Accuracy of colposcopy to triage HPV-positive women in cervical cancer screening: a systematic review and meta-analysis

作者：Nina Dhollander, Iman Jaafar, Maribel Almonte, Remila Rezhake, Laura Downham, Joan Valls, Arianis Tatiana Ramírez, Armando Baena, Lynne Gaffikin, Paul D. Blumenthal, Siri Hovland, Murat Gultekin, Fanghui Zhao, Rengaswamy Sankaranarayanan, Partha Basu, Le Dang, You‐Lin Qiao, Marc Arbyn · 发表于：EClinicalMedicine · 年份：2026 · DOI：10.1016/j.eclinm.2026.104009 · 被引用次数：1 · 研究领域：Cervical Cancer and HPV Research、Women's cancer prevention and management、Global Cancer Incidence and Screening

Background The World Health Organization (WHO) guidelines on cervical cancer screening recommends colposcopy as one of the methods to triage human papillomavirus (HPV)-positive women. We aimed to assess the diagnostic accuracy of colposcopy in this context. Methods In this systematic review and meta-analysis, we searched for articles reporting the diagnostic accuracy of colposcopy in women with a positive HPV screening test, published in PubMed, Embase or the Cochrane library up to Oct 20, 2025. We included cross-sectional or longitudinal studies if the number of true and false positive and negatives could be derived or obtained after contacting the authors. Studies were excluded if the study population was not representative of a screening population. We collected data on colposcopy triage (index) together with data on cytology triage (comparator), if available, and assessed risk of bias using an adapted Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 checklist. The pooled sensitivity and specificity to detect cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and grade 3 or worse (CIN3+) were calculated, as well as the relative sensitivity and specificity of colposcopy triage compared to cytology triage, using a bivariate logistic random effects model. Heterogeneity was measured using τ 2 and I 2 . Sample size effects were assessed by Deeks' funnel plots and regression test. Certainty of evidence was assessed using the GRADE tool. This study was regist...