Table 2.
Relative effectiveness of HPV testing and cytology
| Cytology | HPV testing | ||||||
|---|---|---|---|---|---|---|---|
| Overall HPV testing | aOR (95%CI) | HPV testing with cytology triage | aOR (95%CI) | HPV testing with genotyping triage | aOR (95%CI) | ||
| Screen positivity, n (%) | 13 224 (4.0) | 84 591 (10.1) | 2.65 (2.59–2.70) | 24 251 (10.0) | 2.57 (2.52–2.63) | 60 340 (10.2) | 2.67 (2.62–2.72) |
| Per protocol colposcopy referral, n (%)a | 13 224 (4.0) | 29 032 (3.5) | 0.85 (0.83–0.87) | 5 256 (2.2) | 0.51 (0.49–0.52) | 23 776 (4.0) | 0.98 (0.96–1.00) |
| Overall colposcopy referral, n (%) | 12 312 (4.4) | 33 067 (4.5) | 1.03 (1.00–1.05) | 7 395 (3.3) | 0.76 (0.74–0.78) | 25 672 (5.0) | 1.13 (1.10–1.15) |
| Per protocol detection rate of CIN or cancer, n (per 1000) | |||||||
| CIN2+ | 1222 (4.4) | 3860 (5.5) | 1.18 (1.11–1.25) | 962 (4.4) | 0.92 (0.85–1.00) | 2898 (5.9) | 1.28 (1.20–1.36) |
| CIN2 or 3 | 1125 (4.0) | 3523 (5.0) | 1.17 (1.09–1.24) | 859 (4.0) | 0.89 (0.82–0.97) | 2664 (5.4) | 1.28 (1.20–1.36) |
| Invasive cervical cancer | 97 (0.3) | 337 (0.5) | 1.33 (1.08–1.64) | 103 (0.5) | 1.31 (1.00–1.70) | 234 (0.5) | 1.34 (1.07–1.66) |
| Overall detection rate of CIN or cancer, n (per 1000) b | |||||||
| CIN2+ | 1302 (4.6) | 4099 (5.7) | 1.17 (1.10–1.24) | 1076 (4.9) | 0.96 (0.88–1.03) | 3023 (6.1) | 1.26 (1.18–1.33) |
| CIN2 or 3 | 1171 (4.2) | 3698 (5.2) | 1.17 (1.09–1.24) | 945 (4.3) | 0.93 (0.85–1.01) | 2753 (5.6) | 1.27 (1.19–1.35) |
| Invasive cervical cancer | 131 (0.5) | 401 (0.6) | 1.18 (0.98–1.43) | 131 (0.6) | 1.23 (0.97–1.56) | 270 (0.5) | 1.16 (0.95–1.41) |
| Positive predictive value, n (%) c | |||||||
| CIN2+ | 1222 (10.9) | 4030 (13.8) | 1.29 (1.21–1.37) | 1045 (16.8) | 1.60 (1.47–1.75) | 2985 (13.0) | 1.22 (1.14–1.30) |
| CIN2 or 3 | 1125 (10.0) | 3668 (12.6) | 1.27 (1.19–1.36) | 926 (14.9) | 1.52 (1.39–1.66) | 2742 (12.0) | 1.21 (1.13–1.30) |
| Invasive cervical cancer | 97 (0.9) | 362 (1.2) | 1.42 (1.16–1.75) | 119 (1.9) | 2.20 (1.70–2.85) | 243 (1.1) | 1.24 (0.99–1.54) |
Note: HPV human papillomavirus, aOR adjusted odds ratio, CI confidential interval, CIN cervical intraepithelial neoplasia, ICC invasive cervical cancer, CI confidential interval. a Per protocol colposcopy referral was defined as the women who were screened positive and referred to colposcopy according to the protocol. b Overall detection rates included cases detected in per protocol colposcopy and others detected in opportunistic colposcopy. c Positive predictive value represented the detected cases from screened positivity. aOR was calculated by using multivariate logistic regression adjusted for age, ever screening, and income classification