Table 4.
Screening Performance of 4 Strategies for the Entire Cohort and 3 Subgroups
| Population | Strategy | Sensitivity (95% CI) | Specificity (95% CI) | PPV (95% CI) | NPV (95% CI) | RR (95% CI) |
|---|---|---|---|---|---|---|
| Entire cohort (n = 1837) | Cytology | 0.85 (.82–.87) | 0.33 (.31–.36) | 0.47 (.44–.50) | 0.76 (.72–.80) | 10.3 (4.4–24.3) |
| hrHPV DNA testing | 0.96 (.95–.98) | 0.27 (.25–.30) | 0.48 (.46–.51) | 0.91 (.88–.94) | 10.4 (4.4–24.7) | |
| Algorithm A | 0.89 (.87–.92) | 0.27 (.24–.30) | 0.46 (.44–.49) | 0.79 (.75–.83) | 10.1 (4.3–23.8) | |
| Algorithm B | 0.97 (.96–.98) | 0.24 (.21–.26) | 0.47 (.45–.50) | 0.93 (.89–.96) | 10.3 (4.4–24.2) | |
| HIV-infected MSM (n = 1504) | Cytology | 0.85 (.82–.88) | 0.33 (.30–.36) | 0.49 (.46–.52) | 0.75 (.70–.79) | 10.7 (4.5–25.1) |
| hrHPV DNA testing | 0.96 (.96–.98) | 0.27 (.24–.30) | 0.50 (.47–.53) | 0.91 (.86–.94) | 10.8 (4.6–25.6) | |
| Algorithm A | 0.89 (.87–.92) | 0.27 (.24–.30) | 0.48 (.45–.51) | 0.77 (.72–.81) | 10.4 (4.4–24.6) | |
| Algorithm B | 0.97 (.96–.98) | 0.24 (.21–.27) | 0.49 (.46–.52) | 0.92 (.87–.95) | 10.7 (4.5–25.2) | |
| HIV-uninfected MSM (n = 155) | Cytology | 0.76 (.63–.87) | 0.36 (.27–.46) | 0.40 (.30–.50) | 0.74 (.59–.85) | 8.6 (3.6–21.0) |
| hrHPV DNA testing | 0.96 (.88–.99) | 0.23 (.15–.33) | 0.41 (.32–.50) | 0.92 (.74–.99) | 8.9 (3.7–21.4) | |
| Algorithm A | 0.89 (.78–.96) | 0.27 (.19–.37) | 0.40 (.31–.49) | 0.81 (.65–.93) | 8.8 (3.6–21.2) | |
| Algorithm B | 1.00 (.94–1.00) | 0.16 (.09–.25) | 0.40 (.31–.48) | 1.00 (.79–1.00) | 8.6 (3.6–20.8) | |
| HIV-infected women (n = 178) | Cytology | 0.89 (.78–.96) | 0.36 (.27–.45) | 0.38 (.30–.47) | 0.88 (.76–.96) | 8.3 (3.4–20.2) |
| hrHPV DNA testing | 0.96 (.87–1.00) | 0.33 (.24–.42) | 0.39 (.31–.48) | 0.95 (.83–.99) | 8.5 (3.5–20.5) | |
| Algorithm A | 0.98 (.90–1.00) | 0.28 (.21–.37) | 0.38 (.30–.47) | 0.97 (.86–.99) | 8.3 (3.4–20.0) | |
| Algorithm B | 0.96 (.88–1.00) | 0.29 (.21–.38) | 0.38 (.30–.46) | 0.95 (.82–.99) | 8.3 (3.4–20.0) |
HRA referral threshold: (1) cytology: ASCUS, (2) hrHPV testing: any hrHPV positive, (3) algorithm A: benign cytology/HPV16/18 positive or ASCUS/hrHPV positive, and (4) algorithm B: benign or ASCUS cytology/hrHPV positive.
Abbreviations: CI, confidence interval; HIV, human immunodeficiency virus; HRA, high-resolution anoscopy; hrHPV, high-risk human papillomavirus; MSM, men who have sex with men; NPV, negative predictive value; PPV, positive predictive value; RR, relative risk.