Comparative accuracy of cervical cancer screening strategies in healthy asymptomatic women: a systematic review and network meta-analysis.
Adolescent
Adult
Aged
Aged, 80 and over
Alphapapillomavirus
/ genetics
Asymptomatic Diseases
Atypical Squamous Cells of the Cervix
/ pathology
Biopsy
Colposcopy
Cytodiagnosis
Early Detection of Cancer
Female
Human Papillomavirus DNA Tests
Humans
Middle Aged
Neoplasm Grading
Network Meta-Analysis
Polymerase Chain Reaction
Predictive Value of Tests
Reproducibility of Results
Uterine Cervical Neoplasms
/ diagnosis
Young Adult
Uterine Cervical Dysplasia
/ diagnosis
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
07 01 2022
07 01 2022
Historique:
received:
21
07
2021
accepted:
17
12
2021
entrez:
8
1
2022
pubmed:
9
1
2022
medline:
24
2
2022
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 34997127
doi: 10.1038/s41598-021-04201-y
pii: 10.1038/s41598-021-04201-y
pmc: PMC8741996
doi:
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
94Subventions
Organisme : National Cancer Center
ID : 26-A-30
Organisme : National Cancer Center
ID : 29-A-16
Organisme : Ministry of Education, Culture, Sports, Science and Technology
ID : 26460755
Informations de copyright
© 2022. The Author(s).
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