Accuracy of several cervical screening strategies for early detection of cervical cancer: a meta-analysis.
OBJECTIVE
The objectives of this study were to assess the accuracy of 6 common cervical screening strategies, including visual inspection with acetic acid, with a magnifying device, or with Lugol iodine (VILI), human papillomavirus testing with Hybrid Capture 2 assay, conventional Papanicolaou smear, and thin liquid-based cytology (LBC), and then to compare data obtained by the aforementioned 6 strategies.


METHODS
PubMed, EMBASE, and The Cochrane Library were systematically searched for all original relevant studies about early detection of cervical cancer. A meta-analysis was performed to evaluate the accuracy of the 6 screening strategies covering sensitivity, specificity, diagnostic odds ratio, and the area under the receiver operating characteristic curve.


RESULTS
Fifteen articles containing 22 cross-sectional studies were finally identified. The combined estimates of sensitivity for visual inspection with acetic acid, magnified visual inspection with acetic acid, VILI, Hybrid Capture 2 assay, conventional Papanicolaou smear, and LBC were 77%, 64%, 91%, 74%, 59%, and 88%, respectively; the combined values of specificity of these screening strategies were 87%, 86%, 85%, 92%, 94%, and 88%, respectively; the diagnostic odds ratio were 22.43, 10.30, 57.44, 33.26, 22.49, and 51.56, respectively; and the area under the receiver operating characteristic curve were 0.8918, 0.7737, 0.9365, 0.9486, 0.9079, and 0.9418, respectively.


CONCLUSIONS
This meta-analysis suggests that LBC appeared to be promising in primary cervical cancer screening in resourced regions, and VILI might be a good choice to identify/exclude cervical cancerous and precancerous lesions in resource-constrained regions.
Department of Gynecologic Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
Changxian
C
Chen
Zhijun
Z
Yang
Zhuang
Z
Li
Li
L
Li
D019342:Acetic Acid; D004396:Coloring Agents; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007454:Iodides; D008403:Mass Screening; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification; D012372:ROC Curve; D012044:Regression Analysis; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*
D004396:Coloring Agents; D007454:Iodides; D019342:Acetic Acid; C010389:Lugol's solution