Utilization of human papillomavirus testing for cervical cancer prevention in a university hospital

Detalhes bibliográficos
Autor(a) principal: Nomelini, Rosekeila Simões
Data de Publicação: 2007
Outros Autores: Barcelos, Ana Cristina Macêdo, Michelin, Márcia Antoniazi, Adad, Sheila Jorge, Murta, Eddie Fernando Candido
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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spelling 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
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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
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