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.

Good Positive and Negative Likelihood Ratios

Finding	+LR	-LR	Comments, Study
Pap Smear Plus HPV PCR	13.3	0	Study: N Engl J Med. 2007 Oct 18;357(16):1579-88. PMID: 17942871
HPV DNA PCR	16	0.1	Study: N Engl J Med. 2007 Oct 18;357(16):1579-88. PMID: 17942871
ThinPrep Pap Smear	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

Traditional Pap Smear

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