Browsing by Author "Ferrera, A"

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    Distribution of human papillomavirus genotypes by severity of cervical lesions in HPV screened positive women from the ESTAMPA study in Latin America
    (Public Library of Science, 2022) Correa, RM; Baena, A; Valls, J; Colucci, MC; Mendoza, L; Rol, M; Wiesner, C; Ferrera, A; Fellner, MD; González, JV; Basiletti, JA; Mongelos, P; de la Peña, MR; Saino, A; Kasamatsu, E; Velarde, C; Macavilca, N; Martinez, S; Venegas, G; Calderón, A; Rodriguez, G; Barrios, H; Herrero, R; Almonte, M; Picconi, MA; Padín, VM; Mural, J; Figueredo, AI; Borelli, MA; Falabella, PG; Kaznowiecki, NG; García, S; Moreno, A; Guyot, J; Lencioni, MA; Cattarin, N; Quinteiro, M; González, AP; Hernandez, MB; Solano, EG; Quesada, CS; Monet, RP; Hidalgo, RF; Arias, JG; Cabrera, Y; Rodriguez, MI; Paez, M; Castro, A; Centurión, C; Báez, R; Vester, J; Soilán, A; Ortega, M; Cristaldo, C
    The proportion of HPV16 and 18-associated cervical cancer (CC) appears rather constant worldwide (≥70%), but the relative importance of the other HR-HPV differs slightly by geographical region. Here, we studied the HPV genotype distribution of HPV positive Latin American (LA) women by histological grade, in a sub-cohort from the ESTAMPA study
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    Performance of visual inspection of the cervix with acetic acid (VIA) for triage of HPV screen-positive women: results from the ESTAMPA study
    (John Wiley and Sons Inc, 2023) Baena, A; Mesher, D; Salgado, Y; Martínez, S; Villalba, GR; Amarilla, ML; Salgado, B; Flores, B; Bellido-Fuentes, Y; Álvarez-Larraondo, M; Valls, J; Lora, O; Virreira-Prout, G; Figueroa, J; Turcios, E; Soilán, AM; Ortega, M; Celis, M; González, M; Venegas, G; Terán, C; Ferrera, A; Mendoza, L; Kasamatsu, E; Murillo, R; Wiesner, C; Broutet, N; Luciani, S; Herrero, R; Almonte, M
    VIA is recommended for triage of HPV-positive women attending cervical screening. In the multicentric ESTAMPA study, VIA performance for detection of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) among HPV-positive women was evaluated. Women aged 30-64 years were screened with HPV testing and cytology and referred to colposcopy if either test was positive. At colposcopy visit, study-trained midwives/nurses/GPs performed VIA ahead of colposcopy. VIA was considered positive if acetowhite lesions were observed in or close to the transformation zone. Ablative treatment eligibility was assessed for VIA positives. Performance indicators were estimated. Three thousand one hundred and forty-two HPV-positive women were included. Sensitivity for CIN3+ was 85.9% (95% CI 81.2-89.5) among women <50 years and, although not significant, slightly lower in women 50+ (78.0%, 95% CI 65.9-86.6). Overall specificity was 58.6% (95% CI 56.7-60.5) and was significantly higher among women 50+ (70.3%, 95% CI 66.8-73.5) compared to women <50 (54.3%, 95% CI 52.1-56.5). VIA positivity was lower among women 50+ (35.2%, 95% CI 31.9-38.6) compared to women <50 (53.2, 95% CI 51.1-55.2). Overall eligibility for ablative treatment was 74.5% and did not differ by age. VIA sensitivity, specificity, and positivity, and ablative treatment eligibility varied highly by provider (ranges: 25%-95.4%, 44.9%-94.4%, 8.2%-65.3%, 0%-98.7%, respectively). VIA sensitivity for cervical precancer detection among HPV-positive women performed by trained providers was high with an important reduction in referral rates. However, scaling-up HPV screening triaged by VIA will be challenging due to the high variability of VIA performance and providers' need for training and supervision.