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Citologija naspram HPV testiranja za probir na rak vrata maternice u općoj populaciji

Appendices

Appendix 1. Search strategy

MEDLINE (Pubmed):

((Uterine Cervical Neoplasms [MeSH Terms] OR Uterine Cervical Dysplasia [MeSH Terms] OR Cervical Intraepithelial Neoplasia [MeSH Terms] OR ((cervix [tw] OR cervical [tw] OR cervico* [tw]) AND (cancer* [tw] OR carcinoma OR adenocarcinoma OR neoplas* [tw] OR dysplas* [tw] OR dyskaryos* [tw] OR squamous [tw] OR CIN [tw] OR CINII* [tw] OR CIN2* [tw] OR CINIII* [tw] OR CIN3* [tw] OR SIL [tw] OR HSIL [tw] OR H‐SIL [tw] OR LSIL [tw] OR L‐SIL [tw] OR ASCUS [tw] OR AS‐CUS [tw])))
AND
(papillomaviridae [MeSH:NoExp] OR alphapapillomavirus [MeSH Terms] OR “DNA, viral” [MeSH Terms] OR Papillomavirus Infections [MeSH Terms] OR Tumor Virus Infections [MeSH Terms] OR “Cervix Uteri/virology” [MeSH Terms] OR HPV [tw] OR “human papillomavirus” [tw] OR papillomaviridae [tw] OR PCR OR “hybrid capture*” [tw] OR HC2 [tw] OR HCII [tw] OR “HC 2” [tw] OR “HC II” [tw] OR ((viral [tw] OR virolog* [tw]) AND (DNA [tw])))
AND
(Vaginal smears [MeSH Terms] OR Cytodiagnosis [MeSH Terms] OR Cell Transformation, Viral [MeSH Terms] OR Cytopathogenic Effect, Viral [MeSH Terms] OR ((pap [tw] OR papanicolaou [tw] OR vagina* [tw] OR cervical [tw] OR cervix [tw] OR cervico* [tw] OR cytolog* [tw]) AND (smear* OR test [tw] OR tests [tw] OR testing [tw] OR tested [tw] OR swab* OR scrap*))))

Embase (Ovid):

  1. exp uterine cervix tumor/

  2. exp uterine cervix dysplasia/

  3. exp uterine cervix carcinoma in situ/

  4. (cervi$ adj3 (cancer or carcinoma or adenocarcinoma or neoplasm$ or dysplas$ or dyskaryo$ or or squamous or CIN$ or HSIL or LSIL or ASCUS).mp.

  5. or/1‐4

  6. papillomaviridae/

  7. exp alphapapillomavirus/

  8. exp DNA, viral/ 

  9. exp Papillomavirus Infections/

  10. exp Tumor Virus Infections/

  11. exp uterine cervix

  12. HPV.mp.

  13. human papillomavirus.mp.

  14. papillomaviridae.mp.

  15. PCR.mp.

  16. hybrid capture$.mp.

  17. HC2.mp.

  18. HCII.mp.

  19. HC 2.mp.

  20. HC II.mp.

  21. ((viral or virology$) adj3 DNA).mp.

  22. or/6‐21

  23. exp Vaginal smears/

  24. exp Cytodiagnosis/

  25. exp Cell Transformation, Viral/

  26. exp Cytopathogenic Effect, Viral/

  27. ((pap or papanicolaou or vagina$ or cervical or cervix or cervico$ or cytology$) adj3 (smear$ or test or tests or testing or tested or swab$ or scrap$)).mp.

  28. or/ 23‐27

  29. 5 and 22 and 28

Appendix 2. Quality Assessment of Diagnostic test Accuracy Studies (QUADAS) items

  • Item 1 of the QUADAS tool (representative spectrum of participants) will be scored as 'yes' if the tests are done on a representative population of women attending cervical cancer screening within the age range 20‐70 not being followed up for cervical abnormalities. The item will be scored as 'no' if the majority of the population is outside this range and 'unclear' if there is not sufficient information. Studies with a case‐control design would score 'no' but they are excluded anyway from this review.

