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Accuracy of visual inspection with acetic acid and with Lugol's iodine for cervical cancer screening: Meta-analysis

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机构: [1]Department of Cancer Prevention and Treatment, Sichuan Cancer Hospital and Institute and Sichuan Cancer Prevention and Treatment Center, Chengdu, China [2]Department of Gynecologic Oncology, Sichuan Cancer Hospital and Institute and Sichuan Cancer Prevention and Treatment Center, Chengdu, China
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关键词: bivariate model cervical cancer meta-analysis screening visual inspection

摘要:
The aim of this review was to provide an updated summary estimation of the accuracy of visual inspection with acetic acid (VIA) and with Lugol's iodine (VILI) in detecting cervical cancer and precancer. Studies on VIA/VILI accuracy were eligible in which VIA/VILI was performed on asymptomatic women who all underwent confirmatory testing of histology, combination of colposcopy and histology, or combination of multiple screening tests, colposcopy and histology, to detect cervical intraepithelial neoplasia grade 2 or worse (CIN2+ or CIN3+). A bivariate model was fitted to estimate the accuracy of VIA/VILI and provide estimates of heterogeneity. Subgroup analysis was used to investigate the source of heterogeneity. A total of 29 studies on VIA and 19 studies on VILI were included finally in the meta-analysis. The summary sensitivity and specificity of VIA for CIN2+ were 73.2% (95% CI: 66.5-80.0%) and 86.7% (95% CI: 82.9-90.4%), respectively, and those for VILI were 88.1% (95% CI: 81.5-94.7%) and 85.9%(95% CI: 81.7-90.0%), respectively. VIA and VILI were both more sensitive in detecting more severe outcome, although there was a slight loss in specificity. Apparent heterogeneity existed in sensitivity and specificity for both VIA and VILI. High sensitivity of both VIA and VILI for CIN2+ was found when a combination of colposcopy and histology was used as disease confirmation. VIA, VILI, even a combination of the min parallel, could be good options for cervical screening in low-resource settings. Significant differences in sensitivity between different gold standards might provide a proxy for optimization of ongoing cervical cancer screening programs.

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出版当年[2015]版:
大类 | 4 区 医学
小类 | 4 区 妇产科学
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 妇产科学
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出版当年[2015]版:
Q4 OBSTETRICS & GYNECOLOGY
最新[2023]版:
Q3 OBSTETRICS & GYNECOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2015版] 出版当年五年平均 出版前一年[2014版] 出版后一年[2016版]

第一作者:
第一作者机构: [1]Department of Cancer Prevention and Treatment, Sichuan Cancer Hospital and Institute and Sichuan Cancer Prevention and Treatment Center, Chengdu, China
通讯作者:
通讯机构: [2]Department of Gynecologic Oncology, Sichuan Cancer Hospital and Institute and Sichuan Cancer Prevention and Treatment Center, Chengdu, China [*1]Department of Gynecologic Oncology, Sichuan Cancer Hospital and Institute and Sichuan Cancer Prevention and Treatment Center. No. 55, Section 4, People’s South Road. Chengdu 610041, China
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