Browsing by Autor "Yuli Salgado"

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    Impact of knowledge of human papillomavirus positivity on cervical cytology performance in Latin America
    (Oxford University Press, 2024) Arianis Tatiana Ramírez; David Mesher; Armando Baena; Yuli Salgado; Elena Kasamatsu; Carmen Cristaldo; Rodrigo Álvarez; Freddy David Rojas; Katherine Ramírez; Jean-Luc Guyot
    The increase in sensitivity of cytology with HPV knowledge was limited and highly variable, reinforcing the need for alternative triage methods to support cervical cancer elimination goals.
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    Performance of visual inspection of the cervix with acetic acid (<scp>VIA</scp>) for triage of <scp>HPV</scp> screen‐positive women: results from the <scp>ESTAMPA</scp> study
    (Wiley, 2022) Armando Baena; David Mesher; Yuli Salgado; Sandra Martínez; Griselda Villalba; María Luisa Amarilla; Brenda Salgado; Bettsy Flores; Yenny Bellido‐Fuentes; Manuel Álvarez‐Larraondo
    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.