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Comparing PAP smear cytology, aided visual inspection, screening colposcopy, cervicography and HPV testing as optional screening tools in Latin America. Study design and baseline data of the LAMS study.
Anticancer Res. 2005 Sep-Oct; 25(5):3469-80.AR

Abstract

OBJECTIVES

This is a European Commission (EC)-funded ongoing study known as the LAMS (Latin American Screening) study, where PAP smear/liquid-based cytology and screening colposcopy were compared with i) three optional screening tools [visual inspection with acetic acid (VIA), or Lugol's iodine (VILI), cervicography] and with ii) Hybrid Capture II from a) conventional samples and from b) self-samples, in women at different risk for cervical cancer in Brazil and Argentina.

STUDY DESIGN

During 2002-2003, a cohort of 12,107 women attending four clinics: Campinas (CA), Sao Paulo (SP), Porto Alegre (PA) and Buenos Aires (BA), were interviewed for risk factors, and examined using the 8 diagnostic arms. Colposcopy was performed for women positive in any test and for 5% of women with baseline PAP-negative and 20% of HCII-negatives. All high-grade lesions (CIN2/3) were treated, and low-grade CIN are prospectively followed-up.

RESULTS

Of the 12,107 women, the following baseline data are available: epidemiological data (n=11,996), conventional PAP smears (n=10,363), LBC, SurePATH (n=320), LBC, DNA-Citoliq (n=1,346), VIA (n=12.067), VILI (n=3,061), cervicography (n=279), screening colposcopy (n=3,437), HCII conventional (n=4,710), HCII self-sampling (n=246) and cervical biopsies (n=1,524). The four sub-cohorts differ significantly in all their baseline data on the implicated risk factors of cervical cancer, consonant with their origin from regions with different cancer incidence. Around 95% of all PAP smears were negative, with slight variations in the prevalence of LSIL and HSIL between the four centers. Significant differences were found in the detection rates of abnormal findings in VIA, VILI and colposcopy between the four centers (p=0.0001). The prevalence of HPV was practically identical (16.5-18.8%) in all four cohorts (p=0.486), with no differences in the relative viral loads. Biopsy results were different depending on whether the women underwent screening colposcopy (BA) or elective colposcopy (others).

CONCLUSION

Four cohorts with significantly different baseline data are available, and prospective follow-up of these women permits analysis of whether variations in cervical cancer incidence in these regions is due to i) different natural history of the precursor lesions, or ii) due to different levels of exposure to the known risk factors.

Authors+Show Affiliations

Department of Oncology and Radiotherapy, Turku University Central Hospital, Turku, Finland. kari.syrjanen@smwconsultants.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16101165

