Utilization of human papillomavirus testing for cervical cancer prevention in a university hospital
Autor(a) principal: | |
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Data de Publicação: | 2007 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/3050 |
Resumo: | This study aimed to evaluate the performance and cost of using polymerase chain reaction (PCR) and hybrid capture in the detection of cervical intraepithelial neoplasia (CIN) in patients with cytological abnormalities (ASCUS/low-grade squamous intraepithelial lesion - LSIL), and the feasibility of implementing these methods in Brazil's Unified National Health System (SUS). Colposcopy gave a negative predictive value of 92.86% and efficiency of 87.8% for diagnosing CIN. The sensitivity of PCR and hybrid capture for detecting CIN was 83.33% and 66.67%, respectively, and the negative predictive value for diagnosing CIN2/CIN3 was 100% and 94.74%, respectively. The annual cost for 80 patients was lower when all patients with ASCUS/LSIL were referred for colposcopy than when HPV testing was performed and those with positive results were referred for colposcopy. Therefore, at present, it is financially unfeasible for the National Health System to implement HPV testing to screen patients with cytological abnormalities (ASCUS/LSIL). However, considering that large-scale use might make such methods cheaper, PCR should be the chosen method, since it is less expensive, more sensitive, and has a high negative predictive value. |
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Utilization of human papillomavirus testing for cervical cancer prevention in a university hospitalCervical Intraepithelial NeoplasiaPolymerase Chain ReactionColposcopyHealth Care CostsThis study aimed to evaluate the performance and cost of using polymerase chain reaction (PCR) and hybrid capture in the detection of cervical intraepithelial neoplasia (CIN) in patients with cytological abnormalities (ASCUS/low-grade squamous intraepithelial lesion - LSIL), and the feasibility of implementing these methods in Brazil's Unified National Health System (SUS). Colposcopy gave a negative predictive value of 92.86% and efficiency of 87.8% for diagnosing CIN. The sensitivity of PCR and hybrid capture for detecting CIN was 83.33% and 66.67%, respectively, and the negative predictive value for diagnosing CIN2/CIN3 was 100% and 94.74%, respectively. The annual cost for 80 patients was lower when all patients with ASCUS/LSIL were referred for colposcopy than when HPV testing was performed and those with positive results were referred for colposcopy. Therefore, at present, it is financially unfeasible for the National Health System to implement HPV testing to screen patients with cytological abnormalities (ASCUS/LSIL). However, considering that large-scale use might make such methods cheaper, PCR should be the chosen method, since it is less expensive, more sensitive, and has a high negative predictive value.O trabalho objetivou avaliar o desempenho e o custo do PCR e captura híbrida na detecção de neoplasia intra-epitelial cervical (NIC) em pacientes com anormalidades citológicas (ASCUS/lesões de baixo grau - LBG), e a viabilidade da implantação destes métodos no serviço público de saúde. Observou-se valor preditivo negativo de 92,86% e eficiência de 87,8% da colposcopia para diagnóstico de NIC. A sensibilidade do PCR e captura híbrida na detecção de NIC foi de 83,33% e 66,67%, respectivamente. O valor preditivo negativo no diagnóstico de NICII e III do PCR e captura híbrida foi de 100% e 94,74%, respectivamente. O custo anual das oitenta pacientes foi menor encaminhando-se todas as pacientes com ASCUS/ LBG à colposcopia do que se fossem realizados testes biomoleculares e encaminhando-se aquelas com resultados positivos à colposcopia. Portanto, por enquanto, é inviável financeiramente para o Sistema Único de Saúde a implantação de métodos de biologia molecular para pacientes com ASCUS e LBG à citologia cérvico-vaginal, mas considerando que o uso em grande escala poderia torná-los mais baratos, o PCR deveria ser o método escolhido, por ter menor custo, alto valor preditivo negativo e melhor sensibilidade.Reports in Public HealthCadernos de Saúde Pública2007-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/3050Reports in Public Health; Vol. 23 No. 6 (2007): JuneCadernos de Saúde Pública; v. 23 n. 6 (2007): Junho1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZenghttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/3050/6154https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/3050/6155Nomelini, Rosekeila SimõesBarcelos, Ana Cristina MacêdoMichelin, Márcia AntoniaziAdad, Sheila JorgeMurta, Eddie Fernando Candidoinfo:eu-repo/semantics/openAccess2024-03-06T15:27:23Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/3050Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:03:33.162475Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
