Abstract
The timely detection of precancerous lesions and early intervention can greatly reduce cervical cancer occurrence. The current study aimed to assess the diagnostic value and accuracy of different methods of cervical lesion screening. A total of 1622 females who visited the Outpatient Department of Xinjiang Uyghur Autonomous Region People’s Hospital between January and December 2018 were consecutively enrolled. All participants underwent separate high-risk human papilloma virus (HR-HPV) DNA detection, ThinPrep cytology testing (TCT) and colposcopic biopsy. Their medical records were retrospectively analyzed. While considering biopsy outcomes as the gold standard, the diagnostic values of TCT, HR-HPV testing, and TCT+HR-HPV testing for cervical cancer screening were compared. The sensitivity, specificity and Youden index of each method were calculated. Among the different methods, TCT+HR-HPV testing had the highest sensitivity (89.8%), followed by TCT (79.9%) and HR-HPV testing (49.2%). The combined method also had the highest Youden value, and its screening outcomes exhibited the highest consistency with those of biopsy. In addition, the combined method had the largest area under the receiver operating characteristic (ROC) curve, which was 0.673 (0.647, 0.699), compared with any other screening method. Compared with TCT or HR-HPV testing alone, TCT+HR-HPV testing serves as a better screening method for cervical cancer and precancerous lesions.
Highlights
Cervical cancer is the fourth most common malignancy in terms of incidence and mortality in women worldwide
high-risk human papilloma virus (HR-human papillomavirus (HPV)) positivity was detected in 680 patients, which represented 41.9% of all participants
ThinPrep cytology testing (TCT) and HPV testing have been widely applied in cervical cancer screening in China, comparisons of the diagnostic value of different screening methods based on a large sample size have rarely been reported
Summary
Cervical cancer is the fourth most common malignancy in terms of incidence and mortality in women worldwide. In 2018, a total of 570,000 new cases of cervical cancer were diagnosed worldwide, and the number of deaths due to cervical cancer reached 311,000; among cervical cancer-related deaths, approximately 85% occurred in developing and undeveloped countries, and the mortality was 18 times higher in low–middle-income countries than high-income countries [1]. China is the largest developing country in the world, and cervical cancer is highly prevalent in China. TCT and HPV testing in cervical lesion diagnosis
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