Table 3:
Operating Test Characteristics for Anal Cancer Screening Test Strategies for Predicting Anal Histological HSIL (hHSIL) in 29 WLHIV
| Anal Testing screening Strategies | Positive Test (HRA Referral) | Number referred per hHSIL identified* | Youden’s J1 | SENS (95% CI) | SPEC (95% CI) | PPV (95% CI) | 1-NPV2 (95% CI) |
|---|---|---|---|---|---|---|---|
| Single test | |||||||
| Cytology (ASC-US+) | 135 (59%) | 2.3 | 0·33 | 83% (71%, 92%) | 50% (42%, 57%) | 37% (29%, 46%) | 11% (5%, 19%) |
| Cytology (LSIL+) | 66 (29%) | 1.1 | 0·40 | 58% (45%, 71%) | 82% (75%, 87%) | 53% (40%, 65%) | 15% (10%, 22%) |
| Cytology (ASC-H/HSIL) | 21 (9%) | 0.3 | 0·24 | 27% (16%, 40%) | 97% (93%, 99%) | 76% (53%, 92%) | 21% (16%, 27%) |
| APTIMA (positive any type) | 102 (45%) | 1.7 | 0·44 | 77% (64%, 87%) | 67% (59%, 74%) | 45% (35%, 55%) | 11% (6%, 18%) |
| APTIMA 16/18/45+ | 47 (21%) | 0.8 | 0·37 | 48% (35%, 62%) | 89% (84%, 94%) | 62% (46%, 75%) | 17% (12%, 23%) |
| HC2 | 111 (48%) | 1.8 | 0·36 | 75% (62%, 85%) | 61% (53%, 68%) | 41% (31%, 50%) | 13% (7%, 20%) |
| Triage (Both screening tests positive) | |||||||
| ASC-US+ Cytology and APTIMA | 82 (36%) | 1.4 | 0·46 | 70% (57%, 81%) | 76% (69%, 83%) | 51% (40%, 62%) | 12% (7%, 19%) |
| ASC-US+ Cytology and HC2 | 84 (37%) | 1.4 | 0·38 | 65% (52%, 77%) | 73% (66%, 80%) | 46% (35%, 58%) | 14% (9%, 21%) |
| (ASC-US and APTIMA+) OR LSIL+ | 100 (44%) | 1.7 | 0·42 | 75% (62%, 85%) | 67% (60%, 74%) | 45% (35%, 55%) | 12% (7%, 18%) |
| (ASC-US/LSIL and APTIMA+) OR ASC-H+ | 85 (37%) | 1.4 | 0·45 | 70% (57%, 81%) | 75% (67%, 81%) | 49% (38%, 60%) | 13% (8%, 19%) |
| ASC-US+ and APIMA 16/18/45+ | 38 (17%) | 0.7 | 0·36 | 43% (31%, 57%) | 93% (88%, 96%) | 68% (51%, 83%) | 18% (13%, 24%) |
| APTIMA and HC2 | 91 (40%) | 1.5 | 0·41 | 70% (57%, 81%) | 71% (64%, 78%) | 46% (36%, 57%) | 13% (8%, 20%) |
| Co-testing (One or more positive screening tests) | |||||||
| ASC-US+ Cytology or APTIMA | 155 (68%) | 2.6 | 0·30 | 90% (79%, 96%) | 40% (33%, 48%) | 35% (27%, 43%) | 8% (3%, 17%) |
| ASC-US+ Cytology or HC2 | 162 (71%) | 2.7 | 0·30 | 93% (84%, 98%) | 37% (30%, 45%) | 35% (27%, 42%) | 6% (2%, 15%) |
| HC2 or APTIMA | 122 (53%) | 2.0 | 0·39 | 82% (70%, 90%) | 57% (49%, 64%) | 40% (31%, 49%) | 10% (5%, 18%) |
SENS=Sensitivity, SPEC=Specificity, PPV=Positive Predictive Value, NPV=Negative Predictive Value;
1
SENS+SPEC-1;
2
1-NPV, or false omission rate