Clinical value of colposcopy with selective thinprep cytology test for opportunistic cervical cancer screening

Abstract:

Objective：To explore the clinical value and cost-benefit value of colposcopy combined with selective thinprep cytology test （TCT） in opportunistic cervical cancer screening. Methods：Retrospective analysis was conducted among 1 055 patients undergoing colposcopy，TCT，human papillomavirus（HPV） and histopathological examination from June 2014 to December 2016. The final diag－nosis depended on the pathological results. The sensitivity，specificity，positive and negative predictive value，false negative rate，the area under ROC curve and cost-benefit value of colposcopy and colposcopy combined with TCT，TCT combined with HPV were compared. Results：For lesions≥cervical intraepithelial neoplasia（CIN）Ⅱ，the specificity，positive predictive value of colposcopy was 96.9% and 84.2%，higher than that of other methods，and the cost of screening was the lowest（P＜0.05）；the sensitivity and false neg－ative rate was 65.9% and 34.1%，the screening sensitivity was lower than that of other methods. In transformation zone（TZ）Ⅰ，the sensitivity and false negative rate was 88.4% and 11.6%，and the screening sensitivity was higher than that in type Ⅱ and Ⅲ TZ（P＜0.05）. When combined with selective TCT，the sensitivity and false negative rate could be improved（P＜0.05）. The total sensitivity could be raised to 81.5%，the false negative rate could be reduced to 18.5%（P＜0.05）. Conclusion：Colposcopy combined with selective liquid based cytology has high sensitivity and low false negative rate，and it has high screening sensitivity and low screening cost. It should be used for opportunistic cervical cancer screening in underdeveloped regions.