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Cited by 199Cervical Cancer and HPV ResearchWomen's cancer prevention and managementReproductive tract infections research

Systematic reviews and meta-analyses of the accuracy of HPV tests, visual inspection with acetic acid, cytology, and colposcopy

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Mustafa, Reem A., Santesso, Nancy, Khatib, Rasha, Mustafa, Ahmad A., Wiercioch, Wojtek, Kehar, Rohan, Gandhi, Shreyas, Chen, Yaolong +7 more·2016·International Journal of Gynecology & Obstetrics
DOI 10.1016/j.ijgo.2015.07.024
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Abstract

BACKGROUND: Cervical cancer screening is offered to women to identify and treat cervical intraepithelial neoplasia (CIN). OBJECTIVES: To support WHO guidelines, a systematic review was performed to compare test accuracy of the HPV test, cytology (cervical smear), and unaided visual inspection with acetic acid (VIA); and to determine test accuracy of HPV and colposcopy impression. SEARCH STRATEGY: Medline and Embase were searched up to September 2012, and experts were contacted for references. SELECTION CRITERIA: Studies of at least 100 nonpregnant women (aged ≥18years) not previously diagnosed with CIN were included. DATA COLLECTION AND ANALYSIS: Two investigators independently screened and collected data. Pooled sensitivity and specificity, and absolute differences were calculated, and the quality of evidence assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation). MAIN RESULTS: High to moderate quality evidence was found. The greatest difference in overtreatment occurred with VIA instead of the cervical smear (58 more per 1000 women). Differences in missed treatment ranged from 2-5 per 1000 women. For 1000 women screened positive and then sent to colposcopy, 464 would be falsely diagnosed with CIN grade 2-3 and treated. CONCLUSIONS: Although differences in sensitivity between tests could be interpreted as large, absolute differences in missed diagnoses were small. By contrast, small differences in specificity resulted in fairly large absolute differences in overtreatment.

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  • Sensitivity and specificity of each screening strategy and colposcopy, and efficacy of HPV vaccine, were based on published meta-analysis studies.

    “Sensitivity and specificity of each of the screening strategy and colposcopy and efficacy of HPV vaccine was based on the published meta-analysis studies (Table 1). [29, 33, 34]”

    From Cost effectiveness of strategies for cervical cancer prevention in India (2020) · cites this paper as [34]

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Authors
Mustafa, R. A., Santesso, N., Khatib, R., Mustafa, A. A., Wiercioch, W., Kehar, R., Gandhi, S., Chen, Y., Cheung, A., Hopkins, J., Ma, B., Lloyd, N., Wu, D., Broutet, N., & Schünemann, H. J.
Affiliations
  • University of Missouri–Kansas City (US)
  • McMaster University (CA)
  • Population Health Research Institute (CA)
  • Jordan University of Science and Technology (JO)
  • Lanzhou University (CN)
  • University of British Columbia (CA)
  • Guangzhou University of Chinese Medicine (CN)
  • World Health Organization (CH)
Corresponding author
Schünemann, Holger J
ORCID
Venue
International Journal of Gynecology & Obstetrics
Publisher
Wiley
Published
2015-11-12
Volume
132
Issue
3
Pages
259-265
ISSN
  • 0020-6695 (ISSN-L)
  • 0020-7292
DOI
10.1016/j.ijgo.2015.07.024
OpenAlex
W2176203755
Cited by
199
References
2
Citations by year
2026: 13 · 2025: 13 · 2024: 20 · 2023: 18 · 2022: 15 · 2021: 28 · 2020: 28 · 2019: 19 · 2018: 11 · 2017: 16 · 2016: 17 · 2015: 1
FWCI
1.94
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Gynecology & Obstetrics (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Lanzhou University Institutional Repository (submittedVersion)
Funders
  • WHO
  • World Health Organization
Topics
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
Keywords
cervical cancer screening, HPV testing, visual inspection with acetic acid, cervical cytology, colposcopy, cervical intraepithelial neoplasia, diagnostic accuracy, sensitivity and specificity, overtreatment, missed diagnosis
MeSH terms
Uterine Cervical Dysplasia, Uterine Cervical Neoplasms, Colposcopy, Female, Humans, Sensitivity and Specificity, Vaginal Smears, Acetic Acid, Papillomaviridae, Early Detection of Cancer, Papanicolaou Test

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