Impact of digital tool on CIN2+ detection rate
| CIN2+ | Pb | Adjusted Pc | Cervical cancer | P | Adjusted Pc | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Pre-digital (%, n/N) | Post-digital (%, n/N) | Absolute deltaa (%, 95% CI) | Pre-digital (%, n/N) | Post-digital (%, n/N) | Absolute delta (%, 95% CI) | |||||
| Overall | 0.35 (275/78,958) | 0.67 (505/75,020) | 0.32 (0.25, 0.40) | < 0.001 | < 0.001 | 0.04 (34/78,958) | 0.04 (31/75,020) | −0.00 (−0.02, 0.02) | 0.868b | 1.000 |
| Age group | ||||||||||
| 35–44 | 0.35 (84/24,320) | 0.63 (127/20,230) | 0.28 (0.15, 0.41) | < 0.001 | < 0.001 | 0.05 (11/24,320) | 0.02 (5/20,230) | −0.02 (−0.05, 0.01) | 0.255b | 1.000 |
| 45–54 | 0.29 (109/36,985) | 0.60 (194/32,314) | 0.31 (0.20, 0.41) | < 0.001 | < 0.001 | 0.02 (8/36,985) | 0.03 (10/32,314) | 0.01 (−0.02, 0.03) | 0.448b | 1.000 |
| 55–64 | 0.46 (82/17,653) | 0.82 (184/22,476) | 0.35 (0.20, 0.51) | < 0.001 | < 0.001 | 0.08 (15/17,653) | 0.07 (16/22,476) | −0.01 (−0.07, 0.04) | 0.622b | 1.000 |
| Site | ||||||||||
| Zezhou County | 0.30 (44/14,500) | 0.53 (69/13,013) | 0.23 (0.07, 0.38) | 0.003 | 0.040 | 0.04 (6/14,500) | 0.04 (5/13,013) | −0.00 (−0.05, 0.04) | 0.903b | 1.000 |
| Xiangyuan County | 0.79 (88/11,171) | 0.82 (89/10,893) | 0.03 (−0.21, 0.26) | 0.807 | 1.000 | 0.08 (9/11,171) | 0.05 (5/10,893) | −0.03 (−0.10, 0.03) | 0.307b | 1.000 |
| Yanting County | 0.48 (52/10,899) | 1.02 (149/14,624) | 0.54 (0.33, 0.75) | < 0.001 | < 0.001 | 0.06 (7/10,899) | 0.02 (3/14,624) | −0.04 (−0.10, 0.01) | 0.110d | 1.000 |
| Shimian County | 0.30 (32/10,782) | 0.49 (26/5,351) | 0.19 (−0.02, 0.40) | 0.059 | 0.706 | 0.05 (5/10,782) | 0.07 (4/5,351) | 0.03 (−0.06, 0.11) | 0.491d | 1.000 |
| Mangshi | 0.15 (36/23,725) | 0.27 (39/14,690) | 0.11 (0.02, 0.21) | 0.014 | 0.169 | 0.02 (4/23,725) | 0.05 (7/14,690) | 0.03 (−0.01, 0.07) | 0.118d | 1.000 |
| Xinping County | 0.29 (23/7,881) | 0.81 (133/16,449) | 0.52 (0.34, 0.70) | < 0.001 | < 0.001 | 0.04 (3/7,881) | 0.04 (7/16,449) | 0.00 (−0.05, 0.06) | 1.000d | 1.000 |
| Strategy | ||||||||||
| HPV | 0.51 (48/9,358) | 0.70 (40/5,739) | 0.18 (−0.08, 0.44) | 0.149 | 1.000 | 0.06 (6/9,358) | 0.05 (3/5,739) | −0.01 (−0.09, 0.07) | 1.000d | 1.000 |
| HPV + VIA/VILI Triage | NA (0/0) | 0.83 (116/13,945) | NA | NA | NA | NA (0/0) | 0.06 (9/13,945) | NA (0/0) | NA | NA |
| HPV + cytology | 0.97 (22/2,276) | 0.57 (114/20,019) | −0.40 (−0.81, 0.02) | 0.021 | 0.253 | 0.13 (3/2,276) | 0.01 (3/20,019) | −0.12 (−0.27, 0.03) | 0.017d | 0.201 |
| HPV + cytology Triage | NA (0/0) | 0.62 (173/28,127) | NA | NA | NA | NA (0/0) | 0.05 (14/28,127) | NA (0/0) | NA | NA |
| HPV + cytology + VIA/VILI | NA (0/0) | 0.86 (62/7,190) | NA | NA | NA | NA (0/0) | 0.03 (2/7,190) | NA (0/0) | NA | NA |
| VIA + cytology Triage | 0.18 (15/8,272) | NA (0/0) | NA | NA | NA | 0.00 (0/8,272) | NA (0/0) | NA (0/0) | NA | NA |
| Cytology | 0.32 (190/59,052) | NA (0/0) | NA | NA | NA | 0.04 (25/59,052) | NA (0/0) | NA (0/0) | NA | NA |
↵aAbsolute delta was defined as the post-digital rate minus the pre-digital rate. Positive values indicate the improvement. bχ2 test comparing 2024 with pooled 2021–23 counts. cAdjusted p-values were obtained using Bonferroni correction for 12 independent tests. dFisher exact test comparing 2024 with pooled 2021–23 counts due to expected cell counts < 5. CI, confidence interval; VIA, visual inspection with acetic acid; VILI, visual inspection with Lugol’s iodine.