Efficacy of Pap test in combination with ThinPrep cytological test in screening for cervical cancer.
BACKGROUND
Our aim was to investigate the efficacy of the Pap test in combination with the ThinPrep cytological test (TCT) in screening for cervical cancer in China.


METHODS
From March 2006 to October 2008, 988 women with the mean age 46.4 ± 10.5 years (range, 23-80 years) were recruited to receive cervical cancer screening. Pap test results ≥ grade III and TCT findings ≥ ASCUS/AGUS were considered abnormal. Subjects with a Pap test result ≥ grade IIb received TCT. Colposcopy and biopsies were performed in all participants, and final diagnosis was based on pathological findings. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Youden index for predicting CIN I or above were determined.


RESULTS
The sensitivity, specificity, PPV, NPV and Youden index of the Pap test were 43.1%, 97.2%, 70.0%, 91.9%, and 40.3%, respectively. The same values for TCT in predicting CIN were 80.0%, 63.2%, 16.0%, 97.3%, and 43.2%, respectively. The two tests in combination gave values for predicting CIN of 64.8%, 87.6%, 43.6%, 94.4%, and 53.5%, respectively. Combined testing exhibited the highest Youden index (53.4%).


CONCLUSIONS
The Pap test with a reduced threshold in combination with the TCT has high sensitivity and high specificity in screening for cervical cancer.
Department of Obstetric and gynecology, Gongli hospital, Shanghai, China.
Hua
H
Chen
Hui-Min
HM
Shu
Zhou-Lin
ZL
Chang
Zhi-Feng
ZF
Wang
Hai-Hong
HH
Yao
Hong-Mei
HM
Zhu
Tian-Mei
TM
Lu
Qiang-Yan
QY
Ma
Bin-Lie
BL
Yang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology*; D002584:Cervix Uteri / Q000473:pathology*; D002681:China; D003127:Colposcopy; D003581:Cytodiagnosis; D055088:Early Detection of Cancer / Q000379:methods*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology*; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology*