Page 54 - Screening for Cervical Cancer: Systematic Evidence Review

Chapter III. Results

Although we updated the evidence tables from the Cervical Cytology report by including

two new studies about PapNet 57,60 and a final publication of an article available in manuscript

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form, we have not summarized them in greater detail here. The reason is that these reports use
cytology reference standards and do not change the overall picture of the performance of new

technologies. Thus, they serve as confirmation of similar earlier publications, not as wholly new

information.

Harms

We did not identify publications that specifically address harms of new technologies for

cervical cancer screening. These screening tools are implemented at the laboratory level and not

at the level of clinical specimen collection, so they do not increase risk of harm from the actual

specimen acquisition.

The performance characteristics of the new technologies will determine the risk of harm.

Although the data are limited, on average these tools improve sensitivity and reduce specificity.

This finding suggests that increased detection of low-grade lesions and false positives are the

primary potential sources of harm; i.e., harm may take the form of increased evaluations,

possible over-intervention, and psychological distress for the women diagnosed with

abnormalities. These harms are poorly documented for conventional Pap testing and have not

yet been assessed for new technologies.

Benefits

Likewise, direct benefits of new technologies for improving care processes or outcomes

are not documented. The characteristics of these new tools suggest that they can improve

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