The Risk of False-Positive Histology According to the Reason for Colposcopy Referral in Cervical Cancer Screening
| Autor: | GianPiero Casadei, Paolo Palma, Paolo Giorgi Rossi, Guido Collina, Maurizio Lestani, Anna Maria Buccoliero, Mirella Aldi, Gianlibero Onnis, Guglielmo Ronco, Giuseppe Galanti, Vincenzo Gomes, Pamela Giubilato, D. Aldovini, B. Ghiringhello |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
medicine.medical_specialty Uterine Cervical Neoplasms Cervical intraepithelial neoplasia Sensitivity and Specificity Risk Factors Internal medicine Biopsy medicine Humans Mass Screening False Positive Reactions Single-Blind Method Referral and Consultation Mass screening Vaginal Smears Cervical cancer Colposcopy Gynecology medicine.diagnostic_test business.industry Papillomavirus Infections Reproducibility of Results Cancer Anatomical pathology General Medicine Uterine Cervical Dysplasia medicine.disease Squamous intraepithelial lesion Female business |
| Zdroj: | American Journal of Clinical Pathology. 129:75-80 |
| ISSN: | 1943-7722 0002-9173 |
| Popis: | All cervical intraepithelial neoplasia (CIN) diagnoses identified during the New Technologies for Cervical Cancer trial (ISRCTN81678807) were blindly reviewed by 2 pathologists. Original diagnoses based on colposcopy-guided biopsies were compared with those made by the reviewers who had access to all clinical histologic samples (including postsurgical). Cases downgraded from CIN 2+ by the reviewers were considered indicative of unnecessary treatments. The analyses are presented according to the molecular (high-risk human papillomavirus [HPV]) and/or cytologic diagnosis used to refer the women for colposcopy. We reviewed 812 CIN 1 and 364 CIN 2 + diagnoses. The specificity of colposcopy-guided biopsy was 98% and the sensitivity, 84%. The probability of unnecessary treatment was 27% for women with atypical squamous cells of undetermined significance cytologic findings and 8% for women with low-grade squamous intraepithelial lesion or worse, 10% for HPV+ and positive cytologic findings, and 16% for HPV+ alone. The positive predictive value of the first-level screening test was inversely associated with probability of a histologic false-positive result (P = .015). In screening, a low positive predictive value of the colposcopy-referring test may result in unnecessary treatments. |
| Databáze: | OpenAIRE |
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