  • Item 2 of the QUADAS tool (selection criteria clearly described) will not be used as suggested in Chapter 9 of the Cochrane Handbook for Diagnostic Test Accuracy ReviewsReitsma 2009.

  • Item 3 of the QUADAS tool (acceptable reference standard) will be scored as 'yes' if the reference standard used is colposcopy with directed biopsies as minimum, or better yet by histological examination of the whole excised transformation zone. The item will be scored 'no' if the reference standard used is colposcopy alone without histology, and 'unclear' if there is not sufficient information.

  • Item 4 of the QUADAS tool (acceptable delay between tests) will be scored as 'yes' if the total interval between cytology, human papillomavirus (HPV) testing and verification with the reference standard was less than 12 weeks, as the status of the condition is unlikely to change within this time period. The item will be scored 'no' if the interval was equal to or more than 12 weeks, and 'unclear' if there is not sufficient information.

  • Item 5 of the QUADAS tool (partial verification avoided) will be scored as 'yes' if all women or at least a random sample of all women tested with cytology or HPV testing had disease status verification by the reference standard (colposcopy with directed biopsies) or when all women being positive for at least one screen test were verified together with a random sample of women being negative for all screen tests . The item will be scored 'no' if the selection of women who will receive verification is influenced by the results of the screening tests (i.e. if all screen‐positives are verified and not all screen‐negatives). The item will be scored as 'unclear' if there is not sufficient information.

  • Item 6 of the QUADAS tool (differential verification avoided) will be scored as 'yes' if all women who had disease status verification, had this done by the same method. The item will be scored 'no' if the method of verification differed between groups of participants, and 'unclear' if there is not sufficient information.

  • Item 7 of the QUADAS tool (incorporation avoided) will be scored as 'yes' if the reference standard used for disease status verification is not composed in any part by cervical cytology or HPV testing. A reference standard such as colposcopy would score 'yes'. If cytology is used as a reference standard the item will be scored as 'no', and 'unclear' if there is not sufficient information

  • Item 8 of the QUADAS tool (sufficient index test description) will not be used as suggested in Chapter 9 of the Cochrane Handbook for Diagnostic Test Accuracy ReviewsReitsma 2009.

  • Item 9 of the QUADAS tool (sufficient reference standard description) will not be used as suggested in Chapter 9 of the Cochrane Handbook for Diagnostic Test Accuracy ReviewsReitsma 2009.

  • Item 10 of the QUADAS tool (index test results blinded) will be scored as 'yes' if the cytologists and the technicians interpreting the Pap smear and the HPV test were not aware of the colposcopy/biopsy results. The item will be scored 'no' if they were made aware of the reference standard results prior to the interpretation of the screening tests, and 'unclear' if there is not sufficient information given in the text.

  • Item 11 of the QUADAS tool (reference standard results blinded) will be scored as 'yes' if the colposcopists and the pathologists were not aware of the cytology and HPV test results when interpreting the results of the reference standard. The item will be scored 'no' if either was aware of the screening test results (which is the case in clinical practice), and 'unclear' if there is not sufficient information in the text.

  • Item 12 of the QUADAS tool (relevant clinical information) will be scored as 'yes' if the cytologist was aware of the woman's basic history (age, symptoms, previous cervical surgery). If the cytologist was not aware the item will be scored 'no', and if this information is not given in the text it will be scored 'unclear'.

  • Item 13 of the QUADAS tool (un‐interpretable results reported) will be scored as 'yes' if the numbers of inadequate cytology and HPV test results are given. It will be scored 'no' if the numbers of inadequate tests are not given, and 'unclear' if it is not certain whether all test results have been reported.

