China
  5. 5 Maine Medical Partners Women’s Health Division of Gynecologic Oncology, Portland, Maine, USA
  6. 6 Maternal and Child Health and Family Planning Service Center of Longyang District, Yunnan, China
  7. 7 Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, Massachusetts, USA
  1. Correspondence to Baosheng Zhu, Department of Obstetricsand Gynecology, National Health Commission’s Key Laboratory for Healthy Births in WesternChina, First People's Hospital of Yunnan Province, Yunnan 650032, China; bszhu{at}aliyun.com

Abstract

Objective To evaluate the use of a portable, rechargeable colposcope combined with human papillomavirus (HPV) testing, as compared with HPV testing alone, for screening of cervical cancer and pre-cancerous lesions.

Methods This was a cross-sectional study among 488 women in Baoshan County, Yunnan. The women underwent HPV testing followed by Gynocular portable colposcopy with visual inspection with acetic acid. Obvious lesions were biopsied. If portable colposcopy testing was negative but HPV testing was positive, the women underwent follow-up testing with thin-prep cytology and traditional colposcopy. Cervical biopsies were performed for any abnormalities. Histopathology was followed up with diagnosis and treatment.

Results Among 488 women screened with portable colposcopy, 24 women underwent biopsy based on positive colposcopy screening. Of these 24 women, three were HPV positive and 21 were HPV negative. Five women had cervical intra-epithelial neoplasia (CIN) I and one had advanced cervical cancer. Forty-six women tested positive for HPV. Three of these women had screened positive on preliminary colposcopy, with one positive for CIN III/squamous cell carcinoma and one woman with CIN I. Forty-three women underwent follow-up testing with thin-prep cytology. Two women had atypical squamous cells of undetermined significance and five had low-grade squamous intra-epithelial lesions and were biopsied; three women had CIN I, one had CIN II and one had CIN III. HPV testing and portable colposcopy was more sensitive but slightly less specific than portable colposcopy or HPV testing alone.

Conclusion While HPV testing has high sensitivity and specificity for the detection of pre-cancerous and cancerous lesions and portable colposcopy has lower specificity, both methods of detection have low positive predictive value and high negative predictive value. In tandem, HPV testing and portable colposcopy had higher sensitivity for detection among women who underwent biopsies. In clinical practice, portable colposcopy was an effective, easy and affordable tool to transport to villages where cytology is not currently feasible.

  • cervical cancer screening
  • portable colposcopy
  • human papillomavirus

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, an indication of whether changes were made, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0

https://doi.org/10.1136/ijgc-2018-000006

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • HN and JH contributed equally.

    • Funding Gynius AB, Stockholm, Sweden, donated the two Gynocular colposcopes to be used in the study. They did not have any role in preparing the study protocol, conducting the study, analysis or manuscript preparation. The study was supported by The First People’s Hospital of Yunnan Province.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.