Format

Send to

Choose Destination
Eur J Obstet Gynecol Reprod Biol. 2019 Mar;234:112-116. doi: 10.1016/j.ejogrb.2019.01.008. Epub 2019 Jan 17.

Screening capacity and cost-effectiveness of the human papillomavirus test versus cervicography as an adjunctive test to Pap cytology to detect high-grade cervical dysplasia.

Author information

1
Department of Obstetrics & Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
2
Department of Obstetrics & Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, Republic of Korea. Electronic address: sjseongcheil@naver.com.
3
Department of Obstetrics & Gynecology, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
4
Department of Obstetrics & Gynecology, School of Medicine, Wonkwang University, Iksan, Republic of Korea.
5
Department of Obstetrics & Gynecology, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
6
Department of Obstetrics & Gynecology, Pusan National University School of Medicine, Busan, Republic of Korea.
7
Department of Obstetrics & Gynecology, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
8
Department of Obstetrics & Gynecology, Dongguk University Gyeongju Hospital, Graduate School of Medicine of Dongguk University, Gyeongju, Republic of Korea.
9
Department of Obstetrics and Gynecology, Konkuk University School of Medicine, Seoul, Republic of Korea.

Abstract

OBJECTIVE:

This study compared the screening capacities and cost-effectiveness of the human papillomavirus (HPV) test versus cervicography as an adjunctive test to Papanicolaou (Pap) cytology to detect high-grade cervical neoplasia in Korea, a country with a high prevalence of cervical cancer.

STUDY DESIGN:

Of 33,531 Korean women who underwent cervicography as a screening test for cervical cancer between January 2015 and December 2016, we retrospectively analyzed the records of 4117 women who simultaneously or subsequently underwent Pap cytology, an HPV test, cervicography, and colposcopically directed biopsy. At a threshold of cervical intraepithelial neoplasia grade 2 or worse (CIN2+), based on colposcopic biopsy, we compared the diagnostic capacities and cost-effectiveness of these screening tools.

RESULTS:

The CIN2+ prevalence was 10.8% (446 of 4117 women) and the positive rate of high-risk HPV was 61.0% (2511 of 4117 women). Cervicography as an adjunctive to Pap cytology was a more sensitive test (97.5% vs 93.7%) with a higher odds ratio (15.65 vs 5.86) than the HPV test for detection of CIN2+ (P-value = 0.003). Moreover, the cost of cervicography co-testing was 23% less than that of HPV co-testing, decreasing the cost per patient with CIN2+ lesions from $1474 to $1135.

CONCLUSION:

Cervicography and Pap co-testing had superior screening capacity and cost-effectiveness for detection of preinvasive cervical lesions than HPV and Pap co-testing and may be an effective and cost-saving screening strategy in clinical practice in country with a high prevalence of cervical cancer.

KEYWORDS:

Cervicography; Cytology; Diagnosis; Uterine cervical neoplasms

PMID:
30682600
DOI:
10.1016/j.ejogrb.2019.01.008
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center