A COMPARATIVE STUDY ON CERVICAL CANCER SCREENING METHOD: IS IMMUNO-MARKER A BETTER OPTION?

Abstract

Cervical cytology by Papanicolaou [PAP] staining has been the backbone of primary screening of cervical cancer. For low resource countries, the major constraints in running a successful screening program are paucity of experienced personnel, requirement for multiple visits, economic considerations and inherent attributes of the test including a low sensitivity and specificity. The present study was designed to compare the efficacy of commonly available screening tests and feasibility of immuno-markers [p16 & Ki-67] as a primary screening tool. This was a cross-sectional analytical study. 100 patients were approached and agreed to participate in this study. They underwent cervical screening by multiple modalities including PAP smear, Liquid based cytology [LBC], HPV- DNA testing, cytology + HPV- DNA/p16/ Ki-67 and dual markers. Screening test results were compared with histopathology and statistical analysis done. The sensitivity and specificity of conventional cytology was 61.11% and 70%; LBC: 88.88% and 50%; Cytology + HPV DNA: 94.44% and 50%; Cytology + p16: 88.88% and 60%; Cytology + Ki-67: 88.88% and 100%; P16+Ki67: 88.88% and 60%. Combining Ki- 67 with Conventional cytology improved specificity and positive predictive value of cervical cancer screening.