Risk of invasive cancer among women visually screened and colposcopy triaged by trained nurses in rural South India
No Thumbnail Available
Date
2015-09
Journal Title
Journal ISSN
Volume Title
Publisher
Int J Gynaecol Obstet.
Abstract
Objective: To estimate the long-term risk of cervical cancer among women screened by visual inspection with
acetic acid (VIA) and to evaluate the benefit of additional colposcopy triage in rural south India. Methods: A
retrospective analysis was conducted among 31 343 women who had undergone VIA at Dindigul district,
India between January 1, 2000, and August 5, 2003, as part of a randomized screening trial. Women with positive
VIA test results were offered colposcopy triage by trained nurses. Cervical cancer incidence data during follow-up
(January 1, 2000, to December 31, 2012) were obtained from a regional cancer registry. Results: Among 3021
screen-positive women free of cancer at baseline, 2974 women underwent colposcopy; colposcopic abnormalities
suggestive of precancerous lesions were detected among 2792 of these women (93.9%). Compared with the
women with negative VIA screening results, the hazard ratio (HR) of cervical cancer during follow-up among the
VIA-positive women without colposcopic abnormalities was 6.5 (95% confidence interval [CI], 1.6–27.1). The risk
was similar among VIA-positive women with colposcopic abnormalities but without histological confirmation
(HR 5.2; 95% CI, 1.9–14.6). Conclusion: The high risk of cancer among women without colposcopic abnormalities
who tested positive by VIA suggested that screening without triage is potentially effective.
Description
Keywords
Cervical cancer
Cervical intraepithelial neoplasia
Colposcopy
Long-term risk
Screening
Visual inspection with acetic acid
Citation
Thulaseedharan JV, Malila N, Esmy PO, Muwonge R, Hakama M, Sankaranarayanan R. Risk of invasive cancer among women visually screened and colposcopy triaged by trained nurses in rural South India. Int J Gynaecol Obstet. 2015;129(2):104-108