Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus: results from the ESTAMPA multicentric screening study

作者：Joan Valls, Armando Baena, Gino Venegas, Marcela Celis, Mauricio González, Carlos R. Sosa, Jorge Luis Santin, Marina Ortega, Ana Soilán, Elmer Turcios, Jacqueline Figueroa, Margarita Rodríguez de la Peña, Alicia Figueredo, Andrea Verónica Beracochea, Natalia Pérez, Josefina Martínez-Better, Oscar Lora, Julio Yamil Jiménez, Diana Giménez, Laura Fleider, Yuly Salgado, Sandra Martínez, Yenny Bellido‐Fuentes, Bettsy Flores, Sílvio Tatti, Verónica Villagra, Aurelio Cruz-Valdéz, Carolina Terán, Gloria Inés Sánchez, Guillermo Rodríguez‐Domínguez, Marı́a Alejandra Picconi, Annabelle Ferrera, Laura Mendoza, Alejandro Calderón, Raúl Murillo, Carolina Wiesner, Nathalie Broutet, Silvana Luciani, Carlos Pérez, Teresa M. Darragh, José Jerónimo, Rolando Herrero, Maribel Almonte · 发表于：The Lancet Global Health · 年份：2023 · DOI：10.1016/s2214-109x(22)00545-9 · 被引用次数：54 · 研究领域：Cervical Cancer and HPV Research、Women's cancer prevention and management、Global Cancer Incidence and Screening

BACKGROUND: Colposcopy, currently included in WHO recommendations as an option to triage human papillomavirus (HPV)-positive women, remains as the reference standard to guide both biopsy for confirmation of cervical precancer and cancer and treatment approaches. We aim to evaluate the performance of colposcopy to detect cervical precancer and cancer for triage in HPV-positive women. METHODS: This cross-sectional, multicentric screening study was conducted at 12 centres (including primary and secondary care centres, hospitals, laboratories, and universities) in Latin America (Argentina, Bolivia, Colombia, Costa Rica, Honduras, Mexico, Paraguay, Peru, and Uruguay). Eligible women were aged 30-64 years, sexually active, did not have a history of cervical cancer or treatment for cervical precancer or a hysterectomy, and were not planning to move outside of the study area. Women were screened with HPV DNA testing and cytology. HPV-positive women were referred to colposcopy using a standardised protocol, including biopsy collection of observed lesions, endocervical sampling for transformation zone (TZ) type 3, and treatment as needed. Women with initial normal colposcopy or no high-grade cervical lesions on histology (less than cervical intraepithelial neoplasia [CIN] grade 2) were recalled after 18 months for another HPV test to complete disease ascertainment; HPV-positive women were referred for a second colposcopy with biopsy and treatment as needed. Diagnostic accuracy of colpo...