  • Item 14 of the QUADAS tool (withdrawals explained) will be scored as 'yes' if it is clear what happened to all participants who entered the study, including the withdrawals. The item will be scored 'no' if it is not explained why no outcome could be obtained for some women, and if it is not clear whether all participants who entered the study were accounted for it will be scored 'unclear'.

Study flow diagram detailing the number of the initially retrieved articles and consequent exclusions
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Figure 1

Study flow diagram detailing the number of the initially retrieved articles and consequent exclusions

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Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies
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Figure 2

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies

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Methodological quality summary: review authors' judgements about each methodological quality item for each included study
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Figure 3

Methodological quality summary: review authors' judgements about each methodological quality item for each included study

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Summary ROC plot of 2 tests for detection of CIN 2+ (verified with histology): Conventional Cytology (ASCUS+) and HPV testing with hybrid capture 2 (1pg/mL). The black and red solid circles correspond to the summary estimates of sensitivity and specificity, and are shown with a 95% confidence region.
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Figure 4

Summary ROC plot of 2 tests for detection of CIN 2+ (verified with histology): Conventional Cytology (ASCUS+) and HPV testing with hybrid capture 2 (1pg/mL). The black and red solid circles correspond to the summary estimates of sensitivity and specificity, and are shown with a 95% confidence region.

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Summary ROC plot of 2 tests for detection of CIN 3+ (verified with histology): Conventional Cytology (CC) (ASCUS+) and HPV testing with hybrid capture (HC) 2 (1pg/mL). The black and red solid circles correspond to the summary estimates of sensitivity and specificity, and are shown with a 95% confidence region.
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Figure 5

Summary ROC plot of 2 tests for detection of CIN 3+ (verified with histology): Conventional Cytology (CC) (ASCUS+) and HPV testing with hybrid capture (HC) 2 (1pg/mL). The black and red solid circles correspond to the summary estimates of sensitivity and specificity, and are shown with a 95% confidence region.

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Summary ROC plot of 2 tests for detection of CIN 2+ (verified with histology): Conventional Cytology (CC) (LSIL+) and HPV testing with hybrid capture (HC) 2 (1pg/mL). The black and red solid circles correspond to the summary estimates of sensitivity and specificity, and are shown with a 95% confidence region.
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Figure 6

Summary ROC plot of 2 tests for detection of CIN 2+ (verified with histology): Conventional Cytology (CC) (LSIL+) and HPV testing with hybrid capture (HC) 2 (1pg/mL). The black and red solid circles correspond to the summary estimates of sensitivity and specificity, and are shown with a 95% confidence region.

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Summary ROC plot of 2 tests for detection of CIN 3+ (verified with histology): Conventional Cytology (CC) (LSIL+) and HPV testing with hybrid capture (HC) (1pg/mL). The black and red solid circles correspond to the summary estimates of sensitivity and specificity, and are shown with a 95% confidence region.
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Figure 7

Summary ROC plot of 2 tests for detection of CIN 3+ (verified with histology): Conventional Cytology (CC) (LSIL+) and HPV testing with hybrid capture (HC) (1pg/mL). The black and red solid circles correspond to the summary estimates of sensitivity and specificity, and are shown with a 95% confidence region.

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Summary ROC plot of 2 tests for detection of CIN 2+ (verified with histology): Liquid Based Cytology (LBC) (ASCUS+) and HPV testing with hybrid capture (HC) 2 (1pg/mL). The black and red solid circles correspond to the summary estimates of sensitivity and specificity, and are shown with a 95% confidence region.
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Figure 8

Summary ROC plot of 2 tests for detection of CIN 2+ (verified with histology): Liquid Based Cytology (LBC) (ASCUS+) and HPV testing with hybrid capture (HC) 2 (1pg/mL). The black and red solid circles correspond to the summary estimates of sensitivity and specificity, and are shown with a 95% confidence region.

