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Cardenas-Turanzas M , Nogueras-Gonzalez GM , Scheurer ME , Adler-Storthz K , Benedet JL , Beck JR , Follen M , Cantor SB
The performance of human papillomavirus high-risk DNA testing in the screening and diagnostic settings
Cancer Epidemiology Biomarkers & Prevention. 2008 Oct;17(10) :2865-2871
PMID: ISI:000260051000045   
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Abstract
Objective: We sought to evaluate the performance of the human papillomavirus high-risk DNA test in patients 30 years and older. Materials and Methods: Screening (n = 835) and diagnosis (n = 518) groups were defined based on prior Papanicolaou smear results as part of a clinical trial for cervical cancer detection. We compared the Hybrid Capture 11 (HCII) test result with the worst histologic report. We used cervical intraepithelial neoplasia (CIN) 2/3 or worse as the reference of disease. We calculated sensitivities, specificities, positive and negative likelihood ratios (LR+ and LR-), receiver operating characteristic (ROC) curves, and areas under the ROC curves for the HCII test. We also considered alternative strategies, including Papanicolaou smear, a combination of Papanicolaou smear and the HCII test, a sequence of Paparticolaou smear followed by the HCII test, and a sequence of the HCII test followed by Papanicolaou smear. Results: For the screening group, the sensitivity was 0.69 and the specificity was 0.93; the area under the ROC curve was 0.81. The LR+ and LR- were 10.24 and 0.34, respectively. For the diagnosis group, the sensitivity was 0.88 and the specificity was 0.78; the area under the ROC curve was 0.83. The LR+ and LR- were 4.06 and 0.14, respectively. Sequential testing showed little or no improvement over the combination testing. Conclusions: The HCII test in the screening group had a greater LR+ for the detection of CIN 2/3 or worse. HCII testing may be an additional screening tool for cervical cancer in women 30 years and older.
Notes
Cardenas-Turanzas, Marylou Nogueras-Gonzalez, Graciela M. Scheurer, Michael E. 11 AMER ASSOC CANCER RESEARCH; 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA 360IK