Human Papillomavirus (HPV) test and Pap Smear in Screening for Cervical Cancer: A systematic review on systematic review study

Document Type : Review Article


1 Associate Professor, Department of Emergency Medicine, Ramsar International Medical Campus, Mazandaran University of Medical sciences, Mazandaran, Iran.

2 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 General Physician, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 General Physician, Ramsar International Medical Campus, Mazandaran University of Medical sciences, Mazandaran, Iran.

5 Obstetrician and Gynecologist, Valiasr Hospital, Birjand, South Khorasan, Iran.


Introduction:Cervical cancer is one of the most common cancers among women. Early diagnosis of this disease can reduce mortality among patients. So, women's screening is very important. One of the most common screening methods in this field is Pap smear screening and human papillomavirus test. Therefore, this study was performed with aim to compare these two methods in cervical cancer screening.
Methods:In this systematic review of systematic review research, for finding the systematic review and meta-analysis articles about cervical cancer screening, the databases of pubmed, Scopus, science direct and Cochrane were searched using the keywords of " Cervical cancer screening", " Pap Test", "HPV Test " and " cotest " from 2015 to 2018. The quality of the included studies was assessment by the AMSTAR checklist.
Results: sensitivity of HPV in two studied researches was 94% and 89.9%, and its specificity was 90% and 89.9%, while the sensitivity of Pap smear was 70% and 72.9% and its specifity was 95 % and 95.3 %. In the Cotest experiment in comparison to the cytology test, false positives results ranged 5.8 to 19.9 versus 6.2 to 10.9.
Conclusion:According to the results of the studies, it seems that HPV test had more sensitivity, less specificity and more false positive results than Pap smear. However, regarding the great importance of this issue in clinical decisions, the final conclusion needs to more evaluation.


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