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Summary ROC plot of 2 tests for detection of CIN 3+ (verified with histology): Liquid Based Cytology (LBC) (ASCUS+) and HPV testing with hybrid capture (HC) 2 (1pg/mL). The black and red solid circles correspond to the summary estimates of sensitivity and specificity, and are shown with a 95% confidence region.
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Figure 9

Summary ROC plot of 2 tests for detection of CIN 3+ (verified with histology): Liquid Based Cytology (LBC) (ASCUS+) and HPV testing with hybrid capture (HC) 2 (1pg/mL). The black and red solid circles correspond to the summary estimates of sensitivity and specificity, and are shown with a 95% confidence region.

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Summary ROC plot of 2 tests for detection of CIN 2+ (verified with histology): Liquid Based Cytology (LBC) (LSIL+) and HPV testing by hybrid capture (HC) 2 (1pg/mL). The black and red solid circles correspond to the summary estimates of sensitivity and specificity, and are shown with a 95% confidence region.
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Figure 10

Summary ROC plot of 2 tests for detection of CIN 2+ (verified with histology): Liquid Based Cytology (LBC) (LSIL+) and HPV testing by hybrid capture (HC) 2 (1pg/mL). The black and red solid circles correspond to the summary estimates of sensitivity and specificity, and are shown with a 95% confidence region.

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CC (ASCUS+) for CIN2+.
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Test 1

CC (ASCUS+) for CIN2+.

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CC (ASCUS+) for CIN3+.
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Test 2

CC (ASCUS+) for CIN3+.

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CC (LSIL+) for CIN2+.
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Test 3

CC (LSIL+) for CIN2+.

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CC (LSIL+) for CIN3+.
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Test 4

CC (LSIL+) for CIN3+.

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LBC (ASCUS+) for CIN2+.
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Test 5

LBC (ASCUS+) for CIN2+.

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LBC (ASCUS+) for CIN3+.
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Test 6

LBC (ASCUS+) for CIN3+.

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LBC (LSIL+) for CIN2+.
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Test 7

LBC (LSIL+) for CIN2+.

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LBC (LSIL+) for CIN3+.
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Test 8

LBC (LSIL+) for CIN3+.

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HC2 (1pg/mL) for CIN2+.
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Test 9

HC2 (1pg/mL) for CIN2+.

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HC2 (1 pg/mL) for CIN3+.
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Test 10

HC2 (1 pg/mL) for CIN3+.

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HC2 (2 pg/mL) for CIN2+.
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Test 11

HC2 (2 pg/mL) for CIN2+.

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HC2 (2 pg/mL) for CIN3+.
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Test 12

HC2 (2 pg/mL) for CIN3+.

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PCR (13 hr types or more) for CIN2+.
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Test 13

PCR (13 hr types or more) for CIN2+.

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PCR (13 hr types or more) for CIN3+.
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Test 14

PCR (13 hr types or more) for CIN3+.

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PCR (10‐11 hr types) for CIN2+.
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Test 15

PCR (10‐11 hr types) for CIN2+.

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PCR (10‐11 hr types) for CIN3+.
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Test 16

PCR (10‐11 hr types) for CIN3+.

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Aptima for CIN2+.
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Test 17

Aptima for CIN2+.

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Aptima for CIN3+.
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Test 18

Aptima for CIN3+.

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PCR (4 hr types) for CIN2+.
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Test 19

PCR (4 hr types) for CIN2+.

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Care HPV test (0.5 pg/ml) for CIN2+.
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Test 20

Care HPV test (0.5 pg/ml) for CIN2+.

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Care HPV test (0.5 pg/ml) for CIN3+.
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Test 21

Care HPV test (0.5 pg/ml) for CIN3+.

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Cobas for CIN2+.
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Test 22

Cobas for CIN2+.

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Cobas for CIN3+.
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Test 23

Cobas for CIN3+.

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NASBA (5 types) for CIN2+.
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Test 24

NASBA (5 types) for CIN2+.

