title: Performance of the R-way Colposcopic Evaluation System in Cervical Cancer Screening.
abstract: OBJECTIVE
  To investigate the diagnostic value of the R-way colposcopic evaluation system (R-way system) in cervical cancer screening.
  
  
  METHODS
  Between August 2013 and August 2014, a total of 1,059 cases referred to colposcopy in Peking University First Hospital were studied using both the R-way system and conventional colposcopy. Our study evaluated and compared the diagnostic ability of the two methods in detecting high-grade lesions and cervical cancer (hereinafter called CIN2+). Evaluation indicators including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Youden index and the area under the curve (AUC) of the receiver operating characteristic (ROC) were calculated.
  
  
  RESULTS
  The R-way system had a slightly lower specificity (94.5%) than conventional colposcopy (96.0%) for CIN2+ detection (P=0.181). However, the sensitivity (77.8%) was significantly higher than with the conventional colposcopic method (46.6%) (χ2=64.351, P<0.001). In addition, the AUC of the ROC for CIN2+ detection using the R-way system (0.839) was larger than that with conventional colposcopy (0.731) (Z=4.348, P<0.001). If preliminary result had been drawn from cervical exfoliated cytology before colposcopy referral, combination of the R-way system with cytology could increase the sensitivity to 93.9% for CIN2+ detection (excluding ASCUS\LSIL), confirmed by multipoint biopsy or ECC.
  
  
  CONCLUSIONS
  The diagnostic value of the R-way evaluation system is higher than that of conventional colposcopic evaluation in cervical cancer screening. Moreover, taking the ease of use and standardized quality control management into account, the R-way system is highly preferable.
authors.affiliation: Department of Gynaecology and Obstetrics, Peking University First Hospital, Peking University Health Science Center, Peking University, Beijing, China E-mail : qiaoy@cicams.ac.cn.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhao
authors.forename: Xi
authors.initials: X
authors.lastname: Zhang
authors.forename: Rui
authors.initials: R
authors.lastname: Chen
authors.forename: Yu-Qian
authors.initials: YQ
authors.lastname: Zhao
authors.forename: Ting-Ting
authors.initials: TT
authors.lastname: Wang
authors.forename: Shan
authors.initials: S
authors.lastname: He
authors.forename: You-Lin
authors.initials: YL
authors.lastname: Qiao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D003127:Colposcopy / Q000379:methods*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D002583:Uterine Cervical Neoplasms / Q000473:pathology*