Table 3 Relative effectiveness of HPV testing versus cytology by income classifications
| Â | Lower-middle-income areas | Upper-middle-income areas | ||||
|---|---|---|---|---|---|---|
Cytology | Overall HPV testing | aOR (95%CI) | Cytology | Overall HPV testing | aOR (95%CI) | |
Screen positivity (%, 95%CI) | 4879 (3.1) | 23 764 (9.6) | 3.40 (3.29–3.51) | 8345 (4.9) | 60 827 (10.4) | 2.27 (2.21–2.32) |
Per protocol colposcopy referral (%, 95%CI)a | 4879 (3.1) | 9050 (3.7) | 1.21 (1.17–1.25) | 8345 (4.9) | 19 982 (3.4) | 0.69 (0.67–0.71) |
Overall colposcopy referral (%, 95%CI) | 4206 (2.7) | 9721 (3.9) | 1.55 (1.50–1.61) | 8106 (4.8) | 23 346 (4.0) | 0.83 (0.80–0.85) |
Per protocol detection rate of CIN or cancer (per 1000, 95%CI) | ||||||
 CIN2+ | 406 (3.0) | 993 (4.7) | 1.53 (1.37–1.70) | 816 (5.6) | 2867 (5.7) | 1.03 (0.96–1.11) |
  CIN2 or 3 | 368 (2.7) | 912 (4.3) | 1.55 (1.38–1.73) | 757 (5.2) | 2611 (5.2) | 1.01 (0.94–1.09) |
  Invasive cervical cancer | 38 (0.3) | 81 (0.4) | 1.32 (0.92–1.89) | 59 (0.4) | 256 (0.5) | 1.32 (1.02–1.71) |
Overall detection rate of CIN or cancer b (per 1000, 95%CI) | ||||||
 CIN2+ | 417 (3.1) | 1039 (4.9) | 1.56 (1.40–1.73) | 885 (6.0) | 3060 (6.1) | 1.01 (0.95–1.09) |
  CIN2 or 3 | 373 (2.8) | 938 (4.4) | 1.57 (1.41–1.76) | 798 (5.5) | 2760 (5.5) | 1.01 (0.94–1.09) |
  Invasive cervical cancer | 44 (0.3) | 101 (0.5) | 1.44 (1.03–2.01) | 87 (0.6) | 300 (0.6) | 1.08 (0.86–1.35) |
Positive predictive value c (%, 95%CI) | ||||||
 CIN2+ | 406 (9.9) | 1018 (12.4) | 1.23 (1.10–1.38) | 816 (11.4) | 3012 (14.3) | 1.31 (1.21–1.41) |
  CIN2 or 3 | 368 (9.0) | 936 (11.4) | 1.25 (1.11–1.40) | 757 (10.6) | 2732 (13.0) | 1.27 (1.17–1.38) |
  Invasive cervical cancer | 38 (0.9) | 82 (1.0) | 1.02 (0.71–1.46) | 59 (0.8) | 280 (1.3) | 1.65 (1.27–2.14) |