机构：[1]Departments of Internal Medicine/Nephrology and Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, MO, USA[2]Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada[3]Population Health Research Institute, McMaster University, Hamilton, ON, Canada[4]Faculty of Medicine, University of Science and Technology, Irbid, Jordan[5]Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China[6]Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada[7]Department of Clinical Epidemiology, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China[8]Reproductive Health and Research, World Health Organization,Geneva, Switzerland[9]Department of Medicine, McMaster University, Hamilton, ON, Canada
Background: Cervical cancer screening is offered to women to identify and treat cervical intraepithelial neoplasia (CIN). Objectives: To support WHO guidelines, a systematic review was performed to compare test accuracy of the HPV test, cytology (cervical smear), and unaided visual inspection with acetic acid (VIA); and to determine test accuracy of HPV and colposcopy impression. Search strategy: Medline and Embase were searched up to September 2012, and experts were contacted for references. Selection criteria: Studies of at least 100 nonpregnant women (aged >= 18 years) not previously diagnosed with CIN were included. Data collection and analysis: Two investigators independently screened and collected data. Pooled sensitivity and specificity, and absolute differences were calculated, and the quality of evidence assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation). Main results: High to moderate quality evidence was found. The greatest difference in overtreatment occurred with VIA instead of the cervical smear (58 more per 1000 women). Differences in missed treatment ranged from 2-5 per 1000 women. For 1000 women screened positive and then sent to colposcopy, 464 would be falsely diagnosed with CIN grade 2-3 and treated. Conclusions: Although differences in sensitivity between tests could be interpreted as large, absolute differences in missed diagnoses were small. By contrast, small differences in specificity resulted in fairly large absolute differences in overtreatment. (C) 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd.
第一作者机构：[1]Departments of Internal Medicine/Nephrology and Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, MO, USA[2]Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
通讯作者：
通讯机构：[2]Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada[9]Department of Medicine, McMaster University, Hamilton, ON, Canada[*1]Department of Clinical Epidemiology and Biostatistics, Room 2C16, Health Sciences Centre, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
推荐引用方式(GB/T 7714)：
Mustafa Reem A.,Santesso Nancy,Khatib Rasha,et al.Systematic reviews and meta-analyses of the accuracy of HPV tests, visual inspection with acetic acid, cytology, and colposcopy[J].INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS.2016,132(3):259-265.doi:10.1016/j.ijgo.2015.07.024.
APA：
Mustafa, Reem A.,Santesso, Nancy,Khatib, Rasha,Mustafa, Ahmad A.,Wiercioch, Wojtek...&Schuenemann, Holger J..(2016).Systematic reviews and meta-analyses of the accuracy of HPV tests, visual inspection with acetic acid, cytology, and colposcopy.INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS,132,(3)
MLA：
Mustafa, Reem A.,et al."Systematic reviews and meta-analyses of the accuracy of HPV tests, visual inspection with acetic acid, cytology, and colposcopy".INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS 132..3(2016):259-265
