Table 1.
Accuracy and diagnostic efficiency of screening strategies to detect cervical intraepithelial neoplasia grade 3 or worse.
| No. | Strategy | Sensitivity (95% CI) | n1/N1 | Specificity (95% CI) | n2/N2 | PPV | NPV | Referral rate | Referrals needed to detect one CIN3+ | Number of tests/1000 women screened | ||
| Cytology-based screening | ||||||||||||
| 1 | Cytology (≥HSIL) | 59.3% | (46.8–71.9) | 35/59 | 91.6% | (88.0–95.2) | 207/226 | 64.8% | 89.6% | 18.9% | 1.5 | 1000 |
| 2 | Cytology (≥HSIL) with FAM19A4/miR124-2 triage of ASC-US/LSIL | 67.8% | (55.9–79.7) | 40/59 | 85.0% | (80.3–89.6) | 192/226 | 54.1% | 91.0% | 26.0% | 1.9 | 1095 |
| 3 | FAM19A4/miR124-2 with cytology (≥ASC-US) triage | 62.7% | (50.4–75.1) | 37/59 | 87.2% | (82.2–91.5) | 197/226 | 56.1% | 90.0% | 23.2% | 1.8 | 1674 |
| HPV-based screening | ||||||||||||
| 4 | HPV | 83.1% | (73.5–92.6) | 49/59 | 66.4% | (60.2–72.5) | 150/226 | 39.2% | 93.8% | 43.9% | 2.6 | 1000 |
| 5 | HPV with FAM19A4/miR124-2 triage | 72.9% | (61.5–84.2) | 43/59 | 76.1% | (70.5–81.7) | 172/226 | 44.3% | 91.5% | 34.0% | 2.3 | 1440 |
| 6 | HPV16/18 with FAM19A4/miR124-2 triage of non16/18HPV+ | 79.7% | (69.4–89.9) | 47/59 | 74.8% | (69.1–80.4) | 169/226 | 45.2% | 93.4% | 36.5% | 2.2 | 1315 |
Cytology with threshold high-grade squamous intraepithelial lesion or worse (≥HSIL, includes atypical squamous cells – cannot exclude HSIL); cytology with threshold atypical squamous cells of unknown significance or worse (≥ASC-US). 95% CI, 95% confidence interval; ASC-US, atypical squamous cells of unknown significance; CIN3+, cervical intraepithelial neoplasia grade 3 or worse; HPV, human papillomavirus; HSIL, high-grade squamous intraepithelial lesion; LSIL, low-grade squamous intraepithelial lesion; n1, number of screen-positive disease cases; N1, total number of disease cases; n2, number of screen-negative nondisease cases; N2, total number of nondisease cases; NPV, negative predictive value; PPV, positive predictive value.