Clinical Value Of Colposcopy With Selective Thinprep Cytology Test For Opportunistic Cervical Cancer Screening

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 of 1055 patients undergoing colposcopy,TCT,human papillomavirus(HPV)and histopathological examination from June,2014 to December,2016.The final diagnosis depend on the pathological results,to compare 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.Results: For lesions ≥ cervical intraepithelial neoplasia(CIN)Ⅱ,the specificity,positive predictive value of colposcopy is 96.9%,84.2%,higher than other methods,the cost of screening is the least(P < 0.05),the sensitivity and false negative rate is 65.9%,34.1%,the screening sensitivity is lower than other methods.In transformation zone(TZ)Ⅰ,the sensitivity and false negative rate is 88.4%,11.6%,the screening sensitivity is 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 couldbe reduced to 18.5%(P<0.05).Conclusions: Colposcopy combined with selective liquid based cytology has high sensitivity and low false negative rate,it has high screening sensitivity and low screening cost.It should be used for opportunistic cervical cancer screening in underdeveloped regions.