Cervical cancer: Difference between revisions
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==Screening== | ==Screening== | ||
===Papanicolaou smear=== | ===Accuracy of screening tests=== | ||
====Papanicolaou smear==== | |||
A [[systematic review]] of available studies found the follow results.<ref name="pmid18165406">{{cite journal |author=Arbyn M, Bergeron C, Klinkhamer P, Martin-Hirsch P, Siebers AG, Bulten J |title=Liquid Compared With Conventional Cervical Cytology: A Systematic Review and Meta-analysis |journal=Obstet Gynecol |volume=111 |issue=1 |pages=167–177 |year=2008 |pmid=18165406 |doi=10.1097/01.AOG.0000296488.85807.b3 |issn=}}</ref> | A [[systematic review]] of available studies found the follow results.<ref name="pmid18165406">{{cite journal |author=Arbyn M, Bergeron C, Klinkhamer P, Martin-Hirsch P, Siebers AG, Bulten J |title=Liquid Compared With Conventional Cervical Cytology: A Systematic Review and Meta-analysis |journal=Obstet Gynecol |volume=111 |issue=1 |pages=167–177 |year=2008 |pmid=18165406 |doi=10.1097/01.AOG.0000296488.85807.b3 |issn=}}</ref> | ||
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A more recent study of the convention method reported very similar results:<ref name="pmid17942871">{{cite | A more recent study of the convention method reported very similar results:<ref name="pmid17942871">{{cite journal |author=Mayrand MH, Duarte-Franco E, Rodrigues I, ''et al'' |title=Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer |journal=N. Engl. J. Med. |volume=357 |issue=16 |pages=1579–88 |year=2007 |pmid=17942871 |doi=10.1056/NEJMoa071430|url=http://content.nejm.org/cgi/content/full/357/16/1579}}</ref> | ||
* [[sensitivity (tests)|sensitivity]] 55% | * [[sensitivity (tests)|sensitivity]] 55% | ||
* [[specificity (tests)|specificity]] 94% | * [[specificity (tests)|specificity]] 94% | ||
===Human papillomavirus testing=== | ====Human papillomavirus testing==== | ||
* [[sensitivity (tests)|sensitivity]] 95%<ref name="pmid17942871"/> | * [[sensitivity (tests)|sensitivity]] 95%<ref name="pmid17942871"/> | ||
* [[specificity (tests)|specificity]] 97%<ref name="pmid17942871"/> | * [[specificity (tests)|specificity]] 97%<ref name="pmid17942871"/> | ||
===Combined testing=== | ====Combined testing==== | ||
If either the Papanicolaou smear or Human papillomavirus testing are abnormal: | If either the Papanicolaou smear or Human papillomavirus testing are abnormal: | ||
* [[sensitivity (tests)|sensitivity]] 100%<ref name="pmid17942871"/> | * [[sensitivity (tests)|sensitivity]] 100%<ref name="pmid17942871"/> | ||
* [[specificity (tests)|specificity]] 93%<ref name="pmid17942871"/> | * [[specificity (tests)|specificity]] 93%<ref name="pmid17942871"/> | ||
===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."<ref name="pmid17942871">{{cite journal |author=Mayrand MH, Duarte-Franco E, Rodrigues I, ''et al'' |title=Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer |journal=N. Engl. J. Med. |volume=357 |issue=16 |pages=1579–88 |year=2007 |pmid=17942871 |doi=10.1056/NEJMoa071430|url=http://content.nejm.org/cgi/content/full/357/16/1579}}</ref> | |||
In another [[randomized controlled trial]], the addition of Human papillomavirus testing to screening for cervical cancer led to earlier detection of CIN3+ lesions.<ref name="pmid17919718">{{cite journal |author=Bulkmans NW, Berkhof J, Rozendaal L, ''et al'' |title=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 |journal=Lancet |volume=370 |issue=9601 |pages=1764–72 |year=2007 |pmid=17919718 |doi=10.1016/S0140-6736(07)61450-0}}</ref> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 09:43, 24 January 2008
Screening
Accuracy of screening tests
Papanicolaou smear
A systematic review of available studies found the follow results.[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 convention method reported very similar results:[2]
- sensitivity 55%
- specificity 94%
Human papillomavirus testing
- sensitivity 95%[2]
- specificity 97%[2]
Combined testing
If either the Papanicolaou smear or Human papillomavirus testing are abnormal:
- sensitivity 100%[2]
- specificity 93%[2]
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."[2]
In another randomized controlled trial, the addition of Human papillomavirus testing to screening for cervical cancer led to earlier detection of CIN3+ lesions.[3]
References
- ↑ 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. Research Blogging.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 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. Research Blogging.
- ↑ 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. Research Blogging.