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NASBA (9 types) for CIN2+.
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Test 25

NASBA (9 types) for CIN2+.

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HC2+4 (1 pg/ml) for CIN2+.
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Test 26

HC2+4 (1 pg/ml) for CIN2+.

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HC2+4 (1 pg/ml) for CIN3+.
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Test 27

HC2+4 (1 pg/ml) for CIN3+.

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HC2 (1pg/mL) for CIN2+ no verification bias.
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Test 28

HC2 (1pg/mL) for CIN2+ no verification bias.

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CC or LBC (ASCUS+) for CIN2+ no verification bias.
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Test 29

CC or LBC (ASCUS+) for CIN2+ no verification bias.

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HC2 (1pg/mL) for CIN2+ women >30.
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Test 30

HC2 (1pg/mL) for CIN2+ women >30.

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self HPV test for CIN2+.
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Test 31

self HPV test for CIN2+.

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Summary of findings HPV (HC2, 1 pg/mL) vs Pap (LBC, ASCUS)

Human papillomavirus (HPV) compared to Papanicolaou (Pap) test for detection of cervical intraepithelial neoplasia (CIN 2+) in asymptomatic women

Patient or population: adult asymptomatic women

Settings: outpatient screening programmes

New Test: HPV, HC2 test Cut‐off value: 1 pg/mL

Comparison Test: Pap, liquid‐based cytology (LBC) test Cut‐off value: atypical squamous cells of undetermined significance (ASCUS)

Reference Test: a colposcopy exam with or without biopsy as clinically indicated

HPV

138,230 women
(25 studies)

Pooled sensitivity
(95% CI)

89.9%

(88.6 to 91.1%)

Pooled specificity
(95% CI)

89.9%

(89.7 to 90.0%)

Pap

82,003 women
(15 studies)

Pooled sensitivity
(95% CI)

72.9%

(70.7 to 75%)

Pooled specificity
(95% CI)

90.3%

(90.1 to 90.5%)

Test results

Number of results per 1000 women tested
(95% CI)

Quality of the evidence
(GRADE)

Comments

Prevalence of CIN 2+, 2%1

HPV

Pap

True positives (TP)

18

(18 to 18)

15

(14 to 15)

⊕⊕⊕⊝
moderate
due to inconsistency2,3

Women will be correctly classified and will receive further confirmatory testing or treatment

TP absolute difference

3 more

False negatives (FN)

2

(2 to 2)

5

(5 to 6)

Women will be falsely reassured that they do not have CIN 2+, and the potentially beneficial treatment may be missed or will be delayed

FN absolute difference

3 fewer

True negatives (TN)

881

(879 to 882)

885

(883 to 887)

⊕⊕⊕⊕
high3

Women will be correctly reassured that they do not have CIN 2+

TN absolute difference

4 fewer

False positives (FP)

99

(98 to 101)

95

(93 to 97)

Women will likely receive unnecessary further testing and possibly also unnecessary treatment; additionally further testing and unnecessary treatment may lead to adverse effects and use of resources without any health benefits

FP absolute difference

4 more

CI: Confidence interval; HPV human papillomavirus; Pap: Papanicolaou test, CIN: cervical intraepithelial neoplasia

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Prevalence of 2% (20 women out of 1000) was assumed to be the average prevalence of cervical intraepithelial neoplasia 2+ in non HIV asymptomatic women.
2Serious inconsistency in sensitivity among studies with sensitivity ranging from 52%‐94% for Pap, and 61% to 100% for HPV.
3We did not downgrade for risk of bias, but the few limitations with studies were considered with inconsistency.

