The Value Of Cytology And HPV Test In Primary Cervical Lesion Screening: A Meta-Analysis

[Objective] This is a meta analysis to compare test performance characteristics of cytologic test(pap smear,liquid-based cytology) and HPV test with regard to their accuracy in the detection of high grade cervical intraepithelial neoplasia in primary cervical cancer screening.[Method] We search database and retrieve of all studies in accordance with strict selection standards where all subjects are submitted to gold standard verification. According to the different screening strategies , three groups are defined , and we calculate the screening odds ratios (DOR), then plot three SROCs.[Results] 14 studies are included in the present analysis. The incorporate DOR value of cytologic test is 11. 35 (95%CI 8. 92=43.1) ;the incorporate DOR value of HPV test is 41.8 (95%CI 12.7-72.17); the incorporate DOR value of the combined test is 93.39 (95%CI35.47-351.03). All the results are statistically significant. Analysis of the SROC showes that there is significant difference between cytologicaltest and HPV test, and that the combined test is the most efficient and can improve sensitivity significantly.[Conclusions] It suggestes that HPV is an important adjunct to cytologic test in the detection of high grade cervical intraepithelial neoplasia in primary cervical cancer screening.