Table 3.
Sensitivity, specificity, area under the curve of sensitivity and 1–specificity, positive predictive value, negative predictive value and test positivity of screening methods individually and in combination to detect CIN2/CIN3 (n = 453)a.
| CIN2/CIN3 | Sensitivity (95% CI) | Specificity (95% CI) | AUC | PPV (95% CI) | NPV (95% CI) | Test positivity | |
|---|---|---|---|---|---|---|---|
| Pap | |||||||
| ASCUS+ | 102 | 92.7 (86.3–96.3) | 49.3 (44.0–54.5) | 0.71 | 37.0 (31.5–42.8) | 95.5 (91.3–97.7) | 60.9 |
| <ASCUS+ | 8 | ||||||
| Pap | |||||||
| LSIL+ | 94 | 85.5 (77.7–90.8) | 67.3 (62.2–72.1) | 0.76 | 45.6 (39.0–52.5) | 93.5 (89.7–96.0) | 45.5 |
| <LSIL+ | 16 | ||||||
| Pap | |||||||
| HSIL+ | 79 | 71.8 (62.8–79.4) | 97.1 (94.7–98.4) | 0.85 | 88.8 (80.5–93.8) | 91.5 (88.2–93.9) | 19.6 |
| <HSIL+ | 31 | ||||||
| VIA | |||||||
| Positive | 69 | 62.7 (53.4–71.2) | 65.9 (60.7–70.7) | 0.64 | 37.1 (30.5–44.2) | 84.6 (79.8–88.5) | 41.1 |
| Negative | 41 | ||||||
| HPV | |||||||
| Positive | 92 | 83.6 (75.6–89.4) | 55.7 (50.4–60.9) | 0.70 | 37.7 (31.9–43.9) | 91.4 (86.8–94.5) | 53.9 |
| Negative | 18 | ||||||
| VIA+HPV | |||||||
| Positive | 64 | 58.2 (48.8–67.0) | 83.7 (79.4–87.2) | 0.71 | 53.3 (44.4–62.0) | 86.2 (82.1–89.5) | 26.5 |
| Negative | 46 | ||||||
| VIA+Pap (ASCUS+) | |||||||
| Positive | 66 | 60.0 (50.7–68.7) | 81.9 (77.5–85.6) | 0.71 | 51.6 (43.0–60.1) | 86.5 (82.3–89.8) | 28.3 |
| Negative | 44 | ||||||
| VIA+Pap (LSIL+) | |||||||
| Positive | 64 | 58.2 (48.8–67.0) | 88.0 (84.2–91.1) | 0.73 | 61.0 (51.4–69.7) | 86.8 (82.8–89.9) | 23.2 |
| Negative | 46 | ||||||
| VIA+Pap (HSIL+) | |||||||
| Positive | 56 | 50.9 (41.7–60.1) | 99.1 (97.5–99.7) | 0.75 | 94.9 (86.1–98.3) | 86.3 (82.5–89.3) | 13.0 |
| Negative | 54 | ||||||
| HPV+Pap (ASCUS+) | |||||||
| Positive | 87 | 79.1 (70.6–85.6) | 76.4 (71.6–80.6) | 0.78 | 51.8 (44.3–59.2) | 91.9 (88.2–94.6) | 37.1 |
| Negative | 23 | ||||||
| HPV+Pap (LSIL+) | |||||||
| Positive | 81 | 73.6 (64.7–81.0) | 84.3 (80.0–87.7) | 0.79 | 60.0 (51.6–67.9) | 90.9 (87.2–93.6) | 29.8 |
| Negative | 29 | ||||||
| HPV+Pap (HSIL+) | |||||||
| Positive | 69 | 62.7 (53.4–71.2) | 98.5 (96.6–99.4) | 0.81 | 93.2 (85.1–97.1) | 89.2 (85.7–91.9) | 16.3 |
| Negative | 41 | ||||||
| VIA or HPV | |||||||
| Positive | 97 | 88.2 (80.8–93.0) | 37.9 (32.9–43.1) | 0.63 | 31.3 (26.4–36.7) | 90.9 (85.1–94.6) | 68.4 |
| Negative | 13 | ||||||
| VIA or Papb | |||||||
| Positive | 92 | 83.6 (75.6–89.4) | 63.8 (58.6–68.8) | 0.74 | 42.6 (36.2–49.3) | 92.4 (88.3–95.2) | 47.7 |
| Negative | 18 | ||||||
| Papb or HPV | |||||||
| Positive | 102 | 92.7 (86.3–96.3) | 54.2 (48.9–59.4) | 0.73 | 39.4 (33.6–45.4) | 95.9 (92.1–97.9) | 57.2 |
| Negative | 8 | ||||||
ASCUS, atypical squamous cells of undetermined significance; AUC, area under the curve; CI, confidence interval; CIN, cervical intraepithelial neoplasia; HPV, human papillomavirus; HSIL, high-grade squamous intraepithelial lesion; LSIL, low-grade squamous intraepithelial lesion; NPV, negative predictive value; Pap, Papanicolau; PPV, positive predictive value; VIA, visual inspection with acetic acid. ‘+’ denotes both test positive is positive. ‘or’ denotes either test positive is positive.
Only women with adequate results on all tests included.
Positive Pap smear defined as HSIL+.