Cervical cancer: Difference between revisions
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===Effectiveness of screening=== | ===Effectiveness of screening=== | ||
In a [[randomized controlled trial]], the addition of Human papillomavirus testing to screening for cervical cancer "reduces the incidence of grade 2 or 3 cervical intraepithelial neoplasia or cancer detected by subsequent screening examinations."<ref name=" | In a [[randomized controlled trial]], the addition of Human papillomavirus testing to screening for cervical cancer "reduces the incidence of grade 2 or 3 cervical intraepithelial neoplasia or cancer detected by subsequent screening examinations."<ref name="pmid17942872">{{cite journal |author=Naucler P, Ryd W, Törnberg S, ''et al'' |title=Human papillomavirus and Papanicolaou tests to screen for cervical cancer |journal=N. Engl. J. Med. |volume=357 |issue=16 |pages=1589–97 |year=2007 |pmid=17942872 |doi=10.1056/NEJMoa073204 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=17942872&promo=ONFLNS19}}</ref> | ||
In another [[randomized controlled trial]], the addition of Human papillomavirus testing to screening for cervical cancer led to earlier detection of CIN3+ lesions.<ref name=" | In another [[randomized controlled trial]], the addition of Human papillomavirus testing to screening for cervical cancer led to earlier detection of CIN3+ lesions.<ref name="pmid17919718">{{cite journal |author=Bulkmans NW, Berkhof J, Rozendaal L, ''et al'' |title=Human papillomavirus DNA testing for the detection of cervical intraepithelial neoplasia grade 3 and cancer: 5-year follow-up of a randomised controlled implementation trial |journal=Lancet |volume=370 |issue=9601 |pages=1764–72 |year=2007 |pmid=17919718 |doi=10.1016/S0140-6736(07)61450-0}}</ref> | ||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 23:01, 10 March 2008
Screening
Accuracy of screening tests
Papanicolaou smear
A systematic review of available studies found the follow results.[1]
| ASCUS or worse | High grade or worse | |||
|---|---|---|---|---|
| sensitivity | specificity | sensitivity | specificity | |
| Conventional method | 88% | 71% | 55% | 97% |
| Liquid-based thin prep | 88% | 71% | 57% | 97% |
A more recent study of the convention method reported very similar results:[2]
- sensitivity 55%
- specificity 94%
Human papillomavirus testing
- sensitivity 95%[2]
- specificity 97%[2]
Combined testing
If either the Papanicolaou smear or Human papillomavirus testing are abnormal:
- sensitivity 100%[2]
- specificity 93%[2]
Effectiveness of screening
In a randomized controlled trial, the addition of Human papillomavirus testing to screening for cervical cancer "reduces the incidence of grade 2 or 3 cervical intraepithelial neoplasia or cancer detected by subsequent screening examinations."[3]
In another randomized controlled trial, the addition of Human papillomavirus testing to screening for cervical cancer led to earlier detection of CIN3+ lesions.[4]
References
- ↑ 1.0 1.1 Arbyn M, Bergeron C, Klinkhamer P, Martin-Hirsch P, Siebers AG, Bulten J (2008). "Liquid Compared With Conventional Cervical Cytology: A Systematic Review and Meta-analysis". Obstet Gynecol 111 (1): 167–177. DOI:10.1097/01.AOG.0000296488.85807.b3. PMID 18165406. Research Blogging.
- ↑ 2.0 2.1 2.2 2.3 2.4 Mayrand MH, Duarte-Franco E, Rodrigues I, et al (2007). "Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer". N. Engl. J. Med. 357 (16): 1579–88. DOI:10.1056/NEJMoa071430. PMID 17942871. Research Blogging.
- ↑ Naucler P, Ryd W, Törnberg S, et al (2007). "Human papillomavirus and Papanicolaou tests to screen for cervical cancer". N. Engl. J. Med. 357 (16): 1589–97. DOI:10.1056/NEJMoa073204. PMID 17942872. Research Blogging.
- ↑ Bulkmans NW, Berkhof J, Rozendaal L, et al (2007). "Human papillomavirus DNA testing for the detection of cervical intraepithelial neoplasia grade 3 and cancer: 5-year follow-up of a randomised controlled implementation trial". Lancet 370 (9601): 1764–72. DOI:10.1016/S0140-6736(07)61450-0. PMID 17919718. Research Blogging.