Citation

Syrjänen, K, et al. "Comparing PAP Smear Cytology, Aided Visual Inspection, Screening Colposcopy, Cervicography and HPV Testing as Optional Screening Tools in Latin America. Study Design and Baseline Data of the LAMS Study." Anticancer Research, vol. 25, no. 5, 2005, pp. 3469-80.
Syrjänen K, Naud P, Derchain S, et al. Comparing PAP smear cytology, aided visual inspection, screening colposcopy, cervicography and HPV testing as optional screening tools in Latin America. Study design and baseline data of the LAMS study. Anticancer Res. 2005;25(5):3469-80.
Syrjänen, K., Naud, P., Derchain, S., Roteli-Martins, C., Longatto-Filho, A., Tatti, S., Branca, M., Erzen, M., Hammes, L. S., Matos, J., Gontijo, R., Sarian, L., Braganca, J., Arlindo, F. C., Maeda, M. Y., Lörincz, A., Dores, G. B., Costa, S., & Syrjänen, S. (2005). Comparing PAP smear cytology, aided visual inspection, screening colposcopy, cervicography and HPV testing as optional screening tools in Latin America. Study design and baseline data of the LAMS study. Anticancer Research, 25(5), 3469-80.
Syrjänen K, et al. Comparing PAP Smear Cytology, Aided Visual Inspection, Screening Colposcopy, Cervicography and HPV Testing as Optional Screening Tools in Latin America. Study Design and Baseline Data of the LAMS Study. Anticancer Res. 2005;25(5):3469-80. PubMed PMID: 16101165.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparing PAP smear cytology, aided visual inspection, screening colposcopy, cervicography and HPV testing as optional screening tools in Latin America. Study design and baseline data of the LAMS study. AU - Syrjänen,K, AU - Naud,P, AU - Derchain,S, AU - Roteli-Martins,C, AU - Longatto-Filho,A, AU - Tatti,S, AU - Branca,M, AU - Erzen,M, AU - Hammes,L S, AU - Matos,J, AU - Gontijo,R, AU - Sarian,L, AU - Braganca,J, AU - Arlindo,F C, AU - Maeda,M Y S, AU - Lörincz,A, AU - Dores,G B, AU - Costa,S, AU - Syrjänen,S, PY - 2005/8/17/pubmed PY - 2005/10/14/medline PY - 2005/8/17/entrez SP - 3469 EP - 80 JF - Anticancer research JO - Anticancer Res. VL - 25 IS - 5 N2 - OBJECTIVES: This is a European Commission (EC)-funded ongoing study known as the LAMS (Latin American Screening) study, where PAP smear/liquid-based cytology and screening colposcopy were compared with i) three optional screening tools [visual inspection with acetic acid (VIA), or Lugol's iodine (VILI), cervicography] and with ii) Hybrid Capture II from a) conventional samples and from b) self-samples, in women at different risk for cervical cancer in Brazil and Argentina. STUDY DESIGN: During 2002-2003, a cohort of 12,107 women attending four clinics: Campinas (CA), Sao Paulo (SP), Porto Alegre (PA) and Buenos Aires (BA), were interviewed for risk factors, and examined using the 8 diagnostic arms. Colposcopy was performed for women positive in any test and for 5% of women with baseline PAP-negative and 20% of HCII-negatives. All high-grade lesions (CIN2/3) were treated, and low-grade CIN are prospectively followed-up. RESULTS: Of the 12,107 women, the following baseline data are available: epidemiological data (n=11,996), conventional PAP smears (n=10,363), LBC, SurePATH (n=320), LBC, DNA-Citoliq (n=1,346), VIA (n=12.067), VILI (n=3,061), cervicography (n=279), screening colposcopy (n=3,437), HCII conventional (n=4,710), HCII self-sampling (n=246) and cervical biopsies (n=1,524). The four sub-cohorts differ significantly in all their baseline data on the implicated risk factors of cervical cancer, consonant with their origin from regions with different cancer incidence. Around 95% of all PAP smears were negative, with slight variations in the prevalence of LSIL and HSIL between the four centers. Significant differences were found in the detection rates of abnormal findings in VIA, VILI and colposcopy between the four centers (p=0.0001). The prevalence of HPV was practically identical (16.5-18.8%) in all four cohorts (p=0.486), with no differences in the relative viral loads. Biopsy results were different depending on whether the women underwent screening colposcopy (BA) or elective colposcopy (others). CONCLUSION: Four cohorts with significantly different baseline data are available, and prospective follow-up of these women permits analysis of whether variations in cervical cancer incidence in these regions is due to i) different natural history of the precursor lesions, or ii) due to different levels of exposure to the known risk factors. SN - 0250-7005 UR - https://www.unboundmedicine.com/medline/citation/16101165/Comparing_PAP_smear_cytology_aided_visual_inspection_screening_colposcopy_cervicography_and_HPV_testing_as_optional_screening_tools_in_Latin_America__Study_design_and_baseline_data_of_the_LAMS_study_ L2 - http://ar.iiarjournals.org/cgi/pmidlookup?view=long&pmid=16101165 DB - PRIME DP - Unbound Medicine ER -