Observational studies have shown a reduction in invasive cervical cancer incidence and mortality thanks to screening programs that use cervical cytological testing. Moreover, randomized controlled trials have shown that cytological testing plus hrHPV testing (co-testing) further reduces invasive cervical cancer incidence.
The current guidelines recommend three main screening options: cytological testing, standalone hrHPV testing, and co-testing. This systematic review and meta-analysis, published in Scientific Reports, analyzes the comparative accuracy of all cervical cancer screening strategies in healthy asymptomatic women.
MEDLINE and EMBASE searches up to October 2020 identified 27 prospective studies and a total of 185,269 subjects for study inclusion. Multiple data analysis methods were used, including a duplicate assessment of eligibility, double extraction of quantitative data, validity assessment, random-effects network meta-analysis of test accuracy, and GRADE rating.
Ultimately, it was found that the combination of cytology and hrHPV testing with the either-positive criterion was the most sensitive/least specific screening method, while the same combination with the both-positive criterion was the most specific/least sensitive screening method. The sensitivity and specificity of standalone screening methods and primary screening algorithms fell somewhere in the middle.
In closing, this analysis suggests that combining cervical cancer screening methods might help overcome the weaknesses of standalone cytological or hrHPV screening and reduce false-negative and false-positive results. However, more research is needed to confirm these findings and assess them at the program level [1].
Source:
[1] Terasawa, T., Hosono, S., Sasaki, S., Hoshi, K., Hamashima, Y., Katayama, T., & Hamashima, C. (2022). Comparative accuracy of cervical cancer screening strategies in healthy asymptomatic women: a systematic review and network meta-analysis. Scientific Reports, 12(1). https://doi.org/10.1038/s41598-021-04201-y
