Lack of agreement between cervicography and cytology and the effect of human papillomavirus infection and viral load

Nicolas F. Schlecht, Andrea Trevisan, Maria Luiza Baggio, Lenice Galan, Eliane Duarte-Franco, Mitchell D. Greenberg, Thomas E. Rohan, Alex Ferenczy, Luisa L. Villa, Eduardo L. Franco

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVE. Cohort studies of the natural history of human papillomavirus (HPV) infection and cervical squamous intraepithelial lesions with repeated screening allow the comparison of different macroscopic and microscopic diagnostic methods. MATERIALS AND METHODS. Concurrent visual inspection using cervicography and conventional Pap cytology tests were performed during multiple visits in a cohort of women attending a maternal and child health clinic in São Paulo, Brazil. HPV infection status at the same visits was determined by polymerase chain reaction followed by typing with specific oligonucleotide probing and viral load quantification. Information on reproductive health and hygiene habits was also collected at each visit. RESULTS. Overall agreement between cervicography and cytology was low (κ = 0.046), which increased only slightly when high oncogenic-risk HPV types (κ = 0.120) or high viral burden (>100 copies/cell) (κ = 0.170) was present. Analysis of reproductive health and hygiene habits revealed somewhat different risk factors for cervical lesions detected by these tests. However, presence of oncogenic HPV DNA (odds ratio = 36.0, 95% CI = 16.6-77.8) and high viral burden (odds ratio = 67.34; 95% CI = 27.1-167.0) were strongly associated with lesions detected by cytology but not by cervicography. CONCLUSIONS. Although changes in the cervix (because of age, gravidity, or hormonal effects) may influence the performance of morphology-based screening tests, the lack of agreement and the different degrees of association with HPV infection measures indicate that a visual inspection method such as cervicography may detect different cervical abnormalities relative to cytology.

Original languageEnglish (US)
Pages (from-to)229-237
Number of pages9
JournalJournal of Lower Genital Tract Disease
Volume10
Issue number4
DOIs
StatePublished - Oct 2006

Fingerprint

Papillomavirus Infections
Viral Load
Cell Biology
Reproductive Health
Hygiene
Habits
Odds Ratio
Gravidity
Papanicolaou Test
Cervix Uteri
Oligonucleotides
Brazil
Cohort Studies
Polymerase Chain Reaction
DNA

Keywords

  • Cervical neoplasia
  • Cervicography
  • Diagnostic tests
  • Human papillomavirus
  • Pap smear

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Schlecht, N. F., Trevisan, A., Baggio, M. L., Galan, L., Duarte-Franco, E., Greenberg, M. D., ... Franco, E. L. (2006). Lack of agreement between cervicography and cytology and the effect of human papillomavirus infection and viral load. Journal of Lower Genital Tract Disease, 10(4), 229-237. https://doi.org/10.1097/01.lgt.0000225892.03613.2c

Lack of agreement between cervicography and cytology and the effect of human papillomavirus infection and viral load. / Schlecht, Nicolas F.; Trevisan, Andrea; Baggio, Maria Luiza; Galan, Lenice; Duarte-Franco, Eliane; Greenberg, Mitchell D.; Rohan, Thomas E.; Ferenczy, Alex; Villa, Luisa L.; Franco, Eduardo L.

In: Journal of Lower Genital Tract Disease, Vol. 10, No. 4, 10.2006, p. 229-237.

