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Published on: March 11, 2014
Posttreatment human papillomavirus testing for recurrent cervical intraepithelial neoplasia: a systematic review
Benjamin K S Chan1, Joy Melnikow, Christina A Slee
1Oregon Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA.
Objective:
We conducted a systematic review to evaluate the characteristics of human papillomavirus testing, particularly Hybrid Capture 2, in follow-up evaluations after treatment for cervical intraepithelial neoplasia for the detection of residual or recurrent cervical intraepithelial neoplasia grade >/= 2.
Study Design:
Medline was searched for relevant studies that were published between 1992 and September 2007. Of the 1107 citations that were identified, 20 articles met the inclusion criteria.
Results:
Studies that used polymerase chain reaction testing were too heterogeneous to combine. We identified 5 studies that performed both Hybrid Capture 2 and colposcopy. Pooled sensitivity for Hybrid Capture 2 was 90.7% (95% CI, 75.4-96.9%), and pooled specificity was 74.6% (95% CI, 60.4-85.0%). Pooled sensitivity for cervical cytologic testing was 76.6% (95% CI, 62.0-86.8%), and pooled specificity was 89.7% (95% CI, 22.7-99.6%).
Conclusion:
Hybrid Capture 2 testing can identify approximately 91% of women with residual or recurrent cervical intraepithelial neoplasia grade >/= 2; however, approximately 30% of women would undergo colposcopy in follow-up evaluation.