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Cited by 51Cervical Cancer and HPV ResearchWomen's cancer prevention and managementReproductive tract infections research

Performance of careHPV, hybrid capture 2 and visual inspection with acetic acid for detection of high-grade cervical lesion in Tanzania: A cross-sectional study

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Katanga, Johnson, Kjaer, Susanne K., Manongi, Rachel, Wu, Chun Sen, Iftner, Thomas, Waldstrom, Marianne, Pembe, Andrea B., Mwaiselage, Julius +1 more·2019·PLOS ONE
DOI 10.1371/journal.pone.0218559PMC PMC6583973
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Abstract

OBJECTIVE: To examine the test performance of careHPV, Hybrid Capture2 (HC2) and visual inspection with acetic acid (VIA) for detection of cytologically diagnosed high-grade cervical lesions or cancer (HSIL+). DESIGN: Cross-sectional study. SETTING: Ocean Road Cancer Institute (ORCI) and Kilimanjaro Christian Medical Center (KCMC), Tanzania. POPULATION: Women attending routine cervical cancer screening. METHOD: We enrolled 4080 women (25-60 years) in the study. The women were interviewed on lifestyle habits, and tested for HIV. A cervical specimen for careHPV testing (performed at ORCI and KCMC), and a liquid-based cytology sample for HPV DNA detection using HC2 (performed at Tuebingen University Hospital, Germany) and for cytology assessment (performed at Vejle Hospital, Denmark) were obtained at a gynecological examination. Subsequently, VIA was performed. With cytology as gold standard, the sensitivity and specificity of careHPV, HC2, and VIA for detection of HSIL+ were calculated. RESULTS: Altogether, 23.6% had a positive careHPV test, 19.1% had positive HC2 test, and 6.3% had a positive VIA test. The sensitivity/specificity was 88.9%/78.9% for careHPV and 91.1%/83.7%, for HC2. VIA showed a low sensitivity of 31.1% but a high specificity (94.6%) for detection of HSIL+. The sensitivity of careHPV, HC2 and VIA was higher among younger women, and among HIV positive women. VIA triage of careHPV positive women improved specificity, but sensitivity dropped to 27%. CONCLUSION: Our results confirm the low sensitivity of VIA for detection of HSIL+ and further document that careHPV test is promising as a primary screening method for cervical-cancer prevention in low-resource regions. A suitable triage test has to be identified.

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  • The careHPV system was reported to be less sensitive when combined with self-sampling, especially among older women.

    “Furthermore, careHPV system was reported to be less sensitive when combined with self-sampling, especially among the older women [7].”

    From Comparative analysis of SD biosensor standard™ M10 HPV and seegene anyplex™ II HPV HR for detecting high-risk human papillomavirus: a concordance study (2025) · cites this paper as [7]

    The Results and Discussion report that careHPV sensitivity tended to decrease with age, from about 95% in women aged 25–34 to about 82% in women aged 55–64. The Methods describe cervical samples collected during a gynecological examination; the paper does not report that combining careHPV with self-sampling reduced sensitivity, including among older women. Page numbers are unavailable in our copy. (LLM, conf=0.88)

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  1. [7]Surveillance, Epidemiology and End Results Program (SEER). Cancer Statistics Review (CRS) 1975–2015. 2018, Available seer.cancer.gov
  2. [19]National guideline for the management of HIV and AIDS. 5th edition National AIDS control program; 2015

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Authors
Katanga, J., Kjaer, S. K., Manongi, R., Wu, C. S., Iftner, T., Waldstrom, M., Pembe, A. B., Mwaiselage, J., & Rasch, V.
Affiliations
  • Muhimbili University of Health and Allied Sciences (TZ)
  • Kilimanjaro Christian Medical Centre (TZ)
  • University of Southern Denmark (DK)
  • Universitätsklinikum Tübingen (DE)
  • Ocean Road Cancer Institute (TZ)
Corresponding author
Katanga, Johnson
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2019-06-19
Volume
14
Issue
6
Pages
e0218559
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0218559
PMC
PMC6583973
OpenAlex
W2949656398
Cited by
51
References
34
Citations by year
2026: 3 · 2025: 3 · 2024: 7 · 2023: 5 · 2022: 7 · 2021: 13 · 2020: 11 · 2019: 1
FWCI
6.09
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, cc-by)
Funders
Danish International Development Agency (14-TAN-P02)
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
Hybrid Capture 2, visual inspection with acetic acid, high-grade cervical lesions, cervical cancer screening, HPV testing, liquid-based cytology, sensitivity and specificity, triage, women living with HIV, resource-limited settings, Tanzania
MeSH terms
Adult, Female, Humans, Middle Aged, Sensitivity and Specificity, Tanzania, Papillomavirus Infections, Human Papillomavirus DNA Tests, Squamous Intraepithelial Lesions of the Cervix

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