Table 2. Screening test performance: estimated sensitivity and specificity.
| CIN2+ (N = 310)§ | CIN3+ (N = 102)§ | |||
| Sensitivity 95% CI | Specificity 95% CI | Sensitivity 95% CI | Specificity 95% CI | |
| Cytology* | 75.8% (70.8–80.8) | 83.4% (80.9–85.9) | 94.5% (89.8–99.2) | 72.7% (70.0–75.3) |
| VIA (doctor interpretation) | 75.5% (70.5–80.4) | 68.1% (65.0–71.3) | 76.2% (67.9–84.5) | 58.9% (56.0–61.9) |
| HPV | 91.9% (88.5–95.3) | 51.4% (48.0–54.8) | 97.9% (95.0–100) | 42.8% (39.8–45.7) |
| Cytology** | 94.8% (90.5–99.2) | 35.6% (32.2–38.9) | 99.9% (98.8–100) | 29.6% (26.9–32.3) |
| VIA (nurse interpretation) | 65.4% (59.7–71.1) | 68.5% (65.3–71.7) | 68.2% (59.3–77.2) | 61.5% (58.6–64.4) |
| Combined (Or)** Cytology or VIA | 89.3% (85.4–93.3) | 60.4% (57.1–63.8) | 97.4% (93.9–100) | 50.7% (47.7–53.6) |
| Combined (Or)** Cytology or HPV | 94.3% (91.3–97.4) | 48.5% (45.1–51.9) | 99.9% (99.4–100) | 39.9% (37.0–42.9) |
| Combined (Or)** HPV or VIA | 95.6% (92.8–98.4) | 42.4% (39.1–45.8) | 99.0% (97.0–100) | 34.7% (31.8–37.5) |
| Combined (Or)** Cytology or VIA or HPV | 96.4% (93.8–99.0) | 40.8% (37.4–44.2) | 99.9% (99.4–100) | 32.9% (30.1–35.8) |
| Combined (And)** Cytology & VIA | 61.3% (55.8–66.8) | 91.1% (89.1–93.0) | 72.8% (64.1–81.5) | 80.9% (78.6–83.3) |
| Combined (And)** Cytology & HPV | 72.6% (67.4–77.8) | 86.2% (83.9–88.6) | 91.8% (85.9–97.6) | 75.5% (72.9–78.1) |
| Combined (And)** HPV & VIA | 71.0% (65.8–76.2) | 77.0% (74.1–79.9) | 74.6% (66.0–83.1) | 67.0% (64.2–69.8) |
| Combined (And)** Cytology & VIA & HPV | 59.3% (53.8–64.8) | 91.6% (89.7–93.5) | 71.5% (62.6–80.4) | 81.8% (79.5–84.2) |
§
94.4% (878/930) of women with abnormal Pap smear/VIA and 25% (63/272) women with negative VIA/Pap smear received a colposcopic biopsy.
CIN2+ = CIN2/CIN3/ICC, CIN3+ = CIN3/ICC, CI = Confidence interval, Cytology = Cytology Pap smear, HPV = HPV DNA, VIA = Visual inspection with 5% acetic acid.
*
Cytology negative: normal/LSIL/ASCUS; positive: HSIL, ASC-H, SCC.
**
Cytology negative: normal; positive: otherwise.
A combined test in “Combined (Or)” is positive if either/any of the tests is positive. A Combined test in “Combined (And)” is positive if both/all of the tests are positive.