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

Publication ,  Journal Article
Patanwala, IY; Bauer, HM; Miyamoto, J; Park, IU; Huchko, MJ; Smith-McCune, KK
Published in: Am J Obstet Gynecol
May 2013

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.

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Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

May 2013

Volume

208

Issue

5

Start / End Page

343 / 353

Location

United States

Related Subject Headings

  • Vaginal Smears
  • Uterine Cervical Neoplasms
  • Uterine Cervical Dysplasia
  • Sensitivity and Specificity
  • Randomized Controlled Trials as Topic
  • Predictive Value of Tests
  • Papillomavirus Infections
  • Obstetrics & Reproductive Medicine
  • Humans
  • Female
 

Citation

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ICMJE
MLA
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Patanwala, I. Y., Bauer, H. M., Miyamoto, J., Park, I. U., Huchko, M. J., & Smith-McCune, K. K. (2013). A systematic review of randomized trials assessing human papillomavirus testing in cervical cancer screening. Am J Obstet Gynecol, 208(5), 343–353. https://doi.org/10.1016/j.ajog.2012.11.013
Patanwala, Insiyyah Y., Heidi M. Bauer, Justin Miyamoto, Ina U. Park, Megan J. Huchko, and Karen K. Smith-McCune. “A systematic review of randomized trials assessing human papillomavirus testing in cervical cancer screening.Am J Obstet Gynecol 208, no. 5 (May 2013): 343–53. https://doi.org/10.1016/j.ajog.2012.11.013.
Patanwala IY, Bauer HM, Miyamoto J, Park IU, Huchko MJ, Smith-McCune KK. A systematic review of randomized trials assessing human papillomavirus testing in cervical cancer screening. Am J Obstet Gynecol. 2013 May;208(5):343–53.
Patanwala, Insiyyah Y., et al. “A systematic review of randomized trials assessing human papillomavirus testing in cervical cancer screening.Am J Obstet Gynecol, vol. 208, no. 5, May 2013, pp. 343–53. Pubmed, doi:10.1016/j.ajog.2012.11.013.
Patanwala IY, Bauer HM, Miyamoto J, Park IU, Huchko MJ, Smith-McCune KK. A systematic review of randomized trials assessing human papillomavirus testing in cervical cancer screening. Am J Obstet Gynecol. 2013 May;208(5):343–353.
Journal cover image

Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

May 2013

Volume

208

Issue

5

Start / End Page

343 / 353

Location

United States

Related Subject Headings

  • Vaginal Smears
  • Uterine Cervical Neoplasms
  • Uterine Cervical Dysplasia
  • Sensitivity and Specificity
  • Randomized Controlled Trials as Topic
  • Predictive Value of Tests
  • Papillomavirus Infections
  • Obstetrics & Reproductive Medicine
  • Humans
  • Female