Comparative Accuracy of Anal and Cervical Cytology in Screening for Dysplasia
Author Information
Author(s): Mathews Wm. Christopher, Agmas Wollelaw, Cachay Edward
Primary Institution: University of California San Diego
Hypothesis
How does the accuracy of anal cytology compare to cervical cytology in detecting dysplasia?
Conclusion
Anal cytologic screening is somewhat less discriminating than cervical cytologic screening.
Supporting Evidence
- Anal cytologic screening had a ROC area of 0.700 compared to 0.834 for cervical screening.
- The study included 33 cervical and 11 anal screening studies.
- Heterogeneity was greater among cervical studies than anal studies.
- Operator experience may influence the accuracy of anal screening.
- Only 3% of cervical studies included HIV-infected participants, while 100% of anal studies did.
Takeaway
This study looked at how well anal and cervical tests can find early signs of cancer. It found that the anal test isn't as good as the cervical test.
Methodology
A meta-analysis was conducted comparing the accuracy of anal and cervical cytology using data from eligible studies.
Potential Biases
Potential verification bias due to conditional referral for biopsy based on prior cytology results.
Limitations
The study selection procedures differed by screening setting, which may introduce bias.
Participant Demographics
The study included both cervical and anal screening studies, with a focus on HIV-infected individuals for anal studies.
Statistical Information
P-Value
p<0.0001
Confidence Interval
[0.809–0.859]
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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