Efficacy of Pap Test in Combination with ThinPrep Cytological Test in Screening for Cervical Cancer

Background: Our aim was to investigate the efficacy of the Pap test in combination with the ThinPrepcytological test (TCT) in screening for cervical cancer in China. Design: From March 2006 to October 2008,988 women with the mean age 46.4 ± 10.5 years (range, 23-80 years) were recruited to receive cervical cancerscreening. Pap test results ≥ grade III and TCT findings ≥ ASCUS/AGUS were considered abnormal. Subjectswith a Pap test result ≥ grade IIb received TCT. Colposcopy and biopsies were performed in all participants, andfinal diagnosis was based on pathological findings. The sensitivity, specificity, positive predictive value (PPV),negative predictive value (NPV) and Youden index for predicting CIN I or above were determined.
Results:The sensitivity, specificity, PPV, NPV and Youden index of the Pap test were 43.1%, 97.2%, 70.0%, 91.9%, and40.3%, respectively. The same values for TCT in predicting CIN were 80.0%, 63.2%, 16.0%, 97.3%, and 43.2%,respectively. The two tests in combination gave values for predicting CIN of 64.8%, 87.6%, 43.6%, 94.4%, and53.5%, respectively. Combined testing exhibited the highest Youden index (53.4%).
Conclusion: The Pap testwith a reduced threshold in combination with the TCT has high sensitivity and high specificity in screening forcervical cancer.