Comparative accuracy of cervical cancer screening strategies in healthy asymptomatic women: a systematic review and network meta-analysis
Loading...
Authors
Terasawa, Teruhiko
Hosono, Satoyo
Sasaki, Seiju
Hoshi, Keika
Hamashima, Yuri
Katayama, Takafumi
Hamashima, Chisato
Issue Date
2022-01-07
Type
Article
Language
en_US
Keywords
Cancer Screening , Cervical Cancer , Health Care
Alternative Title
Abstract
To compare all available accuracy data on screening strategies for identifying cervical intraepithelial neoplasia grade ≥ 2 in healthy asymptomatic women, we performed a systematic review and network meta-analysis. MEDLINE and EMBASE were searched up to October 2020 for paired-design studies of cytology and testing for high-risk genotypes of human papillomavirus (hrHPV). The methods used included a duplicate assessment of eligibility, double extraction of quantitative data, validity assessment, random-effects network meta-analysis of test accuracy, and GRADE rating. Twenty-seven prospective studies (185,269 subjects) were included. The combination of cytology (atypical squamous cells of undetermined significance or higher grades) and hrHPV testing (excepting genotyping for HPV 16 or 18 [HPV16/18]) with the either-positive criterion (OR rule) was the most sensitive/least specific, whereas the same combination with the both-positive criterion (AND rule) was the most specific/least sensitive. Compared with standalone cytology, non-HPV16/18 hrHPV assays were more sensitive/less specific. Two algorithms proposed for primary cytological testing or primary hrHPV testing were ranked in the middle as more sensitive/less specific than standalone cytology and the AND rule combinations but more specific/less sensitive than standalone hrHPV testing and the OR rule combination. Further research is needed to assess these results in population-relevant outcomes at the program level.
Description
Citation
Terasawa, T., Hosono, S., Sasaki, S., Hoshi, K., Hamashima, Y., Katayama, T., & Hamashima, C. (2022). Comparative accuracy of cervical cancer screening strategies in healthy asymptomatic women: a systematic review and network meta-analysis. Scientific reports, 12(1), 94. https://doi.org/10.1038/s41598-021-04201-y
Publisher
Scientific Reports