RT - European Journal of Gynaecological Oncology ID - 10.12892/ejgo3798.2018 T1 - Human papillomavirus DNA testing as a screen for cervical cancer: a meta-analysis of randomized controlled trials A1 - Y.L. Ding A1 - W.C. Liu A1 - J.N. Chen A1 - Y.F. Wei A1 - C. Lu A1 - L. Wang A1 - X.L. Hou A1 - Q. Xie A1 - H.Y. Diao K1 - Human papillomavirus; Cervical cancer; Screening YR - 2018 SP - 10 AB -
Purpose: The aim was to evaluate the effectiveness of cervical screening when HPV DNA testing is implemented. Materials and Methods: Medline (PubMed) was searched and experts were contacted for references. Odds ratio (OR) and 95% confidence intervals (CI) were used as measures of effect sizes. Results: The rate of CIN3 and worse decreased about twofold, from 1.19% in round 1 to 0.67% in round 2, and CIN2 decreased from 1.70% in round 1 to 0.80% in round 2. When primary cervical screening with LBC was combined with HPV testing, there was a statistically significant reduction in the detection of CIN2 and CIN3+ at the next screening round compared with liquid-based cytology (LBC) alone. Conclusions: HPV DNA-based screening is more effective than cytology in CIN3 and invasive cervical cancers, by detecting persistent high-grade lesions earlier, and providing a longer low-risk period. However, in younger women, HPV screening leads to over-diagnosis of regressive CIN2.