Four large, fair-quality RCTs compared cotesting with cytology screening alone in European women aged 30 to 64 years (Table 3) (46–49). These 4 studies included NTCC phase 1, POBASCAM, Swedescreen, and ARTISTIC, and comprised 82 390 participants. In contrast to HPV screening alone, cotesting did not detect more CIN3+ after 2 screening rounds than cytology alone (Table 3). Round-specific screening results were not completely consistent. Generally, cotesting detected relatively more CIN2+ (and sometimes CIN3+) after 1 screening round, compared with cytology alone. Cotesting identified less CIN3+ (and, where reported, cancers) after the second round, tending toward fewer cancers cumulatively. Interpreting these mixed results is complicated by uncertainty about the completeness of outcome ascertainment for cancers and high-grade precancers due to between-trial differences in duration and completeness of follow-up for the entire screened population and screening episode (15); lack of consensus on the appropriate surrogate outcome (15), with possible asymmetry bias due to limited long-term follow-up (1); and screening protocol differences (Table 3 and Appendix Table) between trials and with U.S. practice.
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Correction: Liquid-Based Cytology and Human Papillomavirus Screening for Cervical Cancer. Ann Intern Med. ;156:71–72. doi: 10.7326/0003-4819-156-1-201201030-00032
Download citation file:
Published: Ann Intern Med. 2012;156(1_Part_1):71-72.
Copyright © 2018 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use