The clinical performance of computer-assisted liquid-based cytology, primary hrHPV screening, and cotesting at a Turkish Tertiary Care Hospital

Abstract

BackgroundWe aimed to compare the performance of computer-assisted liquid-based cytology, primary high-risk human papillomavirus (hrHPV) screening, and cytology-hrHPV cotesting with regards to the detection rate of cervical cancer precursor lesions. MethodsA total of 22,653 computer-assisted liquid-based cytology specimens interpreted between 2013 and 2015 were included in the study. We compared the false-negative rates and sensitivities for computer-assisted liquid-based cytology, primary hrHPV screening and cytology-hrHPV cotesting among women with normal and abnormal cytologies. Among 1,748 women who had undergone cotesting, 249 underwent follow-up biopsies. ResultsFor detecting biopsy-confirmed high-grade lesions, the sensitivities of using hrHPV, Pap tests, and cytology-hrHPV cotesting were 90.67%, 88%, and 98.67%, respectively, while the false-negative rates for hrHPV and Pap tests were 9.3% and 12%, respectively. The false negative rate for cotesting was only 1.3%. ConclusionBased on the significantly high sensitivity and lower false-negative rates achieved, we conclude that the combination of cytologic screening with hrHPV testing is the best preferred strategy for detection of cervical precursor lesions in our country's conditions.