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Liquid-Based Cytology and Human Papillomavirus Testing to Screen for Cervical Cancer

Table 1. Results of Liquid-Based Cytology Studies

Study, Year (Reference);
Country; USPSTF Quality Rating
Sample Size, n;
Ages Recruited, y
Cytology Cutoff Sensitivity/Relative Detection Ratio (95% CI)* Specificity (95% CI) Positive Predictive Value (95% CI)* False-Positive Rate (95% CI)*
LBC CC LBC CC LBC CC LBC CC
  Detection of CIN3+
NETHCON, 2009 (34); the Netherlands; good 88,988; 30–60 ASC-US+ 1.05 (0.86–1.29) (adjusted) NA 1.17 (0.99–1.39) 0.89 (0.82–0.98)
LSIL+ NR NA 1.17 (1.01–1.36) NR
NTCC, 2007 (33); Italy; fair 45,174; 25–60 ASC-US+ 0.84 (0.56–1.25) NA 0.42 (0.29–0.62) 1.93 (1.72–2.21)
LSIL+ 0.72 (0.46–1.13) NA 0.40 (0.26–0.62) 1.72 (1.42–2.07)
Taylor et al, 2006 (35); South Africa; fair 5647; 35–65 ASC-US+ 75.8 (57.7–88.9) 87.9 (71.8–96.6) 84.2 (82.9–85.5) 84.5 (83.0–86.0) 4.9 (3.2–7.1) 7.2 (4.9–10.2) 15.8 (14.5–17.1) 15.5 (14.0–17.0)
LSIL+ 66.7 (48.2–82.0) 72.7 (54.5–86.7) 93.6 (92.6–94.4) 93.9 (92.9–94.9) 10.0 (6.4–14.7) 14.1 (9.3–20.3) 6.4 (5.6–7.4) 6.1 (5.1–7.1)
  Detection of CIN2+
NETHCON, 2009 (34)   ASC-US+ 1.00 (0.84–1.20) (adjusted) NA 1.09 (0.95–1.25) 0.90 (0.82–0.99)
LSIL+ NR NA 1.04 (0.93–1.15) NR
NTCC, 2007 (33)   ASC-US+ 1.11 (0.81–1.52) NA 0.65 (0.49–0.88) 1.97 (1.75–2.21)
LSIL+ 1.03 (0.74–1.43) NA 0.58 (0.43–0.78) 1.80 (1.48–2.19)
Taylor et al, 2006 (35)   ASC-US+ 70.6 (58.3–81.0) 83.6 (71.2–92.2) 84.8 (83.5–86.1) 85.1 (83.6–86.5) 9.4 (7.0–12.3) 11.4 (8.5–15.0) 15.2 (13.9–16.5) 14.9 (13.5–16.4)
LSIL+ 60.3 (47.7–71.9) 69.1 (55.2–80.9) 94.1 (93.2– 94.9) 94.5 (93.5–95.4) 18.6 (13.7–24.4) 22.4 (16.3–29.4) 5.9 (5.1–6.8) 5.5 (4.6–6.5)
Coste et al, 2003 (36); France; fair 1757; 23–46 ASC-US+ 87.5 (73.2–95.8) 87.8 (73.8–95.9) 88.3 (86.7–89.8) 89.4 (87.9–90.9) 14.9 (10.6–20.1) 16.6 (11.9–22.2) 11.7 (10.2–13.3) 10.6 (9.1–12.1)
LSIL+ 80.0 (64.4–90.9) 73.2 (57.1–85.8) 93.1 (91.8–94.3) 94.6 (93.4–95.6) 21.3 (15.1–28.8) 24.4 (17.1–33.0) 6.9 (5.7–8.2) 5.4 (4.4–6.6)

ASC-US = atypical squamous cells of undetermined significance; ASC-US+ = ASC-US or worse cytology results; CC = conventional cytology; CI = confidence interval; CIN = cervical intraepithelial neoplasia; LBC = liquid-based cytology; LSIL = low-grade squamous intraepithelial lesion; NA = not applicable; NETHCON = Netherlands ThinPrep vs. Conventional Cytology Trial; NTCC = New Technologies for Cervical Cancer Trial; USPSTF = U.S. Preventative Services Task Force.
* Relative detection ratio, relative PPV, and relative false-positive proportion for randomized, controlled trials.
Restricted to centers with ASC-US+ referral criteria.

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