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Cervical cancer

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(PD) Photo: U.S. Centers for Disease Control
(PD) Photo: U.S. Centers for Disease Control

Contents

Screening

Accuracy of screening tests

Papanicolaou smear

A systematic review of available studies for detection of cervical intraepithelial neoplasia grade 2 or worse found the follow results.[1]

Ability to detect ASCUS or worse.[1]
ASCUS or worse High grade or worse
sensitivity specificity sensitivity specificity
Conventional method 88% 71% 55% 97%
Liquid-based thin prep 88% 71% 57% 97%

A more recent study of the conventional method for cervical intraepithelial neoplasia of grade 2 or 3 reported very similar results:[2]

Human papillomavirus testing

Combined testing

If either the Papanicolaou smear or Human papillomavirus testing are abnormal:

Effectiveness of screening

In a randomized controlled trial, the addition of Human papillomavirus testing to screening for cervical cancer "reduces the incidence of grade 2 or 3 cervical intraepithelial neoplasia or cancer detected by subsequent screening examinations."[3]

In another randomized controlled trial, the addition of Human papillomavirus testing to screening for cervical cancer led to earlier detection of CIN3+ lesions.[4]

References

  1. 1.0 1.1 Arbyn M, Bergeron C, Klinkhamer P, Martin-Hirsch P, Siebers AG, Bulten J (2008). "Liquid Compared With Conventional Cervical Cytology: A Systematic Review and Meta-analysis". Obstet Gynecol 111 (1): 167–177. DOI:10.1097/01.AOG.0000296488.85807.b3. PMID 18165406.
  2. 2.0 2.1 2.2 2.3 2.4 Mayrand MH, Duarte-Franco E, Rodrigues I, et al (2007). "Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer". N. Engl. J. Med. 357 (16): 1579–88. DOI:10.1056/NEJMoa071430. PMID 17942871.
  3. Naucler P, Ryd W, Törnberg S, et al (2007). "Human papillomavirus and Papanicolaou tests to screen for cervical cancer". N. Engl. J. Med. 357 (16): 1589–97. DOI:10.1056/NEJMoa073204. PMID 17942872.
  4. Bulkmans NW, Berkhof J, Rozendaal L, et al (2007). "Human papillomavirus DNA testing for the detection of cervical intraepithelial neoplasia grade 3 and cancer: 5-year follow-up of a randomised controlled implementation trial". Lancet 370 (9601): 1764–72. DOI:10.1016/S0140-6736(07)61450-0. PMID 17919718.
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