title: A comparison between Pap and HPV screening tests and screening methods.
abstract: The present study assesses the results of cervical cancer (CC) screening over two 3-year periods (2008-2010 and 2011-2013) by comparing two screening tests [Papanicolaou (Pap) and human papillomavirus (HPV) tests] and two screening methods (organized and spontaneous). The study population includes women aged 25-64 years who underwent CC screening between 2008 and 2010 and/or 2011 and 2013, divided into those who responded to an invitation letter (organized screening) and those who spontaneously underwent testing at a public or private facility (non-programmed screening). Between 2008 and 2010, the response rates increased from 27.7% in 2008 to 44.5% in 2009 and 67.6% in 2010 (P<0.001). Women aged 25-34 years had the lowest response rate, whereas respondents were more frequent among women aged 35-44 and 45-54 years. Significant differences (P<0.001) were identified between organized and spontaneous screening test results with regard to diagnostic categories high-grade squamous intraepithelial lesion (50.5 vs. 49.5%), low-grade squamous intraepithelial lesion (42.8 vs. 57.2%) and undetermined lesion atypical glandular cells (AGC; 57.5 vs. 42.5%) or atypical squamous cells of undetermined significance (ASC-US; 54.2 vs. 45.8%). Compared with spontaneous screening, the organized programme resulted in a larger number of women screened for CC; it reduced the frequency of undetermined diagnoses (AGC, ASC-US), and identified a larger number of high-grade lesions.
authors.affiliation: Department of Life, Health and Environmental Sciences, University of L'Aquila, I-67100 L'Aquila, Italy; Epidemiology and Statistics Unit, AUSL 4, I-67100 Teramo, Italy.
authors.forename: Emma
authors.initials: E
authors.lastname: Altobelli
authors.affiliation: Epidemiology and Statistics Unit, AUSL 4, I-67100 Teramo, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Scarselli
authors.affiliation: Epidemiology and Statistics Unit, AUSL 4, I-67100 Teramo, Italy.
authors.forename: Amedeo
authors.initials: A
authors.lastname: Lattanzi
authors.affiliation: Department of Pathological Anatomy, AUSL 4, I-67100 Teramo, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Fortunato
authors.affiliation: Department of Community Health, AUSL 4, I-67100 Teramo, Italy.
authors.forename: Valerio F
authors.initials: VF
authors.lastname: Profeta
keywords: Papanicolaou test; cancer; cervical cancer; human papillomavirus test; screening