Table 1.
Definitions of Cervical Cancer Screening Technologies Included in This Review
| Cervical Screening Technology | Methodology |
|---|---|
| Conventional cytology or Pap smear | A sample of cervical cells is taken using a spatula and transferred to a glass slide where they are sent to a laboratory for observation using a microscope. A cytotechnologist or physician will examine the cells for cervical abnormalities.1 |
| Liquid-based cytology (LBC) | A sample of cervical cells is taken using a soft brush and transferred to a special preservation liquid. Similar to conventional cytology, the sample is sent to a laboratory for observation under a microscope, where the sample is examined for cervical abnormalities.1 |
| Human papillomavirus (HPV) DNA testing | A molecular diagnostic test designed to detect the presence of high-risk HPV DNA.2 |
| Human papillomavirus (HPV) mRNA testing | A molecular diagnostic test designed to detect the presence of HPV mRNA.2 |
| Colposcopy | A colposcope, much like a microscope, is used for closer examination of the cervix. This procedure is typically performed after an abnormal cytology test or positive HPV test. The doctor may apply a dilute vinegar solution to the cervix causing the abnormal areas to turn white. A biopsy may also be performed.2 |
| Colposcopic digital image analysis systems | Adjunctive technologies to colposcopy which use digital technology to help scan for cellular abnormalities.3 |
| Biomarkers | An immune cytochemistry test to detect virally induced oncogenic molecular changes in the cell through staining of the certain biomarkers found to be overexpressed by HPV-infected cells.4 |
| Epitheliometer | A probe technology which uses electrical impedance spectroscopy to detect cervical cancer and pre-cancerous changes of the cervix in real-time.5 |
| Computer-assisted image analysis (CAIA) | A system designed to scan already prepared cervical cytology slides for abnormalities and has the ability to queue samples to point the cytologist to potential “low-risk” and “high-risk” slides.6 |
| Visual inspection using acetic acid (VIA) | Acetic acid is applied to the cervix, where it is inspected with the naked eye for cervical abnormalities.7 |
1Mayo Clinic. Tests and Procedures: Pap Smear. http://www.mayoclinic.org/tests-procedures/pap-smear/basics/what-you-can-expect/prc-20013038.
2National Cancer Institute (NCI) Dictionary of Cancer Terms. http://www.cancer.gov/dictionary.
3 Wade R, Spackman E, Corbett M, Walker S, Light K, et al. Adjunctive colposcopy technologies for examination of the uterine cervix–DySIS, LuViva Advanced Cervical Scan and Niris Imaging System: a systematic review and economic evaluation. NIHR Health Technol Assess. 2013.
4 Kisser A, Zechmeister-Koss I. P16/Ki-67 dual stain in the triage of PAPIII/IIID cytology in cervical cancer screening. Vienna: Ludwig Boltzmann Institut fuer Health Technology Assessment (LBIHTA)., 2013; HTA-Projektbericht 72.
5 Adelaide Health Technology Assessment (AHTA). Zilico hand-held device for rapid cervical cancer detection. Australia and New Zealand Horizon Scanning Network (ANZHSN). 2010.
6 Willis BH, Barton P, Pearmain P, Bryan S, Hyde C. Cervical screening programmes: can automation help? Evidence from systematic reviews, an economic analysis and a simulation modelling exercise applied to the UK. Health Technology Assessment. 2005; 9(13).
7 University of Zimbabwe/JHPIEGO Cervical Cancer Project. Visual inspection with acetic acid for cervical-cancer screening: test qualities in a primary-care setting. Lancet. 1999; 353: 9156.