Should cervical cytologic testing be augmented by cervicography or human papillomavirus deoxyribonucleic acid detection?

Article Abstract:

Screening tests are used to identify people at risk for developing disease or those with early signs and symptoms of disease. The early diagnosis of disease can be very important, so that the appropriate treatment can be started. There is no single screening test that is 100 percent accurate in its ability to diagnose disease, and screening tests used for detecting abnormalities in the cervix are no exception. A study was performed to compare the sensitivity (the ability to accurately identify those who have disease) and specificity (the ability to accurately identify those who do not have disease) of three different screening tests used for cervical cancer. The study included 1,012 women between the ages of 18 and 35. Cytologic testing (Pap smear or test), cervicography (a procedure used to take photographs of the cervix), and testing for human papillomavirus (by measuring the amount of viral DNA, the genetic material) were performed. The Pap test had a sensitivity of 52 percent and a specificity of 92 percent. Cervicography had a sensitivity of 61 percent and a specificity of 88 percent, while measuring viral DNA had a sensitivity of 61 percent and a specificity of 94 percent. When all three testing methods were used in combination the sensitivity was increased to 83 percent. This means that even when all three tests are used cervical cancer will not be detected in 17 percent of the women who have cervical cancer. It is concluded that the sensitivity of cytologic tests can be improved by using a second or third test. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Medical screening, Health screening, Pap test

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The computerized digital imaging colposcope: future directions

Article Abstract:

The human papillomavirus (HPV) is actually a group of sexually transmitted viruses infecting 10 percent of sexually active men and women in the United States. Two of the 57 types of HPV (types 16 and 18) cause changes in the cells of the cervix which can lead to cervical cancer (cervical neoplasia). In order to diagnose and evaluate the disease, the cells of the cervix are visualized using a colposcope, a type of microscope that magnifies the cells. The colposcope is placed outside of the vagina while the practitioner looks through the magnifying lens to view the cervix. HPV-infected cells appear different when a chemical is applied to them during colposcopic examinations. The nature of the disease and how it causes cell changes are not well understood. A computerized system of enhancing and analyzing colposcopic images has been developed. The advantages of the new digital imaging colposcope (DENCOL 2100) are discussed. The image passes through the lens and is transferred to a microcomputer, which uses a software package to produced video images. The primary benefit of the digital imaging colposcope is that it is able to accentuate the abnormal pattern of cells characteristic of cervical neoplasia. The digital imaging colposcope can make quantitative measurements and store and compare many colposcopic images. The filtering system used to produce enhanced colposcopic images may help to describe the nature of the tissue affected by HPV disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Innovations, Computers, Digital computers, Endoscopes, Medical imaging equipment, Colposcopes

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Screening for cervical intraepithelial neoplasia grade 2/3: validity of cytologic study, cervicography, and human papillomavirus detection

Article Abstract:

Including tests to identify human papillomavirus (HPV) infection with cell and cervix studies may increase detection of moderate to severe cases of abnormally developed cervical tissue. Researchers compared the ability to detect cervical neoplasia of cell screening and examination, cervical examination, and hybrid capture testing for HPV in 967 women. Cell studies identified 29% of cervical neoplasia cases, cervical examination identified 45%, and testing for high-risk strains of HPV identified 50% of cases in 38 women diagnosed with moderate to severe cervical neoplasia. The 38 identified cases were higher than expected, and may indicate enhanced detection of cervical neoplasia by the combination of methods. HPV testing and cervical examination should be used along with cell studies in diagnosing cervical cancer.

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