Cervical Cancer: Likelihood Ratios

Introduction: Screening tests center on finding atypical cells or cervical intraepithelial neoplasia (up to squamous carcinoma in situ). The tests listed here are generally for finding atypia and/or CIN. The pathogenesis of cervical cancer is always or almost always from HPV infection.

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Tags: Gynecologic Neoplasm Tag this Diagnosis.

The likelihood ratios of findings for Cervical Cancer are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Good Positive and Negative Likelihood Ratios
Finding	Result	+LR	-LR
[ + ] Pap Smear Plus HPV PCR	+ 0 -	13.3	0
Study: N Engl J Med. 2007 Oct 18;357(16):1579-88. PMID: 17942871
[ + ] HPV DNA PCR	+ 0 -	16	0.1
Study: N Engl J Med. 2007 Oct 18;357(16):1579-88. PMID: 17942871
[ + ] ThinPrep Pap Smear	+ 0 -	5.4	0.3
Note that different studies disagree on whether ThinPrep is truly better than conventional Pap smears. Study: Gynecol Oncol. 2003 Jul;90(1):137-44. PMID 12821354

Good Positive Likelihood Ratio
Finding	Result	+LR	-LR
[ + ] Traditional Pap Smear	+ 0 -	2.1	0.8
Sensitivity 30-87%, spec 86-100% depending on study. In (N Engl J Med. 2007 Oct 18;357(16):1579-88. PMID: 17942871) the sensitivity was 55.4% with specificity of 92.5%. Study: Ann Intern Med 2000 May 16;132(10):810-9. PMID 10819705