{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T07:00:00Z","timestamp":1761807600152,"version":"3.38.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2010,12,1]],"date-time":"2010-12-01T00:00:00Z","timestamp":1291161600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"},{"start":{"date-parts":[[2010,12,1]],"date-time":"2010-12-01T00:00:00Z","timestamp":1291161600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Med Screen"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> The performance of cervical cancer (CC) screening can be improved by combining Pap smear with human papillomavirus (HPV) testing or visual methods, addressing local demographic, clinical and economic characteristics. <\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p> To examine the performance of standalone and combined screening tools in populations with variable prevalence of cervical intraepithelial neoplasia (CIN) and CC. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Merged data-sets from the Latin American Screening Study and New Independent States cohorts provided results for 15,000 women, screened using Pap smear, HPV testing and visual inspection with acetic acid, in Brazil, Argentina, Russia, Belarus and Latvia. Bayesian correction for verification bias was used. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> At CIN2+ cut-off, HPV detection alone was the most sensitive technique. There was an improvement (88.5% to 92.7%) in Hybrid Capture 2 (HC2) sensitivity among women \u226535 years old. Using HPV detection alone was the least specific screening tool, regardless of the age group (69.9% [95% CI 66.5\u201372.8%] and 86.4% [95% CI 84.6\u201388.2%], in &lt; or \u226535 years, respectively). Of the test combinations, Pap smear (LSIL threshold) with HC2 had the highest specificity (98.7%; 95% CI 98.3\u201399.0%). However, in women \u226535 years, the sensitivity of Pap alone was superior to that of the combination. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> The Pap test is a highly specific screening option in populations with medium-range CC prevalence. Combined testing for HPV in this scenario may yield slightly better positive predictive values in women \u226535 years of age with LSIL, but at a high incremental cost. <\/jats:p><\/jats:sec>","DOI":"10.1258\/jms.2010.010016","type":"journal-article","created":{"date-parts":[[2011,1,24]],"date-time":"2011-01-24T00:17:48Z","timestamp":1295828268000},"page":"195-203","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Optional screening strategies for cervical cancer using standalone tests and their combinations among low- and medium-income populations in Latin America and Eastern Europe"],"prefix":"10.1177","volume":"17","author":[{"given":"Luis Otavio","family":"Sarian","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Universidade Estadual de Campinas, Campinas, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Derchain","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Universidade Estadual de Campinas, Campinas, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irena","family":"Shabalova","sequence":"additional","affiliation":[{"name":"Russian Academy of Post-Graduate Medical Education, Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvio","family":"Tatti","sequence":"additional","affiliation":[{"name":"Hospital de Clinicas, Buenos Aires, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo","family":"Naud","sequence":"additional","affiliation":[{"name":"Hospital de Clinicas de Porto Alegre, and Department of Gynecology and Obstetrics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adhemar","family":"Longatto-Filho","sequence":"additional","affiliation":[{"name":"Department of Pathology, Medical School of S\u00e3o Paulo University (LIM14) and Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stina","family":"Syrj\u00e4nen","sequence":"additional","affiliation":[{"name":"Department of Oral Pathology, Institute of Dentistry, University of Turku, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kari","family":"Syrj\u00e4nen","sequence":"additional","affiliation":[{"name":"Department of Oncology & Radiotherapy, Turku University Hospital, Turku, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2011,1,23]]},"reference":[{"key":"bibr-JMS-10016C1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/93.4.293"},{"key":"bibr-JMS-10016C2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.11.1500"},{"key":"bibr-JMS-10016C3","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.22527"},{"key":"bibr-JMS-10016C4","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0215(20000501)86:3<440::AID-IJC22>3.0.CO;2-A"},{"key":"bibr-JMS-10016C5","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.24774"},{"key":"bibr-JMS-10016C6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.16.2120"},{"key":"bibr-JMS-10016C7","doi-asserted-by":"publisher","DOI":"10.1258\/0969141054855328"},{"key":"bibr-JMS-10016C8","doi-asserted-by":"publisher","DOI":"10.1258\/096914107782066158"},{"key":"bibr-JMS-10016C9","first-page":"3469","volume":"25","author":"Syrj\u00e4nen K","year":"2005","journal-title":"Anticancer Res"},{"key":"bibr-JMS-10016C10","doi-asserted-by":"publisher","DOI":"10.1258\/0956462053420211"},{"key":"bibr-JMS-10016C11","doi-asserted-by":"publisher","DOI":"10.1097\/00128360-200204000-00006"},{"key":"bibr-JMS-10016C12","doi-asserted-by":"publisher","DOI":"10.1159\/000326195"},{"key":"bibr-JMS-10016C13","doi-asserted-by":"publisher","DOI":"10.1097\/01.lgt.0000265778.36797.03"},{"key":"bibr-JMS-10016C14","unstructured":"R Development Core Team (2010). 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