Table 2.
Test performance among women screened at age 24-59 years in the English HPV screening pilot’s first round; detection of CIN3+ and cervical cancer after a positive screening test by screening round, screening test, and age group. Includes first rounds in the pilot in 2013-16, and second rounds in the pilot by end of 2019 for women with negative screening test outcomes in the first round (information on cervical cancer available until the end of 2018)
| After a positive screen | Age 24-49 years | Age 50-59 years | |||||
|---|---|---|---|---|---|---|---|
| HPV testing (No per 1000 screened) | Cytology (No per 1000 screened) | HPV testing v cytology (ORadj (95% CI)) * | HPV testing (No per 1000 screened) | Cytology (No per 1000 screened) | HPV testing v cytology (ORadj (95% CI)) * | ||
| First screening round | |||||||
| No of women screened | 300 677 | 706 820 | — | 79 040 | 175 973 | — | |
| No of CIN3+ lesions detected | 5313 (17.67) | 8232 (11.65) | 1.55 (1.50 to 1.61) | 219 (2.77) | 332 (1.89) | 1.56 (1.31 to 1.85) | |
| No of cervical cancers detected | 259 (0.86) | 441 (0.62) | 1.38 (1.18 to 1.61) | 31 (0.39) | 52 (0.30) | 1.41 (0.90 to 2.21) | |
| Second screening round † | |||||||
| No of women screened | 188 318 | 260 266 | — | 24 550 | 22 195 | — | |
| No of CIN3+ lesions detected | 227 (1.21) | 1177 (4.52) | 0.26 (0.23 to 0.30) | 14 (0.57) | 20 (0.90) | 0.63 (0.32 to 1.25) ‡ | |
| No of cervical cancers detected | 1 (0.01) | 54 (0.21) | 0.02 (0.00 to 0.17) | 1 (0.04) | 2 (0.09) | 0.45 (0.04 to 4.98) ‡ | |
CI=confidence interval; CIN=cervical intraepithelial neoplasia; HPV=human papillomavirus; ORadj=adjusted odds ratio.
Odds ratios (for the detection of CIN3+ or screen detected cancer after a positive screen) were adjusted for age in years, decile of the Index of Multiple Deprivation, and laboratory site. Unadjusted estimates were similar as adjusted estimates and are reported in supplementary table S4.
Women were selected into the analysis of the pilot’s second round if they had a negative screening test in the first round and were screened with the same test, cytology or HPV, in both rounds. Because of the national mitigation strategy from 2018 onward, more women initially screened with cytology in the pilot’s first round were assigned to HPV testing in the second round than the was the case the other way around.
Unadjusted estimates owing to a small number of cases.