TABLE 5.
Strategies for triage to colposcopy, adjusted for verification bias, for women who tested HPV positive and sensitivity and PPV for CIN2+ histology
| Testing and referral | No. referred to colposcopy | No. of cases found immediatelya | Referral/case ratio | Immediate sensitivity for CIN2+ (% [95% CI]) | PPV of referral for CIN2+ (% [95% CI]) |
|---|---|---|---|---|---|
| Cytology only | 194 | 44 | 4.4 | 39.5 (29.4–49.5) | 22.7 (16.3–29.1) |
| Triage of HC2-test-positive cases | |||||
| Refer all to colposcopy | 580 | 104.0 | 5.6 | 93.2 (87.1–99.2) | 17.9 (14.5–21.4) |
| Refer if AHPV test positive | 409 | 94.1 | 4.3 | 84.2 (75.9–92.6) | 23.0 (18.5–27.5) |
| Refer if HPV16/18 positive | 146 | 54.4 | 2.6 | 48.7 (38.3–59.1) | 37.3 (28.6–46.0) |
| Refer if cytology positive | 129 | 43.0 | 3.0 | 38.5 (28.4–48.5) | 33.3 (24.5–42.1) |
| Refer if HPV16/18 positive and/or cytology positive | 227 | 71.2 | 3.2 | 63.8 (53.6–74.0) | 31.4 (24.8–38.1) |
| Triage of AHPV-test-positive cases | |||||
| Refer all to colposcopy | 464 | 98.1 | 4.7 | 87.8 (80.2–95.5) | 21.1 (17.0–25.2) |
| Refer if HC2 test positive | 409 | 94.1 | 4.3 | 84.2 (75.9–92.6) | 23.0 (18.5–27.5) |
| Refer if HPV16/18 positive | 139 | 51.2 | 2.7 | 45.8 (35.5–56.2) | 36.9 (28.0–45.7) |
| Refer if cytology positive | 111 | 39.9 | 2.8 | 35.7 (25.9–45.5) | 35.9 (26.3–45.6) |
| Refer if HPV16/18 positive and/or cytology positive | 206 | 67.0 | 3.1 | 60.0 (49.6–70.3) | 32.6 (25.6–39.6) |
a
Verification bias-adjusted results for an estimated total of 111.7 CIN2+ cases.