A systematic review of randomized trials assessing human papillomavirus testing in cervical cancer screening.

Journal Article (Journal Article;Review;Systematic Review)

Our objective was to assess the sensitivity and specificity of human papillomavirus (HPV) testing for cervical cancer screening in randomized trials. We conducted a systematic literature search of the following databases: MEDLINE, CINAHL, EMBASE, and Cochrane. Eligible studies were randomized trials comparing HPV-based to cytology-based screening strategies, with disease status determined by colposcopy/biopsy for participants with positive results. Disease rates (cervical intraepithelial neoplasia [CIN]2 or greater and CIN3 or greater), sensitivity, and positive predictive value were abstracted or calculated from the articles. Six studies met inclusion criteria. Relative sensitivities for detecting CIN3 or greater of HPV testing-based strategies vs cytology ranged from 0.8 to 2.1. The main limitation of our study was that testing methodologies and screening/management protocols were highly variable across studies. Screening strategies in which a single initial HPV-positive test led to colposcopy were more sensitive than cytology but resulted in higher colposcopy rates. These results have implications for cotesting with HPV and cytology as recommended in the United States.

Full Text

Duke Authors

Cited Authors

  • Patanwala, IY; Bauer, HM; Miyamoto, J; Park, IU; Huchko, MJ; Smith-McCune, KK

Published Date

  • May 2013

Published In

Volume / Issue

  • 208 / 5

Start / End Page

  • 343 - 353

PubMed ID

  • 23159693

Pubmed Central ID

  • PMC3686555

Electronic International Standard Serial Number (EISSN)

  • 1097-6868

Digital Object Identifier (DOI)

  • 10.1016/j.ajog.2012.11.013


  • eng

Conference Location

  • United States