@article{fdi:010075993,
  title = {{I}nt{\'e}r{\^e}t du test {HPV} dans le d{\'e}pistage primaire du cancer du col en milieu rural {\`a} {M}adagascar},
  author = {{D}umont, {A}lexandre and {B}essieres, {N}. and {R}azafindrafara, {G}. and {R}avit, {M}. and {B}enbassa, {A}.},
  editor = {},
  language = {{FRE}},
  abstract = {{B}ackground. - {T}esting for high-risk human papilloma virus ({HR}-{HPV}) is an effective approach to the prevention of cervical cancer. {T}his study in the {A}tsinanana area of {M}adagascar aimed to compare the management of women screened by visual inspection after coloration with acetic acid ({VIA}) and the management of women screened by {HPV} with {VIA} as a triage test. {M}ethod. - {D}uring the last two screening campaigns, the first patients (between 28 and 120 women par center) were sampled using a dry swab, just before the acetic acid application, to test 14 genotypes of {HR}-{HPV} using {R}oche {D}iagnostics {C}obas ({R}) {T}est. {W}e compared current management practices based on primary {VIA} to those that would have been implemented if the clinician had followed the recommendations of the {W}orld {H}ealth {O}rganization for {HPV}-based primary screening. {W}e used a regression {P}oisson model with random effect and robust variance. {R}esults. - {A}mong the 250 screened-women, 28 (11.2%) had acidophilic lesions of the uterine cervix or suspected lesions of invasive cancer ({IVA} +). {T}he {HPV} test was positive in 62 cases (24.8%). {T}he {HPV}-based screening strategy would have reduced by 52% the number of women needing thermocoagulation treatment: 24 women (9.6%) with primary {VIA}-based screening vs. 13 women (5.2%) with primary {HPV}-based screening; {RR}: 0.52 and 95%{CI}: 0.27-1.02. {T}he diagnosis of severe dysplastic lesion or invasive cancer would not have changed. {C}onclusion. - {P}rimary {HPV}-based screening is a strategy that could be useful for low-resource countries like {M}adagascar. {I}t would reduce the rate of false positives and unnecessary treatments compared to the current strategy based on primary {IVA}. {T}he questions of the feasibility and cost-benefit of this strategy should be further explored.},
  keywords = {{S}creening ; {C}ervical cancer ; {H}uman papilloma virus ; {H}igh-risk genotypes ; {V}isual inspection after coloration with acetic acid ({VIA}) ; {S}ee and treat ; {MADAGASCAR}},
  booktitle = {},
  journal = {{R}evue d'{E}pidemiologie et de {S}ant{\'e} {P}ublique},
  volume = {67},
  numero = {2},
  pages = {120--125},
  ISSN = {0398-7620},
  year = {2019},
  DOI = {10.1016/j.respe.2018.10.003},
  URL = {https://www.documentation.ird.fr/hor/fdi:010075993},
}