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

Table 2. Absolute Test Performance of Primary Screening With HPV Test Alone and Combination HPV and Cytology Testing in Developed Countries Only in Women Aged 30 Years or Older

Study, Year (Reference);
USPSTF Quality Rating
Sample Size, n Sensitivity (95% CI) Specificity (95% CI)
HC2 Cytology: ASC-US+ HC2 and Cytology HC2 Cytology: ASC-US+ HC2 and Cytology
  Detection of CIN3+
Petry et al, 2003 (41); fair 7908 97.3 83.2–99.6) 46.0 (30.8–61.9) 100 (93.7–100)* 95.2 (93.4–96.5) 98.0 (96.7–98.8) 94.9 (93.1–96.2)*
Kulasingam et al, 2002 (43); good 774 86.0 (59.7–96.9) 49.7 (32.9–71.5) 49.7 (32.9–71.5) 83.0 (76.8–87.1) 86.4 (84.8–88.1) 94.7 (92.8–96.1)
  Detection of CIN2+
Bigras and de Marval, 2005 (44); fair 13,842 97.0 (91.8–99.4) 58.7 (48.6–68.2) NR 92.4 (91.9–92.9) 96.9 (96.6–97.2) NR
Cardenas-Turanzas et al, 2008 (40); fair 1850 69 (41–89) 44 (20–70) NR 93 (91–95) 94 (92–95) NR
Coste et al, 2003 (36); good 3080 96 (88–100) 65 (50–80) 76 (59–93) 85 (83–87) 98 (98–99) 97 (97–98)
Kulasingam et al, 2002 (43); good 774 62.7 (31.4–93.2) 38.3 (19.3–63.3) 38.3 (19.3–63.3) 83.0 (76.6–87.2) 86.4 (84.7–88.3) 95.0 (93.0–96.4)
Mayrand et al, 2007 (42); fair 9977 97.4 (NR) 56.4 (NR) 100 (NR)§ 94.3 (NR) 97.3 (NR) 92.5 (NR)§
Petry et al, 2003 (41); fair 7908 97.8 (86.3–99.7) 43.5 (30.0–58.0) 100 (93.7–100) 95.3 (93.5–96.6) 98.0 (96.7–98.8) 93.8 (91.8–95.3)

ASC-US = atypical squamous cells of undetermined significance; ASCUS+ = ASC-US or worse; CIN = cervical intraepithelial neoplasia; DNA = deoxyribonucleic acid; HC2 = Hybrid Capture 2; HPV = human papillomavirus; HSIL = high-grade squamous intraepithelial lesion; NR = not reported; Pap = Papanicolaou; USPSTF = U.S. Preventive Services Task Force.
* HC2 and cytology reported as positive on either test with cytology threshold of PapIIw+ (equivalent to ASC-US+) for CIN2+ and PapIII+ for CIN3+.
† HC2 and cytology reported as ASC-US+ and high-risk HPV+.
‡ HC2 and cytology reported as HSIL+ or relative light units/cut-off value ratio > 1.0 if ASC-US or atypical glandular cells of undetermined significance.
§ HC2 and cytology reported as Papanicolaou test result of ASC-US+ or HPV ≥ 1 pg HPV DNA/mL.
║ Data were not stratified by age; the study included women >18 y; the average age was 33.3 y.

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