RESUMO
OBJECTIVE: The objective of this study was to determine the potential benefits of polarized light colposcopy compared with standard colposcopy examinations in the evaluation of women with abnormal cervical cytology. MATERIALS AND METHODS: Polarized and standard colposcopy examinations were performed on 330 subjects. Respective images and biopsy annotations were obtained. Sensitivity and specificity; differences in the severity of cervical neoplasia; agreement of colposcopy impression, biopsy intent, and biopsy site; and differences in the number of biopsies were determined using the ROC, Bowker's test of symmetry, kappa statistic, and paired t test, respectively. RESULTS: The sensitivity and specificity for a lesion being seen with nonpolarized light and polarized light colposcopy were 96.8% and 64.5%, and 96.8% and 64.9%, respectively. There was no statistically significant difference in the ROC of the lesion being seen between nonpolarized (80.7) and polarized (80.9) colposcopy. Likewise, there was no statistically significant difference in the ROC of intent to biopsy between nonpolarized (80.2) and polarized colposcopy (78.8). The agreement of cervical histopathology and colposcopy impression for nonpolarized and polarized colposcopy were 0.986 and 0.952, respectively. There was no significant difference between nonpolarized and polarized colposcopy in the mean number of lesions seen or number of sites intended to biopsy. CONCLUSIONS: Polarized light colposcopy was not useful as an adjunct to conventional colposcopy in this study. Further research needs to be performed to determine the overall utility of polarized light colposcopy in clinical practice.
Assuntos
Colposcopia/métodos , Colposcopia/normas , Displasia do Colo do Útero/patologia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/patologia , Adulto , Feminino , Georgia , Humanos , Microscopia de Polarização/métodos , Microscopia de Polarização/normas , Pessoa de Meia-Idade , Peru , Curva ROC , Sensibilidade e Especificidade , Adulto Jovem , Displasia do Colo do Útero/diagnósticoRESUMO
OBJECTIVES: The purpose of this study was to determine and compare the knowledge and attitudes toward human papillomavirus (HPV), HPV vaccine, Pap tests, and cervical cancer among US and Peruvian women. MATERIALS AND METHODS: A convenience sample of 275 US women in Augusta, GA, and 702 Peruvian women living in or near Cusco, Peru, completed 22- or 21-item questionnaires, respectively. These questionnaires determined their knowledge about HPV, the HPV vaccine, Pap tests, and cervical cancer. Simple logistic regression was used to determine the relationship between location and language on the correct responses. Odds ratios (ORs) and 95% confidence intervals were calculated. RESULTS: US Spanish- (OR = 0.02), Quechua- (OR = 0.05), and Peru Spanish-speaking women (OR = 0.03) were significantly less likely to know that HPV causes cervical cancer compared with US non-Spanish-speaking women. US Spanish- (OR = 10.61, OR = 5.74), Quechua- (OR = 11.08, OR = 9.89), and Peru Spanish-speaking women (OR = 17.25, 14.43) were significantly more likely to be embarrassed and afraid, respectively, to get a Pap test compared with US non-Spanish-speaking women. US Spanish- (OR = 0.11), Quechua- (OR = 0.14), and Peru Spanish-speaking women (OR = 0.11) women were significantly less likely to know the HPV vaccine is safe and effective compared with US non-Spanish-speaking women. CONCLUSIONS: Education must be implemented to address serious misconceptions and worrisome attitudes toward Pap tests and the HPV vaccine to decrease the rate of cervical cancer in Peru and US Spanish-speaking women.