Author/Editor		Syrjaenen, K; Naud, P; Derchain, SM; Roteli-Martins, C; Longatto-Filho, A; Tatti, S; Branca, M; Eržen, M; Serpa-Hammes, L; Gontiko, R
Title		Comparing Pap smear cytology, aided visual inspection (VIA), screening colposcopy, cervico- graphy and HPV testing by HCII (normal and self-sampling) as optional screening tools in Latin America: experience from the LAMS study
Type		članek
Source		In: Monsonego J, editor. EUROGIN 2003. 5th international multidisciplinary congress; 2003 Apr 13.16; Paris. Bologna: Monduzzi editore,
Publication year		2003
Volume		str. 65-73
Language		eng
Abstract		Objectives: The performance of conventional diagnostic techniques (PAP smear and liquid-based cytology, screening colposcopy) is compared with 1) two optional screening tools (VIA, cervicography) and with 2) Hybrid Capture II, from a) conventional samples and b) using self-sampling, in women at different risk for cervical cancer in Brazil and Argentina. Study Design: In this cross-sectional- and prospective cohort study, consecutive women attending the clinics during the first 12 months (expected n=12.000) are screened using the six diagnostic tools (quality controlled by the EC partners), and women with biopsy-confirmed lowgrade CIN are enrolled in the cohort to be prospectively followed-up for 24 months. Data on the risk factors are collected, and cervical biopsies are analysed for pathogenetic and prognostic factors using e.g. cDNA microarrays, real-time PCR and immunohistochemistry. Results: During the first nine months, almost 10.000 women have been examined by the clinics, randomised according to the 6 diagnostic arms. Significant differences in many of the key demographics of the patients between the different clinics have become evident on the basis of the preliminary analyses. Also the available HPV detection data substantiate the concept that these cohorts include women at different risk for cervical cancer. Expected Outcome Measures: This study design provides data necessary for designing new strategies for a cost-effective control of cervical cancer in low-resource settings. Furthermore, the prospective follow-up of women in different regions permits analysis of whether variations in cervical cancer incidence in these regions is due to 1) different natural history of the precursor lesions, or 2) due to different level of exposure to the known risk factors, e.g. HPV.
Descriptors		CERVIX NEOPLASMS VAGINAL SMEARS COLPOSCOPY PAPILLOMAVIRUS, HUMAN MULTICENTER STUDIES LATIN AMERICA