TY - JOUR
T1 - Cytology versus visual inspection with acetic acid among women treated previously with cryotherapy in a low-resource setting
AU - Cremer, Miriam
AU - Bullard, Kimberley
AU - Maza, Mauricio
AU - Peralta, Ethel
AU - Moore, Elizabeth
AU - Garcia, Lydia
AU - Masch, Rachel
AU - Lerner, Veronica
AU - Alonzo, Todd A.
AU - Felix, Juan
N1 - Funding Information:
This research was supported by the Einhorn Family Charitable Trust.
PY - 2010/12
Y1 - 2010/12
N2 - Objective: To compare visual inspection with acetic acid (VIA) with conventional cervical cytology as a follow-up cervical cancer screening method in women who had been treated previously with cryotherapy. Methods: Salvadoran women screened with VIA and treated with cryotherapy within 3 years were eligible to participate. Study participants were rescreened with VIA, Pap smear, colposcopy, 4-quandrant biopsy, and endocervical curettage. Results: Of 147 women enrolled in the study, post-cryotherapy VIA was positive in 39 women (26.5%; 95% CI, 19.6%-34.4%). Of these 39, 1 woman had CIN 1 or higher on biopsy. Post-cryotherapy Pap smear was positive (ASCUS or higher) in 6 women (4.1%; 95% CI, 1.5%-8.7%). Of these 6, 2 women had CIN 1 or higher on biopsy. Post-cryotherapy specificity was significantly higher for Pap compared with VIA (95.8% [138/144]; 95% CI, 91.2%-98.5% vs 73.6% [106/144]; 95% CI, 65.6%-80.6%; P < 0.001). Conclusion: As the single-visit approach for cervical cancer screening gains popularity, more women will have been treated with cryotherapy. Appropriate follow-up screening is therefore vital. Cytology may be a more suitable screening method than VIA in low-resource settings for women treated previously with cryotherapy.
AB - Objective: To compare visual inspection with acetic acid (VIA) with conventional cervical cytology as a follow-up cervical cancer screening method in women who had been treated previously with cryotherapy. Methods: Salvadoran women screened with VIA and treated with cryotherapy within 3 years were eligible to participate. Study participants were rescreened with VIA, Pap smear, colposcopy, 4-quandrant biopsy, and endocervical curettage. Results: Of 147 women enrolled in the study, post-cryotherapy VIA was positive in 39 women (26.5%; 95% CI, 19.6%-34.4%). Of these 39, 1 woman had CIN 1 or higher on biopsy. Post-cryotherapy Pap smear was positive (ASCUS or higher) in 6 women (4.1%; 95% CI, 1.5%-8.7%). Of these 6, 2 women had CIN 1 or higher on biopsy. Post-cryotherapy specificity was significantly higher for Pap compared with VIA (95.8% [138/144]; 95% CI, 91.2%-98.5% vs 73.6% [106/144]; 95% CI, 65.6%-80.6%; P < 0.001). Conclusion: As the single-visit approach for cervical cancer screening gains popularity, more women will have been treated with cryotherapy. Appropriate follow-up screening is therefore vital. Cytology may be a more suitable screening method than VIA in low-resource settings for women treated previously with cryotherapy.
KW - Cryotherapy
KW - Cytology
KW - El Salvador
KW - Follow-up screening
KW - Low-resource setting
KW - VIA
KW - Visual inspection with ascetic acid
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U2 - 10.1016/j.ijgo.2010.06.022
DO - 10.1016/j.ijgo.2010.06.022
M3 - Article
C2 - 20801447
AN - SCOPUS:78049529105
SN - 0020-7292
VL - 111
SP - 249
EP - 252
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
IS - 3
ER -