Table 3. Effect of full implementation of SurePath/FocalPoint or ThinPrep LBC and computer-assisted reading (last phase)a.
| No change (Roskilde)b | SurePath (Hvidovre [CPH M])c | ThinPrep (Odense)d | |
|---|---|---|---|
| Before | Baseline: Conventional cytology, manual reading, cytology triage of ASCUS | Baseline: conventional cytology, manual reading, cytology triage of ASCUS | Baseline: Conventional cytology, manual reading, cytology triage of ASCUS |
| After | As above | SurePath LBC, FocalPoint Slide Profiler 25% cutoff+FocalPoint Imaging System, HC2 triage of ASCUS | ThinPrep LBC, ThinPrep Imaging System, cytology triage of ASCUS |
| 23–59 years | 47 300/53 979 | 23 849/62 644 | 33 614/74 522 |
| ⩾ASCUS | 1012/1173, 0.98 (0.91–1.07) | 1742/2299, 1.99 (1.87–2.11) | 1087/3423, 0.70 (0.66–0.75) |
| CIN2 | 85/118, 0.82 (0.62–1.09) | 162/230, 1.85 (1.51–2.26) | 106/183, 1.28 (1.01–1.63) |
| ⩾CIN3 | 271/281, 1.10 (0.93–1.30) | 394/624, 1.66 (1.46–1.88) | 249/557, 0.99 (0.85–1.15) |
| CIN treatments | 405/482, 0.96 (0.84–1.09) | 603/857, 1.85 (1.67–2.05) | 389/826, 1.04 (0.93–1.18) |
| <CIN2 | 323/471, 0.78 (0.68–0.90) | 581/722, 2.11 (1.90–2.36) | 433/1507; 0.64 (0.57–0.71) |
| False positive for ⩾CIN2 | 656/774, 0.97 (0.87–1.07) | 1186/1445, 2.16 (2.00–2.32) | 732/2683, 0.60 (0.56–0.66) |
| False positive for ⩾CIN3 | 741/892, 0.95 (0.86–1.04) | 1348/1675, 2.11 (1.97–2.27) | 838/2866, 0.65 (0.60–0.70) |
| PPV for ⩾CIN2 | 35%/34%, 1.03 (0.92–1.16) | 32%/37%, 0.86 (0.79–0.94) | 33%/22%, 1.51 (1.36–1.68) |
| PPV for ⩾CIN3 | 27%/24%, 1.12 (0.97–1.29) | 23%/27%, 0.83 (0.75–0.93) | 23%/16%, 1.41 (1.23–1.61) |
| 23–29 years | 5572/7350 | 8228/21 536 | 5310/14 299 |
| ⩾ASCUS | 215/273, 1.04 (0.87–1.24) | 815/1020, 2.09 (1.91–2.28) | 435/1066, 1.10 (0.99–1.22) |
| CIN2 | 22/38, 0.76 (0.45–1.29) | 94/136, 1.81 (1.39–2.35) | 61/93, 1.77 (1.28–2.44) |
| ⩾CIN3 | 71/73, 1.28 (0.93–1.78) | 204/288, 1.85 (1.55–2.21) | 103/250, 1.11 (0.88–1.39) |
| CIN treatments | 103/133, 1.02 (0.79–1.32) | 326/411, 2.08 (1.80–2.40) | 167/373, 1.21 (1.01–1.44) |
| <CIN2 | 49/91, 0.71 (0.50–1.00) | 258/258, 2.62 (2.21–3.10) | 142/372, 1.03 (0.85–1.24) |
| False positive for ⩾CIN2 | 122/162, 0.99 (0.79–1.25) | 517/596, 2.27 (2.02–2.55) | 271/723, 1.01 (0.88–1.16) |
| False positive for ⩾CIN3 | 144/200, 0.95 (0.77–1.17) | 611/732, 2.18 (1.97–2.43) | 332/816, 1.10 (0.97–1.24) |
| PPV for ⩾CIN2 | 43%/41%, 1.06 (0.86–1.31) | 37%/42%, 0.88 (0.78–0.99) | 38%/32%, 1.17 (1.01–1.36) |
| PPV for ⩾CIN3 | 33%/27%, 1.23 (0.94–1.62) | 25%/28%, 0.89 (0.76–1.03) | 24%/23%, 1.01 (0.83–1.23) |
