TY - JOUR
T1 - Performance of alternative strategies for primary cervical cancer screening in sub-Saharan Africa
T2 - Systematic review and meta-analysis of diagnostic test accuracy studies
AU - Fokom-Domgue, Joël
AU - Combescure, Christophe
AU - Fokom-Defo, Victoire
AU - Tebeu, Pierre Marie
AU - Vassilakos, Pierre
AU - Kengne, André Pascal
AU - Petignat, Patrick
N1 - Publisher Copyright:
© BMJ Publishing Group Ltd 2015.
PY - 2015/7/3
Y1 - 2015/7/3
N2 - Objective To assess and compare the accuracy of visual inspection with acetic acid (VIA), visual inspection with Lugol's iodine (VILI), and human papillomavirus (HPV) testing as alternative standalone methods for primary cervical cancer screening in sub-Saharan Africa. Design Systematic review and meta-analysis of diagnostic test accuracy studies. Data sources Systematic searches of multiple databases including Medline, Embase, and Scopus for studies published between January 1994 and June 2014. Review methods Inclusion criteria for studies were: alternative methods to cytology used as a standalone test for primary screening; study population not at particular risk of cervical cancer (excluding studies focusing on HIV positive women or women with gynaecological symptoms); women screened by nurses; reference test (colposcopy and directed biopsies) performed at least in women with positive screening results. Two reviewers independently screened studies for eligibility and extracted data for inclusion, and evaluated study quality using the quality assessment of diagnostic accuracy studies 2 (QUADAS-2) checklist. Primary outcomes were absolute accuracy measures (sensitivity and specificity) of screening tests to detect cervical intraepithelial neoplasia grade 2 or worse (CIN2+).
AB - Objective To assess and compare the accuracy of visual inspection with acetic acid (VIA), visual inspection with Lugol's iodine (VILI), and human papillomavirus (HPV) testing as alternative standalone methods for primary cervical cancer screening in sub-Saharan Africa. Design Systematic review and meta-analysis of diagnostic test accuracy studies. Data sources Systematic searches of multiple databases including Medline, Embase, and Scopus for studies published between January 1994 and June 2014. Review methods Inclusion criteria for studies were: alternative methods to cytology used as a standalone test for primary screening; study population not at particular risk of cervical cancer (excluding studies focusing on HIV positive women or women with gynaecological symptoms); women screened by nurses; reference test (colposcopy and directed biopsies) performed at least in women with positive screening results. Two reviewers independently screened studies for eligibility and extracted data for inclusion, and evaluated study quality using the quality assessment of diagnostic accuracy studies 2 (QUADAS-2) checklist. Primary outcomes were absolute accuracy measures (sensitivity and specificity) of screening tests to detect cervical intraepithelial neoplasia grade 2 or worse (CIN2+).
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U2 - 10.1136/bmj.h3084
DO - 10.1136/bmj.h3084
M3 - Review article
C2 - 26142020
AN - SCOPUS:84940029456
SN - 0959-8146
VL - 351
JO - The BMJ
JF - The BMJ
M1 - h3084
ER -