Utilization of human papillomavirus testing for cervical cancer prevention in a university hospital |
title |
Utilization of human papillomavirus testing for cervical cancer prevention in a university hospital |
spellingShingle |
Utilization of human papillomavirus testing for cervical cancer prevention in a university hospital Nomelini, Rosekeila Simões Cervical Intraepithelial Neoplasia Polymerase Chain Reaction Colposcopy Health Care Costs |
title_short |
Utilization of human papillomavirus testing for cervical cancer prevention in a university hospital |
title_full |
Utilization of human papillomavirus testing for cervical cancer prevention in a university hospital |
title_fullStr |
Utilization of human papillomavirus testing for cervical cancer prevention in a university hospital |
title_full_unstemmed |
Utilization of human papillomavirus testing for cervical cancer prevention in a university hospital |
title_sort |
Utilization of human papillomavirus testing for cervical cancer prevention in a university hospital |
author |
Nomelini, Rosekeila Simões |
author_facet |
Nomelini, Rosekeila Simões Barcelos, Ana Cristina Macêdo Michelin, Márcia Antoniazi Adad, Sheila Jorge Murta, Eddie Fernando Candido |
author_role |
author |
author2 |
Barcelos, Ana Cristina Macêdo Michelin, Márcia Antoniazi Adad, Sheila Jorge Murta, Eddie Fernando Candido |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Nomelini, Rosekeila Simões Barcelos, Ana Cristina Macêdo Michelin, Márcia Antoniazi Adad, Sheila Jorge Murta, Eddie Fernando Candido |
dc.subject.por.fl_str_mv |
Cervical Intraepithelial Neoplasia Polymerase Chain Reaction Colposcopy Health Care Costs |
topic |
Cervical Intraepithelial Neoplasia Polymerase Chain Reaction Colposcopy Health Care Costs |
description |
This study aimed to evaluate the performance and cost of using polymerase chain reaction (PCR) and hybrid capture in the detection of cervical intraepithelial neoplasia (CIN) in patients with cytological abnormalities (ASCUS/low-grade squamous intraepithelial lesion - LSIL), and the feasibility of implementing these methods in Brazil's Unified National Health System (SUS). Colposcopy gave a negative predictive value of 92.86% and efficiency of 87.8% for diagnosing CIN. The sensitivity of PCR and hybrid capture for detecting CIN was 83.33% and 66.67%, respectively, and the negative predictive value for diagnosing CIN2/CIN3 was 100% and 94.74%, respectively. The annual cost for 80 patients was lower when all patients with ASCUS/LSIL were referred for colposcopy than when HPV testing was performed and those with positive results were referred for colposcopy. Therefore, at present, it is financially unfeasible for the National Health System to implement HPV testing to screen patients with cytological abnormalities (ASCUS/LSIL). However, considering that large-scale use might make such methods cheaper, PCR should be the chosen method, since it is less expensive, more sensitive, and has a high negative predictive value. |
publishDate |
2007 |
dc.date.none.fl_str_mv |
2007-06-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/3050 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/3050 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/3050/6154 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/3050/6155 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html application/pdf |
dc.publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 23 No. 6 (2007): June Cadernos de Saúde Pública; v. 23 n. 6 (2007): Junho 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
collection |
Cadernos de Saúde Pública |
repository.name.fl_str_mv |
Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
_version_ |
1798943358908891137 |