| 30–44 years | 21 827/23 376 | 10 081/24 753 | 14 370/32 819 |
| ⩾ASCUS | 544/548, 1.06 (0.95–1.20) | 664/864, 1.89 (1.71–2.08) | 472/1435, 0.75 (0.68–0.83) |
| CIN2 | 49/66, 0.80 (0.55–1.15) | 62/84, 1.81 (1.31–2.51) | 33/73, 1.03 (0.68–1.56) |
| ⩾CIN3 | 161/165, 1.05 (0.84–1.30) | 176/273, 1.58 (1.31–1.91) | 132/259, 1.16 (0.94–1.43) |
| CIN treatments | 244/275, 0.95 (0.80–1.13) | 252/360, 1.72 (1.47–2.02) | 188/367, 1.17 (0.98–1.39) |
| <CIN2 | 168/190, 0.95 (0.77–1.16) | 238/258, 2.27 (1.90–2.70) | 181/579, 0.71 (0.60–0.84) |
| False positive for ⩾CIN2 | 334/317, 1.13 (0.97–1.31) | 426/507, 2.06 (1.82–2.34) | 307/1103, 0.64 (0.56–0.72) |
| False positive for ⩾CIN3 | 383/383, 1.07 (0.93–1.23) | 488/591, 2.03 (1.80–2.28) | 340/1176, 0.66 (0.59–0.74) |
| PPV for ⩾CIN2 | 39%/42%, 0.92 (0.79–1.06) | 36%/41%, 0.87 (0.76–0.99) | 35%/23%, 1.51 (1.29–1.76) |
| PPV for ⩾CIN3 | 30%/30%, 0.98 (0.82–1.18) | 27%/32%, 0.84 (0.71–0.98) | 28%/18%, 1.55 (1.29–1.86) |
| 45–59 years | 19 901/23 253 | 5540/16 355 | 13 934/27 404 |
| ⩾ASCUS | 253/352, 0.84 (0.72–0.99) | 263/415, 1.87 (1.61–2.18) | 180/922, 0.38 (0.33–0.45) |
| CIN2 | 14/14, 1.17 (0.56–2.45) | 6/10, 1.77 (0.64–4.87) | 12/17, 1.39 (0.66–2.91) |
| ⩾CIN3 | 39/43, 1.06 (0.69–1.63) | 14/63, 0.66 (0.37–1.17) | 14/48, 0.57 (0.32–1.04) |
| CIN treatments | 58/74, 0.92 (0.65–1.29) | 25/86, 0.86 (0.55–1.34) | 34/86, 0.78 (0.52–1.16) |
| <CIN2 | 106/190, 0.65 (0.51–0.83) | 85/206, 1.22 (0.95–1.57) | 110/556, 0.39 (0.32–0.48) |
| False positive for ⩾CIN2 | 200/295, 0.79 (0.66–0.95) | 243/342, 2.10 (1.78–2.47) | 154/857, 0.35 (0.30–0.42) |
| False positive for ⩾CIN3 | 214/309, 0.81 (0.68–0.96) | 249/352, 2.09 (1.78–2.45) | 166/874, 0.37 (0.32–0.44) |
| PPV for ⩾CIN2 | 21%/16%, 1.29 (0.92–1.81) | 8%/18%, 0.43 (0.27–0.69) | 14%/7%, 2.05 (1.34–3.14) |
| PPV for ⩾CIN3 | 15%/12%, 1.26 (0.84–1.89) | 5%/15%, 0.35 (0.20–0.61) | 8%/5%, 1.49 (0.84–2.65) |
Abbreviations: ASCUS=atypical squamous cells of undetermined significance; CI=confidence interval; CIN=cervical intraepithelial neoplasia; CPH M=Copenhagen Municipality; HC2=Hybrid Capture 2; Nafter=last phase; Nbefore=phase 1; PPV=positive predictive value; RP=relative proportion; triage=in case of ASCUS at age ⩾30 years.
Bold signifies significant change comparing the last phase (‘after') with phase 1 (‘before').
a
Compared with manually read conventional cytology (baseline).
b
Nafter/Nbefore, RR (95% CI).
c
Nafter/Nbefore, RR (95% CI).
d
Nafter/Nbefore, RR (95% CI).