Low cost versus other screening tests to detect cervical cancer or precancer in developing countries

This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows:

  • To assess the accuracy of low cost screening tests (visual inspection of the cervix with VIA, VILI or VIAM and careHPV test) to detect underlying CIN2+, CIN3+ or cervical cancer among adult women in developing countries

  • To assess the accuracy of comparator tests (cervical cytology and other HPV tests requiring established laboratory infrastructure) to detect underlying CIN2+, CIN3+ or cervical cancer among adult women in developing countries

  • To assess the relative sensitivity and specificity of the low cost index tests compared to each other and to the comparator tests to detect CIN2+, CIN3+ or cervical cancer among adult women in developing countries

Secondary objectives

The following sources of heterogeneity will be investigated:

  • study design and quality issues (quality of the reference standard, timing, completeness, independence of the application of the screening and reference tests, see QUADAS check list);

  • characteristics of the study population (study location, study size, age distribution, prevalence of disease);

  • procedures of reference standard verification;

  • qualification of test assessors performing the visual inspection ;

  • cytology preparation method (conventional or liquid-based):

  • type of HPV assay;

  • test cut-off used to define test positivity

This is a protocol.