Abstract:
Background
Cervical cancer screening has traditionally been based on cervical cytology. Given the aetiological relationship between human papillomavirus
(HPV) infection and cervical carcinogenesis, HPV testing has been proposed as an alternative screening test.
Objectives
To determine the diagnostic accuracy of HPV testing for detecting histologically confirmed cervical intraepithelial neoplasias (CIN) of
grade 2 or worse (CIN 2+), including adenocarcinoma in situ, in women participating in primary cervical cancer screening; and how
it compares to the accuracy of cytological testing (liquid-based and conventional) at various thresholds.
Search methods
We performed a systematic literature search of articles in MEDLINE and Embase (1992 to November 2015) containing quantitative
data and handsearched the reference lists of retrieved articles.
Selection criteria
We included comparative test accuracy studies if all women received both HPV testing and cervical cytology followed by verification of
the disease status with the reference standard, if positive for at least one screening test. The studies had to include women participating
in a cervical cancer screening programme who were not being followed up for previous cytological abnormalities
