>> P-471: Comparison of liquid-based cytology and HPV DNA testing: a pooled-analysis of 18 population-based studies from China
19:00 PM - 19:00 PM
Fang-Hui Zhao1, Margaret Lin1,2,3, Qin-Jing Pan4, Shang-Ying Hu1, Rong Zhang1, Xun Zhang5, You-Lin Qiao1.
1Department of Cancer Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China; 2Fogarty International Clinical Scholars Program, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA; 3Washington University in St. Louis, School of Medicine, St. Louis, MO, USA; 4Department of Cytology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China; 5Department of Pathology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Background: Cytology screening programs have been effective in reducing incidence of cervical cancer in the developed world. However, the sensitivity of cytology has ranged greatly, especially in developing countries. Human papillomavirus DNA testing has been proposed as primary screening method both alone and in combination with cytology. In this study, we aimed to compare the accuracy of liquid-based cytology and HPV DNA testing in China.
Methods: We pooled data from 18 population-based studies conducted from 1999-2008 in various parts of China. All women received liquid-based cytology (LBC), human papillomavirus DNA testing (HC2), and visual inspection by trained physicians. Women received colposcopy and directed biopsy if positive for any of these tests. In some studies, women received random biopsy.
Results:
Of the 31,090 women aged 17-59 years, (mean: 39.8±7.0 years) screened with cytology, we found 5029 (16.2%) ASCUS+ cases and 2108 (6.8%) LSIL+ cases. There were 949 (3.1%) CIN2+ cases and 52 (0.2%) ICC cases confirmed by biopsy results. Overall sensitivity with 95% CI for LBC was 80.6% (77.8-83.0%) for CIN2+ and 87.5% (84.3-90.2%) for CIN3+. Specificity was 95.7% (95.4-95.9%) and 94.6% (94.4-94.9%), respectively for CIN2+ and CIN3+. In comparison with HC2 at 1pg/mL, the relative sensitivity of LBC was 0.84 (0.81-0.87) and 0.90 (0.87- 0.93) for CIN2+ and CIN3+ and the relative specificity of LBC was 1.11 (1.11-1.12) and 1.12 (1.11-1.12) for CIN2+ and CIN3+. The relative sensitivity and specificity of HC2 and LBC together compared with HC2 alone was 1.02 (1.01-1.04) and 0.99 (0.98-1.00), respectively at the CIN2+ cutoff with similar results at the CIN3+ cutoff.
Conclusion: LBC has a lower sensitivity and higher specificity compared to HPV DNA testing. Adding LBC to HPV DNA testing does not greatly change the sensitivity or specificity of the HPV DNA test for CIN2+ or CIN3+ lesions.
