Septia Puji Mayasari

Komparasi Efikasi Skrining Kanker Serviks Menggunakan HPV DNA Testing, Pap Smear, Dan Liquid Biopsy: Tinjauan Sistematis

Introduction

komparasi efikasi skrining kanker serviks menggunakan hpv dna testing, pap smear, dan liquid biopsy: tinjauan sistematis. Tinjauan sistematis membandingkan efikasi skrining kanker serviks: tes HPV DNA (sensitivitas tinggi), Pap smear (spesifisitas baik), dan liquid biopsy (spesifisitas tinggi). Kombinasi direkomendasikan.

Abstract

Cervical cancer is one of the leading causes of death among women worldwide, making early detection through effective screening crucial. This study aims to compare the efficacy of three cervical cancer screening methods: HPV DNA testing, pap smear, and liquid biopsy. The method used is a systematic review based on the PRISMA 2020 guidelines, with literature searches conducted in PubMed, Scopus, ScienceDirect, and Google Scholar from 2019 to 2025. Out of 657 articles, 17 studies met the inclusion criteria and were analyzed descriptively and comparatively. The results indicated that HPV DNA testing had the highest sensitivity (73–96%) and negative predictive value (90–99%), but its specificity varied (39–97%). Pap smear had lower sensitivity (30–64%) but good specificity and positive predictive value (65–92% and 63–89%). Liquid biopsy offered very high specificity and positive predictive value (89–100% and 70–100%), but its sensitivity was still limited (27–78%). A combination of the three methods is recommended to improve diagnostic accuracy and the effectiveness of cervical cancer screening. HPV DNA testing excels in early detection, Pap smear is suitable for resource-limited areas, and liquid biopsy holds potential as a confirmation or monitoring method.

Review

This systematic review, titled "Komparasi Efikasi Skrining Kanker Serviks Menggunakan HPV DNA Testing, Pap Smear, Dan Liquid Biopsy," addresses a highly pertinent topic in global women's health. The authors are commended for undertaking a comprehensive systematic review, guided by the PRISMA 2020 guidelines, to compare the efficacy of established cervical cancer screening methods with the emerging potential of liquid biopsy. The broad literature search across major databases (PubMed, Scopus, ScienceDirect, and Google Scholar) spanning a recent period (2019-2025) suggests a robust methodology aimed at capturing the most current evidence. This timely comparison is critical, given the ongoing evolution of screening technologies and the persistent burden of cervical cancer worldwide. The review effectively delineates the comparative strengths and weaknesses of each screening modality. HPV DNA testing emerges as a strong contender for early detection, demonstrating high sensitivity (73–96%) and negative predictive value (90–99%), though its specificity shows considerable variation (39–97%). Pap smear, while having lower sensitivity (30–64%), maintains good specificity and positive predictive value, reinforcing its continued relevance, particularly in resource-limited settings. Liquid biopsy, an exciting new frontier, exhibits very high specificity (89–100%) and positive predictive value (70–100%), positioning it as a promising tool for confirmation or monitoring, despite its currently limited sensitivity (27–78%). The nuanced presentation of these findings provides valuable insights into the performance characteristics of each method. A key strength of this review lies in its practical recommendations. The authors advocate for a judicious combination of methods to optimize diagnostic accuracy and screening effectiveness, suggesting tailored applications: HPV DNA testing for early detection, Pap smear for areas with limited resources, and liquid biopsy for confirmation or monitoring purposes. While the abstract indicates a descriptive and comparative analysis, the presented ranges for efficacy metrics suggest inherent heterogeneity among the included studies, which is typical for systematic reviews in evolving fields. This review significantly contributes to informing clinical guidelines and decision-making by clarifying the role and potential integration of these diverse screening technologies, thus paving the way for more effective and context-appropriate cervical cancer screening strategies globally.

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