Diagnostic value of the combination of TruScreen and Pap smear in screening cervical epithelial lesions: Does it add advantages over the Pap smear alone?

Abstract

Introduction: Pap smear is a well known test in screening of epithelial cell abnormalities of the cervix. However, adding other screening methods to this test may increase the sensitivity and specificity of case finding. Current study has been designed to assess the sensitivity and specificity of the combination of Tru-Screen and Pap tests in comparison to Pap smear alone in women referred for annual screening. Methods: This case-control study was conducted in two groups of 66 and 73 women with epithelial cell abnormality and normal results on Pap smear, respectively. Both groups were subsequently tested with Tru-Screen and colposcopy. Positive finding in any of the three studies made the patient candidate for biopsy as the standard diagnostic test. SPSS software was used to analyze sensitivity, specificity, positive predictive value, and negative predictive value of TruScreen, Pap smear, colposcopy and the combination of TruScreen and Pap tests. Results: 105 out of 139 women underwent biopsy. Of these, 32 (30.5%) had abnormal result in biopsy. Combination of True screen and Pap smear led to a sensitivity of 93.8% and specificity of 79.5% which means an improvement in both parameters. False negative rate decreased to 6.3% but false positive rate increased to 82.2%. Positive and negative predictive values of the combined tests were 33.3% and 86.7%, respectively. Conclusion: Combination of TruScreen and Pap smear is associated with a significant improvement in both sensitivity and specificity for early screening of preneoplastic and neoplastic cervical epithelial lesions.