BACKGROUND The purpose of this study was to validate the accuracy of an alternative cervical cancer test - visual inspection with acetic acid (VIA) - by addressing possible imperfections in the gold standard through latent class analysis (LCA). The data were originally collected at peri-urban health clinics in Zimbabwe. METHODS Conventional accuracy (sensitivity/specificity) estimates for VIA...

It has been reported that many women referred to outpatient colposcopy clinics fail to attend for their appointments. The aim of this paper is to search the literature to assess the extent of default from colposcopy and to identify interventions, suitable for implementation within primary care, to reduce the proportion of women defaulting. Searches were performed on MEDLINE, PsychLIT, Bids and ...

OBJECTIVE A post hoc analysis to determine the diagnostic yield of random biopsy in detecting high-grade cervical disease in women with negative colposcopy. METHODS The ATHENA (Addressing the Need for Advanced HPV Diagnostics) trial screened more than 47,000 women with cytology and high-risk human papillomavirus (HPV) DNA genotyping. Colposcopy was performed in all women with abnormal cytolog...

The aim of this study was to evaluate the outcomes of women with high-grade squamous intraepithelial lesion (HSIL) smears who had undergone the "see and treat" approach compared to those who underwent a conventional approach. The records of women with HSIL smears undergoing colposcopy at Srinagarind Hospital were reviewed. In those undergoing the conventional approach, the final histological di...

OBJECTIVE To assess the performance of a low cost magnifying device (Magnivisualizer) compared to a standard optical colposcope for detection of precancerous and cancerous lesions of the uterine cervix. METHODS A total of 659 consecutive symptomatic women attending a gynecologic outpatient clinic underwent unaided visual inspection followed by cytology, visual inspection of the cervix using 5...

AIM Domestic violence is common in women and is associated with poorer health-care outcomes. However, no causal pathway has been identified to explain this observation. We have followed a cohort of women to determine whether poorer outcomes can be explained by high rates of default and loss to follow-up. MATERIAL AND METHODS A prospective cohort study was performed. Institutional ethics appro...

OBJECTIVE To evaluate the accuracy of fluorescence spectroscopy in screening for squamous intraepithelial lesions (SILs) and to compare its performance with that of Papanicolaou smear screening, colposcopy, cervicoscopy, cervicography, and human papillomavirus (HPV) testing. DATA SOURCES Receiver operating characteristic (ROC) curve analysis was used to analyze performance by fluorescence spe...

OBJECTIVE An audit of outcomes of cervical cancer screening and prevention services for HIV-positive women in Cape Town, South Africa. DESIGN Retrospective review of clinic registers, patient records and pathology databases at three HIV primary health clinics and a tertiary colposcopy referral centre. SUBJECTS Women recently diagnosed with HIV at three primary health clinics between 2006 an...

PURPOSE To determine the prevalence of screening, cervical dysplasia, and malignancy on the basis of histologic diagnoses from colposcopy and large loop excision of the transformation zone among women living with HIV (WLWH) who attended an urban antiretroviral treatment (ART) clinic in KwaZulu-Natal, South Africa. MATERIALS AND METHODS We performed a retrospective cohort study to examine a ra...

Objective: To study the performance of visual inspection with acetic acid plus 4-quadrant cervical biopsy (V4B) by general practitioners in detecting high grade cervical lesion, compared to highest histopathologic grade from the American Society for Colposcopy and Cervical Pathology American Society for Colposcopy and Cervical Pathology (ASCCP) 2013 work up guidelines. Materials and methods: Pa...