As cervical cancer is a major health problem, regular cervical screening to make an early diagnosis can help prevent cervical cancer, through identifying and treating pre-invasive cervical lesions. The aim of this review is to evaluate the correlation between the cytological screening and histological outcome in the diagnosis of cervical cancer, more specifically the correlation between HSIL on cytology and histological CIN2+. Learning if cytology brings up information about the probability to discover a high grade cervical intraepithelial neoplasia, would imply that the cytological screening program is a valuable tool on its own.
An electronic search was carried out in Medline (through Pubmed) and Cochrane (last searched in November 2016), supplemented with the related article feature in Pubmed and snowballing. Article selection (predefined in- and exclusion criteria), data extraction and methodological quality assessment (QUADAS) were evaluated by two independent reviewers.
After identifying 1065 articles, 24 articles were included in this systematic review, representing 51.962 cytological HSIL women in total. The mean CIN2+ percentage in cytological HSIL women is 65,1% (range: 45,4% – 95,2%). The mean CIN3+ percentage in cytological HSIL women is 43,9% (range: 36,4% – 62,1%).
In this systematic review, the mean CIN2+ percentage in cytological HSIL women is 65,1%. The correlation between HSIL on cytology and histological CIN2+ is therefore fair but a biopsy is necessary to confirm high-grade disease.