CareHPV cervical cancer screening demonstration in a rural population of north India.

Abstract Objective To compare cervical care HPV screening in a rural community setting with other methods of cervical screening for the detection of high-grade cervical intra-epithelial neoplasia (CIN). Study design: Cross-sectional study. All ever-married women aged 30–59 years surveyed in an administrative area of Uttar Pradesh, India were targeted for screening by care HPV (cervical and vaginal samples), Pap test and visual inspection of the cervix following application of acetic acid (VIA). Women who screened positive were referred for colposcopy and the results were confirmed histologically. Sensitivity, specificity and predictive values for the detection of histological CINII+ and CINIII+ were assessed for each screening test. Results Sixty-five percent (5032/7704) of the women invited for cervical screening agreed to participate in the study. Screen-positive rates for cervical care HPV, vaginal care HPV, Pap test and VIA were 3%, 2%, 3% and 6%, respectively. Data for women who did not complete all screening modes, women lost to follow-up and women with missing histological results were excluded before data analysis, resulting in a final sample size of 4658. Cervical care HPV had high sensitivity (85%) for the detection of CINIII+ lesions and moderate sensitivity (53%) for the detection of CINII+ lesions. Sensitivities for the detection of CINIII+ and CINII+ were 54% and 41% for vaginal care HPV, 62% and 44% for Pap test, and 8% and 22% for VIA, respectively. Conclusion Cervical care HPV testing is superior to VIA and Pap test for the detection of high-grade CIN in a rural community setting.