Examination of the effectiveness of combining liquid based cytology and HPV-DNA testing for mass screening of uterine cervical cancer

Frequency of unsatisfactory cervical cytology smears in cancer screening of Japanese women: A systematic review and meta‐analysis

“…After full‐text screening, 11 publications were excluded: five studies that did not adopt TBS, two studies that evaluated partially overlapping participants, one that assessed data from unclear settings, one that assessed data from hospital settings, one that assessed data from laboratory settings, and one review without original data. Finally, 17 studies (three direct, eight indirect, and one both comparison studies between CC and LBC, and five studies assessing CC only) including 1 497 451 unique healthy women were eligible.…”

“…The sample size varied and ranged from 384 to 615 231. Only five studies reported the average age of study participants, which ranged from 39 to 53 years. The reported proportion of screening positives, defined as “atypical squamous cells of undetermined significance “ or worse results, ranged between 1.5% and 5.3%; invasive cancer was in general reported in 0.1% or fewer subjects.…”

“…Among selected studies, Akamatsu et al reported the unsatisfactory rate for CC as 18.09% (95% CI, 15.66‐20.73%) and 11.54% (95% CI, 11.16‐11.93%) before the adoption of TBS in 2008. Although the range of the unsatisfactory rate of CC varied widely, between 0.00% and 6.76%, studies published after 2008 showed an improved unsatisfactory rate. Regarding the sampling device for CC, cotton swabs might cause a significantly higher unsatisfactory rate (summary rate = 2.43%, 95% CI, 0.55‐10.06%) than non‐cotton swab devices (summary rate = 0.31%, 95% CI, 0.05‐2.03%).…”