ArticleJournal of general internal medicine2016
Cost-Effectiveness of Primary HPV Testing, Cytology and Co-testing as Cervical Cancer Screening for Women Above Age 30 Years.
Article in Journal of general internal medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Accuracy of cytological examination of Tao brush endometrial sampling in diagnosing endometrial premalignancy and malignancy.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2022Pooled it
- A systematic review of economic evaluations of cervical cancer screening methods.Systematic reviews · 2022Pooled it
- Cytomorphologic Findings Associated With High-Risk HPV Categories in PAP Smears.Diagnostic cytopathology · 2026Article
- HPV testing with 16/18 genotyping for risk stratification among women with normal cytology: a multicenter prospective cohort study from China.Journal of clinical microbiology · 2026Article
- HPV, Cytology, and Cotest Cervical Cancer Screening and the Risk of Precancer.JAMA network open · 2026Article
- Cervical Cancer Screening: Histologic Outcomes of HPV-Negative HSIL/ASC-H Cytology in a Tertiary Referral Cohort in Northern Thailand.Medicina (Kaunas, Lithuania) · 2026Article
- Article
- Human papilloma virus (HPV) mediated cancers: an insightful update.Journal of translational medicine · 2025Review
- Primary human papillomavirus testing vs cotesting: clinical outcomes in populations with different disease prevalence.Journal of the National Cancer Institute · 2024Article
- Comparing the performance of 2 human papillomavirus assays for a new use indication: a real-world evidence-based evaluation in the United States.American journal of obstetrics and gynecology · 2024Article
- Point-of-Care Molecular Test for the Detection of 14 High-Risk Genotypes of Human Papillomavirus in a Single Tube.Analytical chemistry · 2023Article
- Performance of screening tools for cervical neoplasia among women in low- and middle-income countries: A systematic review and meta-analysis.PLOS global public health · 2023Article
- False Negative Results in Cervical Cancer Screening-Risks, Reasons and Implications for Clinical Practice and Public Health.Diagnostics (Basel, Switzerland) · 2022Review
- Article
- The pandemic and cervical cancer screening: Is it finally time to adopt HPV self-swabbing tests in Canada?Canadian family physician Medecin de famille canadien · 2022Article
- How Can a High-Performance Screening Strategy Be Determined for Cervical Cancer Prevention? Evidence From a Hierarchical Clustering Analysis of a Multicentric Clinical Study.Frontiers in oncology · 2022Article
- Tao brush endometrial cytology is a sensitive diagnostic tool for cancer and hyperplasia among women presenting to clinic with abnormal uterine bleeding.Cancer medicine · 2021Article
- Cotesting in Cervical Cancer Screening.American journal of clinical pathology · 2021Article
- Effect of introducing human papillomavirus genotyping into real-world screening on cervical cancer screening in China: a retrospective population-based cohort study.Therapeutic advances in medical oncology · 2021Article
- Methodologies of Primary HPV Testing Currently Applied for Cervical Cancer Screening.Life (Basel, Switzerland) · 2020Review
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCervical cancer screening guidelines for women aged ≥30 years allow for co-testing or primary cytology testing. Our objective was to determine the test characteristics and costs associated with Cytology, HPV and Co-testing screening strategies. MAIN
methodsRetrospective cohort study of women undergoing cervical cancer screening with both cytology and HPV (Hybrid Capture 2) testing from 2004 to 2010 in an integrated health system. The electronic health record was used to identify women aged ≥30 years who had co-testing. Unsatisfactory or unavailable test results and incorrectly ordered tests were excluded. The main outcome was biopsy-proven cervical intraepithelial neoplasia grade 3 or higher (CIN3+). KEY
resultsThe final cohort consisted of 99,549 women. Subjects were mostly white (78.4 %), married (70.7 %), never smokers (61.3 %) and with private insurance (86.1 %). Overall, 5121 (5.1 %) tested positive for HPV and 6115 (6.1 %) had cytology ≥ ASCUS; 1681 had both and underwent colposcopy and 310 (0.3 %) had CIN3+. Sensitivity for CIN3+ was 91.9 % for Primary Cytology, 99.4 % for Co-testing, and 94.8 % for Primary HPV; specificity was 97.3 % for Co-testing and Primary Cytology and 97.9 % for Primary HPV. Over a 3-year screening interval, Primary HPV detected more cases of CIN3+ and was less expensive than Primary Cytology. Co-testing detected 14 more cases of CIN3+ than Primary HPV, but required an additional 100,277 cytology tests and 566 colposcopies at an added cost of $2.38 million, or $170,096 per additional case detected.
conclusionsPrimary HPV was more effective and less expensive than Primary Cytology. Primary HPV screening appears to represent a cost-effective alternative to Co-testing.
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