{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T13:01:33Z","timestamp":1782910893596,"version":"3.54.5"},"reference-count":49,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T00:00:00Z","timestamp":1665964800000},"content-version":"unspecified","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,9,21]]},"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We compared clinical performance of three strategies of primary human papillomavirus (HPV) testing, primary cytology and co-testing for cervical cancer screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A population-based prospective cohort study of clinical performance of screening strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Patients recruited from community in Changzhi County, Shanxi Province, China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient<\/jats:title>\n                    <jats:p>3209 women aged 30\u201364 years without gynaecological issues.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The performance of different screening strategies for detecting cervical intraepithelial neoplasia grade 2 or more severe (CIN2+).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 53 CIN2+ and 31 CIN3+ cases are detected. For CIN2+, sensitivity of primary HPV (95.9%) and co-testing (98.0%) are not statistically different, but significantly higher than primary cytology (48.0%). Specificity (86.8%), colposcopy referral rate (7.8%) and number of colposcopies required to detect one case (9.8) for primary HPV are better than co-testing (79.8%, 11.9%, 14.3%, respectively). For CIN3+, primary HPV, co-testing have 100% of sensitivity and specificity, which is significantly higher than primary cytology (56.7% and 90.2%). Number of colposcopies required to detect one case for primary HPV (15.9) is better than co-testing (23.8).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with co-testing, HPV primary screening had comparable sensitivity and higher specificity for CIN2+ detection, and both of them showed better performance than cytology primary screening in cervical cancer screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-063622","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T11:21:15Z","timestamp":1666005675000},"page":"e063622","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Comparison of primary cytology, primary HPV testing and co-testing as cervical cancer screening for Chinese women: a population-based screening cohort"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1586-7606","authenticated-orcid":false,"given":"Zhi-Fang","family":"Li","sequence":"first","affiliation":[{"name":"Department of Epidemiology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Beijing, China"},{"name":"Department of Preventive Medicine, Changzhi Medical College, ChangZhi, Shanxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8399-6637","authenticated-orcid":false,"given":"Xin-Hua","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Beijing, China"},{"name":"State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, Xiamen University, Xiamen, Fujian, china"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangxian","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Changzhi Medical College, ChangZhi, Shanxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0154-7126","authenticated-orcid":false,"given":"Shaokai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin-Jing","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun-Wen","family":"Zou","sequence":"additional","affiliation":[{"name":"Macalester College, Saint Paul, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue-Qing","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Changzhi Medical College, ChangZhi, Shanxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi-Bin","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You-Lin","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,10,17]]},"reference":[{"key":"2025121408323428000_12.10.e063622.1","unstructured":"WHO . 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