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Cited by 131Cervical Cancer and HPV ResearchWomen's cancer prevention and managementReproductive tract infections research

Cervical Cancer Prevention in Low- and Middle-Income Countries: Feasible, Affordable, Essential

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Sahasrabuddhe, Vikrant V., Parham, Groesbeck P., Mwanahamuntu, Mulindi H., Vermund, Sten H.·2012·Cancer Prevention Research
DOI 10.1158/1940-6207.capr-11-0540PMC PMC3586242
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Abstract

The annual worldwide burden of the preventable disease cervical cancer is more than 530,000 new cases and 275,000 deaths, with the majority occurring in low- and middle-income countries (LMIC), where cervical cancer screening and early treatment are uncommon. Widely used in high-income countries, Pap smear (cytology based) screening is expensive and challenging for implementation in LMICs, where lower-cost, effective alternatives such as visual inspection with acetic acid (VIA) and rapid human papillomavirus (HPV)-based screening tests offer promise for scaling up prevention services. Integrating HPV screening with VIA in “screen-and-treat-or-refer” programs offers the dual benefits of HPV screening to maximize detection and using VIA to triage for advanced lesions/cancer, as well as a pelvic exam to address other gynecologic issues. A major issue in LMICs is coinfection with human immunodeficiency virus (HIV) and HPV, which further increases the risk for cervical cancer and marks a population with perhaps the greatest need of cervical cancer prevention. Public–private partnerships to enhance the availability of cervical cancer prevention services within HIV/AIDS care delivery platforms through initiatives such as Pink Ribbon Red Ribbon present an historic opportunity to expand cervical cancer screening in LMICs. Cancer Prev Res; 5(1); 11–17. ©2011 AACR.

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  • HPV testing has an overall sensitivity of 80-95% for detecting high-grade cervical intraepithelial neoplasia, compared to 60-80% for cytologic testing.

    “A meta-analysis found an overall sensitivity of 80-95% for HPV testing compared to 60-80% for cytologic testing, and an overall specificity of 50-70% for HPV testing compared to 85-95% for cytologic testing (Sahasrabuddhe et al., 2012).”

    From Acceptability and Concordance of Self- Versus Clinician- Sampling for HPV Testing among Rural South Indian Women (2021) · cites this paper as Sahasrabuddhe et al., 2012

    The “Suitable Screening and Prevention Technologies for LMICs” section describes HPV DNA testing as highly accurate, but gives no sensitivity figures for HPV or cytologic testing. Searches for the stated ranges, a meta-analysis, and sensitivity for high-grade cervical lesions found no passage in our copy establishing the comparison. (LLM, conf=0.75)

    Experimental — accuracy not yet measured

  • HPV testing has an overall specificity of 50-70%, compared to 85-95% for cytologic testing.

    “A meta-analysis found an overall sensitivity of 80-95% for HPV testing compared to 60-80% for cytologic testing, and an overall specificity of 50-70% for HPV testing compared to 85-95% for cytologic testing (Sahasrabuddhe et al., 2012).”

    From Acceptability and Concordance of Self- Versus Clinician- Sampling for HPV Testing among Rural South Indian Women (2021) · cites this paper as Sahasrabuddhe et al., 2012

    The Suitable Screening and Prevention Technologies for LMICs section describes HPV DNA testing as accurate, but gives no specificity estimates or comparison with cytology. Searches for the stated percentages and for a meta-analysis of HPV-versus-cytology test performance found no passage in our copy supporting the claimed 50–70% and 85–95% ranges. The retrieved passages have no page numbers. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

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Authors
Sahasrabuddhe, V. V., Parham, G. P., Mwanahamuntu, M. H., & Vermund, S. H.
Affiliations
Centre for Infectious Disease Research in Zambia (ZM)
Corresponding author
Vermund, Sten H.
ORCID
Venue
Cancer Prevention Research
Publisher
American Association for Cancer Research (AACR)
Published
2012-01-01
Volume
5
Issue
1
Pages
11-17
ISSN
  • 1940-6207 (ISSN-L)
  • 1940-6215
DOI
10.1158/1940-6207.capr-11-0540
PMC
PMC3586242
OpenAlex
W2134344993
Cited by
131
References
1
Citations by year
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FWCI
1.01
Type
journal article
Language
en
Open access
Locations
  • Cancer Prevention Research (publishedVersion, public-domain)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (Z99 CA999999)
  • National Cancer Institute (Z01CP010124, Y99 CA999999, R21CA113465)
  • Fogarty International Center (D43TW001035)
Topics
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
Keywords
cervical cancer prevention, low- and middle-income countries, cervical cancer screening, visual inspection with acetic acid, HPV-based screening, HPV testing, HIV-HPV coinfection, public-private partnerships, cervical cancer burden
MeSH terms
Uterine Cervical Neoplasms, Cost-Benefit Analysis, Female, Humans, Medical Oncology, Poverty, Preventive Medicine, Risk, Vaginal Smears, Global Health, HIV Infections, Papillomavirus Infections, Early Detection of Cancer, Papanicolaou Test

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