TY  - JOUR
AU  - Toliman, PJ
AU  - Kaldor, JM
AU  - Badman, SG
AU  - Gabuzzi, J
AU  - Silim, S
AU  - Kumbia, A
AU  - Kombuk, B
AU  - Kombati, Z
AU  - Munnull, G
AU  - Guy, R
AU  - Vallely, LM
AU  - Kelly-Hanku, A
AU  - Wand, H
AU  - Ryan, C
AU  - Tan, G
AU  - Brotherton, J
AU  - Saville, M
AU  - Mola, GDL
AU  - Garland, SM
AU  - Tabrizi, SN
AU  - Vallely, AJ
Y2  - 2020/12/09
Y1  - 2018/12/01
SN  - 2405-8521
UR  - http://hdl.handle.net/11343/253123
AB  - The performance of different clinical screening algorithms comprising point-of-care HPV-DNA testing using self-collected vaginal ('V') specimens, and visual inspection of the cervix with acetic acid (VIA) was evaluated in Papua New Guinea. Women aged 30-59 years provided V specimens that were tested at point-of-care using the Xpert HPV Test (Cepheid, Sunnyvale, CA). A clinician-collected cervical ('C') specimen was then collected for point-of-care Xpert testing, and liquid-based cytology (LBC). Following this, VIA examination was conducted, blind to HPV test results, and ablative cervical cryotherapy provided if indicated. Detection of high-grade squamous intraepithelial lesion (HSIL) by LBC was the reference standard used to evaluate clinical screening algorithms. Of 1005 women, 36 had HSIL+. Xpert HPV Test performance using V specimens (sensitivity 91.7%, specificity 87.0%, PPV 34.0%, NPV 99.3%) was superior to VIA examination alone (51.5%, 81.4%, 17.5%, 95.6% respectively) in predicting underlying HSIL+. A screening algorithm comprising V specimen HPV testing followed by VIA examination had low sensitivity (45.5%) but comparable specificity, PPV and NPV to HPV testing alone (96.3%, 45.5%, 96.3% respectively). A 'test-and-treat' screening algorithm based on point-of-care HPV testing of V specimens had superior performance compared with either VIA examination alone, or a combined screening algorithm comprising HPV testing plus VIA.
LA  - English
PB  - ELSEVIER SCIENCE BV
T1  - Performance of clinical screening algorithms comprising point-of-care HPV-DNA testing using self-collected vaginal specimens, and visual inspection of the cervix with acetic acid, for the detection of underlying high-grade squamous intraepithelial lesions in Papua New Guinea
DO  - 10.1016/j.pvr.2018.10.009
IS  - Papillomavirus Research
VL  - 6
SP  - 70-76
L1  - /bitstream/handle/11343/253123/PMC6250751.pdf?sequence=1&isAllowed=y
ER  -