Figuras y tablas -
Summary of findings HPV (HC2, 1 pg/mL) vs Pap (LBC, ASCUS)
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Table 1. Pooled diagnostic accuracy of tests

Test

Disease threshold

studies

Pooled sensitivity (95% CI)

Pooled specificity (95% CI)

CC (ASCUS+)

CIN 2+

16

65.87% (54.94 to 75.33)

96.28% (94.72 to 97.39)

LBC (ASCUS+)

CIN 2+

15

75.51% (66.57 to 82.68)

91.85% (88.43 to 94.32)

CC (LSIL+)

CIN 2+

9

62.84% (46.79‐76.50)

97.73% (96.09‐98.70)

LBC (LSIL+)

CIN 2+

10

70.33% (59.73 to 79.11)

96.20% (94.57 to 97.36)

HC2 (1 pg/mL)

CIN 2+

25

92.60% (99.45 to 95.30)

89.30% (87.03 to 91.20)

PCR (> 12 types)

CIN 2+

6

95.13% (89.50 to 97.84)

91.89% (83.79 to 96.13)

APTIMA

CIN 2+

3

92.66% (31.77 to 99.71)

93.31% (47.30 to 99.54)

CC (ASCUS+)

CIN 3+

9

70.27% (57.87 to 80.30)

96.67% (94.56 to 98.00)

LBC (ASCUS+)

CIN 3+

13

75.97% (64.72 to 84.49)

91.19% (87.21 to 94.01)

CC (LSIL+)

CIN 3+

5

74.43% (67.81 to 80.10)

96.86% (94.87 to 98.10)

LBC (LSIL+)

CIN 3+

5

71.91% (51.68 to 86.00)

96.05% (93.53 to 97.60)

HC2 (1 pg/mL)

CIN 3+

19

96.50% (94.00 to 97.90)

89.20% (86.70 to 91.30)

PCR (> 12 types)

CIN 3+

4

93.57% (69.90 to 98.91)

86.49% (68.16 to 95.04)

APTIMA

CIN 3+

4

96.04% (72.91 to 99.54)

92.80% (86.15 to 96.39)

Tests with fewer than three studies are not included in the table.
Figuras y tablas -
Table 1. Pooled diagnostic accuracy of tests
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Table 2. Test comparisons

Comparison

Disease threshold

Relative sensitivity (95% CI)

Relative specificity (95% CI)

Studies

Analysis number

HC2 vs CC (ASCUS+)

CIN 2+

1.52 (1.24 to 1.86)

0.94 (0.92 to 0.96)

9

1

HC2 vs CC (ASCUS+)

CIN 3+

1.46 (1.12 to 1.91)

0.95 (0.93 to 0.9)

6

2

PCR (> 12 types) vs CC (ASCUS+)

CIN 2+

1.37 (0.58 to 3.21)

0.95 (0.76 to 1.19)

3

5

HC2 vs CC (LSIL+)

CIN 2+

1.28 (1.15 to 1.41)

0.91 (0.87 to 0.95)

6

7

HC2 vs CC (LSIL+)

CIN 3+

1.22 (1.12 to 1.32)

0.91 (0.87 to 0.95)

5

8

HC2 vs LBC (ASCUS+)

CIN 2+

1.18 (1.10 to 1.26)

0.96 (0.95 to 0.97)

10

11

HC2 vs LBC (ASCUS+)

CIN 3+

1.17 (1.05 to 1.30)

0.96 (0.95 to 0.98)

8

12

PCR (> 12 types) vs LBC (ASCUS+)

CIN 2+

1.53 (0.53 to 4.44)

0.90 (0.89 to 0.92)

3

15

PCR (> 12 types) vs LBC (ASCUS+)

CIN 3+

1.47 (0.64 to 3.35)

0.94 (0.8 to 1.09)

3

16

HC2 vs LBC (LSIL+)

CIN 2+

1.35 (1.19 to 1.53)

0.92 (0.89 to 0.95)

8

17

HC2 vs LBC (LSIL+)

CIN 3+

1.30 (0.86 to 1.96)

0.92 (0.8 to 1.00)

4

18

APTIMA vs LBC (ASCUS+)

CIN 3+

1.30 (0.49 to 3.41)

0.98 (0.93 to 1.04)

