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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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