Research output: Contribution to journalArticle

Schlecht, NF, Trevisan, A, Baggio, ML, Galan, L, Duarte-Franco, E, Greenberg, MD, Rohan, TE, Ferenczy, A, Villa, LL & Franco, EL 2006, 'Lack of agreement between cervicography and cytology and the effect of human papillomavirus infection and viral load', Journal of Lower Genital Tract Disease, vol. 10, no. 4, pp. 229-237. https://doi.org/10.1097/01.lgt.0000225892.03613.2c
Schlecht, Nicolas F. ; Trevisan, Andrea ; Baggio, Maria Luiza ; Galan, Lenice ; Duarte-Franco, Eliane ; Greenberg, Mitchell D. ; Rohan, Thomas E. ; Ferenczy, Alex ; Villa, Luisa L. ; Franco, Eduardo L. / Lack of agreement between cervicography and cytology and the effect of human papillomavirus infection and viral load. In: Journal of Lower Genital Tract Disease. 2006 ; Vol. 10, No. 4. pp. 229-237.
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abstract = "OBJECTIVE. Cohort studies of the natural history of human papillomavirus (HPV) infection and cervical squamous intraepithelial lesions with repeated screening allow the comparison of different macroscopic and microscopic diagnostic methods. MATERIALS AND METHODS. Concurrent visual inspection using cervicography and conventional Pap cytology tests were performed during multiple visits in a cohort of women attending a maternal and child health clinic in S{\~a}o Paulo, Brazil. HPV infection status at the same visits was determined by polymerase chain reaction followed by typing with specific oligonucleotide probing and viral load quantification. Information on reproductive health and hygiene habits was also collected at each visit. RESULTS. Overall agreement between cervicography and cytology was low (κ = 0.046), which increased only slightly when high oncogenic-risk HPV types (κ = 0.120) or high viral burden (>100 copies/cell) (κ = 0.170) was present. Analysis of reproductive health and hygiene habits revealed somewhat different risk factors for cervical lesions detected by these tests. However, presence of oncogenic HPV DNA (odds ratio = 36.0, 95{\%} CI = 16.6-77.8) and high viral burden (odds ratio = 67.34; 95{\%} CI = 27.1-167.0) were strongly associated with lesions detected by cytology but not by cervicography. CONCLUSIONS. Although changes in the cervix (because of age, gravidity, or hormonal effects) may influence the performance of morphology-based screening tests, the lack of agreement and the different degrees of association with HPV infection measures indicate that a visual inspection method such as cervicography may detect different cervical abnormalities relative to cytology.",
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AU - Schlecht, Nicolas F.

AU - Trevisan, Andrea

AU - Baggio, Maria Luiza

AU - Galan, Lenice

AU - Duarte-Franco, Eliane

AU - Greenberg, Mitchell D.

AU - Rohan, Thomas E.

AU - Ferenczy, Alex

AU - Villa, Luisa L.

AU - Franco, Eduardo L.

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N2 - OBJECTIVE. Cohort studies of the natural history of human papillomavirus (HPV) infection and cervical squamous intraepithelial lesions with repeated screening allow the comparison of different macroscopic and microscopic diagnostic methods. MATERIALS AND METHODS. Concurrent visual inspection using cervicography and conventional Pap cytology tests were performed during multiple visits in a cohort of women attending a maternal and child health clinic in São Paulo, Brazil. HPV infection status at the same visits was determined by polymerase chain reaction followed by typing with specific oligonucleotide probing and viral load quantification. Information on reproductive health and hygiene habits was also collected at each visit. RESULTS. Overall agreement between cervicography and cytology was low (κ = 0.046), which increased only slightly when high oncogenic-risk HPV types (κ = 0.120) or high viral burden (>100 copies/cell) (κ = 0.170) was present. Analysis of reproductive health and hygiene habits revealed somewhat different risk factors for cervical lesions detected by these tests. However, presence of oncogenic HPV DNA (odds ratio = 36.0, 95% CI = 16.6-77.8) and high viral burden (odds ratio = 67.34; 95% CI = 27.1-167.0) were strongly associated with lesions detected by cytology but not by cervicography. CONCLUSIONS. Although changes in the cervix (because of age, gravidity, or hormonal effects) may influence the performance of morphology-based screening tests, the lack of agreement and the different degrees of association with HPV infection measures indicate that a visual inspection method such as cervicography may detect different cervical abnormalities relative to cytology.

AB - OBJECTIVE. Cohort studies of the natural history of human papillomavirus (HPV) infection and cervical squamous intraepithelial lesions with repeated screening allow the comparison of different macroscopic and microscopic diagnostic methods. MATERIALS AND METHODS. Concurrent visual inspection using cervicography and conventional Pap cytology tests were performed during multiple visits in a cohort of women attending a maternal and child health clinic in São Paulo, Brazil. HPV infection status at the same visits was determined by polymerase chain reaction followed by typing with specific oligonucleotide probing and viral load quantification. Information on reproductive health and hygiene habits was also collected at each visit. RESULTS. Overall agreement between cervicography and cytology was low (κ = 0.046), which increased only slightly when high oncogenic-risk HPV types (κ = 0.120) or high viral burden (>100 copies/cell) (κ = 0.170) was present. Analysis of reproductive health and hygiene habits revealed somewhat different risk factors for cervical lesions detected by these tests. However, presence of oncogenic HPV DNA (odds ratio = 36.0, 95% CI = 16.6-77.8) and high viral burden (odds ratio = 67.34; 95% CI = 27.1-167.0) were strongly associated with lesions detected by cytology but not by cervicography. CONCLUSIONS. Although changes in the cervix (because of age, gravidity, or hormonal effects) may influence the performance of morphology-based screening tests, the lack of agreement and the different degrees of association with HPV infection measures indicate that a visual inspection method such as cervicography may detect different cervical abnormalities relative to cytology.

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KW - Cervicography

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KW - Human papillomavirus

KW - Pap smear

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