3

22

Comparisons with fewer than three studies are not included in the table
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Table 2. Test comparisons
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Table 3. Variation in the accuracy of HC2 by covariates

Comparison

Studies

Disease threshold

Relative sensitivity (95% CI)

Relative specificity (95% CI)

Age > 30 vs any age

17 vs 20

CIN 2+

1.13 (1.03 to 1.25)

1.01 (0.98 to 1.04)

13 vs 14

CIN 3+

1.10 (1.02 to 1.19)

1.04 (1.00 to 1.08)

Increased vs low risk of

verification bias

17 vs 20

CIN 2+

1.05 (0.95 to 1.16)

1.00 (0.97 to 1.04)

12 vs 15

CIN 3+

1.09 (1.01 to 1.18)

1.00 (0.96 to 1.05)

High‐income vs

middle‐/low‐income countries

21 vs 16

CIN 2+

1.01 (0.91 to 1.12)

1.03 (1.00 to 1.07)

13 vs 14

CIN 3+

0.94 (0.87 to 1.02)

1.01 (0.96 to 1.05)

Assessed by bivariate random‐effects meta‐analysis including one covariate each time.
Figuras y tablas -
Table 3. Variation in the accuracy of HC2 by covariates
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Table Tests. Data tables by test

Test

No. of studies

No. of participants

1 CC (ASCUS+) for CIN2+ Show forest plot

16

61099

2 CC (ASCUS+) for CIN3+ Show forest plot

9

51857

3 CC (LSIL+) for CIN2+ Show forest plot

9

41494

4 CC (LSIL+) for CIN3+ Show forest plot

5

35648

5 LBC (ASCUS+) for CIN2+ Show forest plot

15

82003

6 LBC (ASCUS+) for CIN3+ Show forest plot

13

71919

7 LBC (LSIL+) for CIN2+ Show forest plot

10

33519

8 LBC (LSIL+) for CIN3+ Show forest plot

5

21166

9 HC2 (1pg/mL) for CIN2+ Show forest plot

25

138230

10 HC2 (1 pg/mL) for CIN3+ Show forest plot

19

120380

11 HC2 (2 pg/mL) for CIN2+ Show forest plot

2

26768

12 HC2 (2 pg/mL) for CIN3+ Show forest plot

2

26768

13 PCR (13 hr types or more) for CIN2+ Show forest plot

6

16343

14 PCR (13 hr types or more) for CIN3+ Show forest plot

4

14048

15 PCR (10‐11 hr types) for CIN2+ Show forest plot

2

3965

16 PCR (10‐11 hr types) for CIN3+ Show forest plot

1

2988

17 Aptima for CIN2+ Show forest plot

3

15895

18 Aptima for CIN3+ Show forest plot

4

17944

19 PCR (4 hr types) for CIN2+ Show forest plot

1

1985

20 Care HPV test (0.5 pg/ml) for CIN2+ Show forest plot

2

7044

21 Care HPV test (0.5 pg/ml) for CIN3+ Show forest plot

2

7046

22 Cobas for CIN2+ Show forest plot

2

11666

23 Cobas for CIN3+ Show forest plot

2

11666

24 NASBA (5 types) for CIN2+ Show forest plot

1

313

25 NASBA (9 types) for CIN2+ Show forest plot

1

313

26 HC2+4 (1 pg/ml) for CIN2+ Show forest plot

1

1352

27 HC2+4 (1 pg/ml) for CIN3+ Show forest plot

1

1352

28 HC2 (1pg/mL) for CIN2+ no verification bias Show forest plot

12

53013

29 CC or LBC (ASCUS+) for CIN2+ no verification bias Show forest plot

8

31341

30 HC2 (1pg/mL) for CIN2+ women >30 Show forest plot

13

69334

31 self HPV test for CIN2+ Show forest plot

4

23474
Figuras y tablas -
Table Tests. Data tables by test
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