Addition of digital VIA/VILI to conventional naked-eye examination for triage of HPV-positive women: A study conducted in a low-resource setting

• DOI: 10.1371/journal.pone.0268015
• Publication Date: 2022-05-12T17:45:56Z
• Authors: Eva Dufeil; Bruno Kenfack; Evelyn Tincho; Jovanny Fouogue; Ania Wisniak; Jessica Sormani; Pierre Vassilakos; Patrick Petignat
• Keywords: Triage

World Health Organization guidelines for cervical cancer screening recommend HPV testing followed by visual inspection with acetic acid (VIA) triage if positive. In order to improve assessment and identification of intraepithelial neoplasia grade 2 worse (CIN2+), providers may use aids such as digital cameras.To determine whether combined examination naked-eye VIA (D-VIA) VILI (D-VILI) improves detection CIN2+ compared the conventional evaluation.Women (30-49 years) living in Dschang (West Cameroon) were prospectively invited a campaign. Primary HPV-based was VIA/VILI D-VIA/VILI HPV-positive. care independently defined diagnosis (pathological or non-pathological) based on D-VIA/VILI. Decision treat (VIA/VILI D-VIA/VILI). Cervical biopsy endocervical curettage performed all HPV-positive participants considered reference standard. Diagnostic performance individual evaluated. A sample size 1,500 women calculated assuming prevalence 20% positivity 10% women.Due COVID-19 pandemic, study had terminate prematurely. total 1,081 median age 40 (IQR 35.5-45) recruited. 17.4% (n = 188) 26 (14.4%) CIN2+. Naked-eye D-VIA sensitivities 80.8% (95% CI 60.6-93.4) 92.0% 74.0-99.0), specificities 31.2% 24-39.1) 31.6% 24.4-39.6), respectively. The combination both methods yielded sensitivity 92.3% 74.9-99.1) specificity 23.2% 16.8-30.7). trend towards improved observed, but did not reach statistical significance.Addition be associated identification. Further studies including larger are needed confirm these results.