You Are Here: U.S. Preventive Services Task Force > Topic Index > Screening for Cervical Cancer > Evidence Update > Table 3.
Liquid-Based Cytology and Human Papillomavirus Testing to Screen for Cervical Cancer
Table 3. Results From Randomized, Controlled Trials of HPV Screening Strategies in Cervical Cancer Screening in Women Older Than 30 Years
| Variable | Screening Round | Study (Reference) | |||||
|---|---|---|---|---|---|---|---|
| NTCC Phase 2 (39) | Finnish Trial* (45, 51) | NTCC Phase 1 (46) | POBASCAM (47) | Swedescreen (49, 50) | ARTISTIC (48) | ||
| Participants randomly assigned and screened (all ages), n | — | 49,196 | 71,337 | 45,174 | 44,938 | 12,527 | 24,510 |
| Ages recruited, y | — | 25–60 | 25–65 | 25–60 | 30–56 | 32–38 | 20–64 |
| Screened women aged ≥30 y, n | — | 35,471 (35–60 y) | 59,757 (35–65 y) | 33,364 (35–60 y ) | 17,155 (30–56 y) | 12,527 (32–38 y) | 19,344 (30–64 y) |
| Test positivity, n (%) | Baseline | IG: 1029 (5.8) CG: 555 (3.1)† 182 (1.0)‡ |
NR | IG: 1789 (10.7) CG: 594 (3.6)† 212 (1.3)‡ |
NR | NR | NR |
| 1 | NR | IG: 1645 (5.5)§, 258 (0.9)∥
CG: 293 (1.0) |
NR | IG: 56 (0.7)
CG: 54 (0.6) |
IG: 146 (2.3)¶ CG: 150 (2.4) |
248 (1.3)§ | |
| 2 | NR | NA | NR | IG: 38 (0.6) CG: 50 (0.7) |
NR | IG: 47 (0.40)** CG: 16 (0.41)** |
|
| Cumulative | NR | NA | NR | IG: 94 (1.1) CG: 104 (1.2) |
NR | IG: 405 (2.2)** CG: 121 (2.0)** |
|
| Colposcopy referrals, n (%) | Baseline | IG: 1029 (5.8) CG: 435 (2.5) |
NR | IG: 1773 (10.6) CG: 498 (3.0) |
NR | NR | NR |
| 1 | NR | IG: 258 (0.9) CG: 293 (1.0) |
NR | IG: 201 (2.3) CG: 115 (1.3)†† |
NR | IG: 707 (4.9) CG: 197 (4.1) |
|
| 2 | NR | NA | NR | IG: 87 (1.3) CG: 129 (1.9)†† |
NR | IG: 160 (NR) CG: 42 (NR) |
|
| Cumulative | NR | NA | NR | IG: 288 (3.4) CG: 244 (2.8) |
NR | IG: 867 (6.0) CG: 239 (4.9) |
|
| Absolute detection for CIN3+, n (%) | Baseline | NR | NR | NR | NR | NR | NR |
| 1 | IG: 52 (0.29) CG: 22 (0.12) |
IG: 32 (0.11%) CG: 23 (0.08%) |
IG: 52 (0.31) CG: 33 (0.20) |
IG: 68 (0.79) CG: 40 (0.47) |
IG: 72 (1.15) CG: 55 (0.88) |
IG: 116 (0.80) CG: 38 (0.79) |
|
| 2 | IG: 3 (0.02) CG: 13 (0.07) |
NR | IG: 5 (0.03) CG: 11 (0.07) |
IG: 24 (0.35) CG: 54 (0.79) |
IG: 16 (0.26) CG: 30 (0.48) |
IG: 29 (0.25)** CG: 18 (0.47)** |
|
| Cumulative | IG: 55 (0.31) CG: 35 (0.20) |
NR | IG: 57 (0.34) CG: 44 (0.26) |
IG: 92 (1.07) CG: 94 (1.10) |
IG: 88 (1.41) CG: 85 (1.36) |
IG: 262 (1.51)** CG: 98 (1.77)** |
|
| Relative detection ratio for CIN3+, n (%) | Baseline | NR | NR | NR | NR | NR | NR |
| 1 | 2.37 (1.44–3.89)†† | 1.38 (0.81–2.36) | 1.57 (1.02–2.43)†† | 1.70 (1.15–2.51)†† | 1.31 (0.92–1.87) | 1.02 (0.71–1.47) | |
| 2 | 0.23 (0.07–0.82)†† | NR | 0.46 (0.16–1.33) | 0.45 (0.28–0.72)†† | 0.53 (0.29–0.98)†† | 0.53 (0.30–0.96)** †† | |
| Cumulative | 1.57 (1.03–2.54)†† | NR | 1.30 (0.87–1.91) | 0.98 (0.74–1.30) | 1.04 (0.77–1.39) | 0.85 (0.67–1.08)** | |
| Relative detection ratio for CIN2+, n (%) | Baseline | NR | NR | NR | NR | NR | NR |
| 1 | 2.13 (1.51–3.00)†† | 1.36 (0.98–1.89) | 1.78 (1.30–2.44)†† | 1.56 (1.14–2.13) | 1.51 (1.13–2.02) | 1.21 (0.91–1.60) | |
| 2 | 0.25 (0.10–0.68)†† | NR | 0.59 (0.28–1.24) | 0.53 (0.36–0.78) | 0.58 (0.36–0.96)†† | 0.63 (0.42–0.96)** †† | |
| Cumulative | 1.58 (1.16–2.13)†† | NR | 1.50 (1.13–1.98)†† | 1.00 (0.79–1.27) | 1.17 (0.92–1.49) | 0.99 (0.83–1.19)** | |
ARTISTIC = A Randomised Trial in Screening to Improve Cytology; ASC-US = atypical squamous cells of undetermined significance; CG = control group; CIN = cervical intraepithelial neoplasia; HPV = human papillomavirus; HSIL = high-grade squamous intraepithelial lesion; IG = intervention group; LSIL = low-grade squamous intraepithelial lesion; NA = not applicable; NR = not reported; NTCC = New Technologies for Cervical Cancer Screening; POBASCAM = Population Based Screening Study Amsterdam Program.
‡‡ Finnish Trial, extended 5-year follow-up data for a subset of the screened population (n = 38,670); absolute detection for CIN3+, IG: 59 (0.30%), CG: 23 (0.17%); relative detection ratio for CIN3+, 1.77 (1.16-2.74).
* Colposcopy referral threshold varied by site: ASC-US+ (7 sites).
† Colposcopy referral threshold varied by site: LSIL+ (2 sites).
∥ Colposcopy referral criteria (HPV+ and LSIL+): HPV+ results.
¶ Colposcopy referral criteria (HPV+ and LSIL+): LSIL+ results.
‡ Colposcopy referral threshold (ASC-US+ or HSIL+): only ASC-US+ reported.
§ Colposcopy referral threshold (HSIL+) pooled across both arms.
** All age data reported (n = 15,542), incomplete round 2 follow-up.
†† Statistically significant.
USPSTF Program Office |
