Komparasi Efikasi Skrining Kanker Serviks Menggunakan HPV DNA Testing, Pap Smear, Dan Liquid Biopsy: Tinjauan Sistematis
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.
References
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Campitelli, M., Jeannot, E., Peter, M., Lappartient, E., Saada, S., De La Rochefordière, A., Fourchotte, V., Alran, S., Petrow, P., Cottu, P., Pierga, J.-Y., Lantz, O., Couturier, J., & Sastre-Garau, X. (2012). Human Papillomavirus Mutational Insertion: Specific Marker of Circulating Tumor DNA in Cervical Cancer Patients. PLoS ONE, 7(8), e43393. https://doi.org/10.1371/journal.pone.0043393
Chona, E. Z., Msengi, E. A., Gosse, R. A., & Ambikile, J. S. (2023). The lived experiences and caring needs of women diagnosed with cervical cancer: A qualitative study in Dar es Salaam, Tanzania. PLOS ONE, 18(8), e0289925. https://doi.org/10.1371/journal.pone.0289925
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Ekawati, F. M., Listiani, P., Idaiani, S., Thobari, J. A., & Hafidz, F. (2024). Cervical cancer screening program in Indonesia: Is it time for HPV-DNA tests? Results of a qualitative study exploring the stakeholders’ perspectives. BMC Women’s Health, 24(1), 125. https://doi.org/10.1186/s12905-024-02946-y
Güzel, C., Van Sten-van’t Hoff, J., De Kok, I. M. C. M., Govorukhina, N. I., Boychenko, A., Luider, T. M., & Bischoff, R. (2021). Molecular markers for cervical cancer screening. Expert Review of Proteomics, 18(8), 675–691. https://doi.org/10.1080/14789450.2021.1980387
Hafidz, F., Icanervilia, A., Rizal, M., Listiani, P., Setyaningsih, H., Sasanti, M., Ekawati, F., Atthobari, J., Utami, T., Trirahmanto, A., Tjokroprawiro, B., Harsono, A., Masytoh, L., Haryani, W., Subekti, Y., & Nadjib, M. (2024). Economic Evaluation of Cervical Cancer Screening by HPV DNA, VIA, and Pap smear Methods in Indonesia. Asian Pacific Journal of Cancer Prevention, 25(9), 3015–3022. https://doi.org/10.31557/APJCP.2024.25.9.3015
Human Papillomavirus (HPV) Questions and Answers. (2025). 4(8). http://www.immunize.org/catg.d/p4207.pdf
Kemenkes RI. (2021). Tingginya Angka Kasus Serviks di Indonesia Akibat Screening Rendah. Https://Upk.Kemkes.Go.Id/New/Pelaksanaan-Skrining-Kanker-Payudara-Dan-Kanker-Leher-Rahim-Melalui-Sister-Klinik-Upk-Kemenkes-Ri-Di-Kementerian-Kelautan-Dan-Perikanan.
Macios, A., & Nowakowski, A. (2022a). False Negative Results in Cervical Cancer Screening—Risks, Reasons and Implications for Clinical Practice and Public Health. Diagnostics, 12(6), 1508. https://doi.org/10.3390/diagnostics12061508
Macios, A., & Nowakowski, A. (2022b). False Negative Results in Cervical Cancer Screening—Risks, Reasons and Implications for Clinical Practice and Public Health. Diagnostics, 12(6), 1508. https://doi.org/10.3390/diagnostics12061508
Marchamah, Dwi Nur Siti; Arumsari, Wahyuni. 2023. “Sustainability of Community Movement Innovation That Cares for Mothers and Toddlers for High Risk Pregnant Women.” Media Ilmu Kesehatan 12(3): 245–59. doi:https://doi.org/10.30989/mik.v12i3.1255.
Milano, G., Guarducci, G., Nante, N., Montomoli, E., & Manini, I. (2023). Human Papillomavirus Epidemiology and Prevention: Is There Still a Gender Gap? Vaccines, 11(6), 1060. https://doi.org/10.3390/vaccines11061060
Mufidah, I., & Maulidiyah, E. C. (2022). PENGARUH GAME BELAJAR MEMBACA TERHADAP KEMAMPUAN MEMBACA PERMULAAN USIA 5-6 TAHUN. 10(4). https://jurnal.uns.ac.id/kumara
Nassar, S. I., Suk, A., Nguyen, S. A., Adilbay, D., Pang, J., & Nathan, C.-A. O. (2024). The Role of ctDNA and Liquid Biopsy in the Diagnosis and Monitoring of Head and Neck Cancer: Towards Precision Medicine. Cancers, 16(18), 3129. https://doi.org/10.3390/cancers16183129
Nutthachote, P., Oranratanaphan, S., Termrungruanglert, W., Triratanachat, S., Chaiwongkot, A., Baedyananda, F., & Bhattarakosol, P. (2019). Comparison of detection rate of high risk HPV infection between self-collected HPV testing and clinician-collected HPV testing in cervical cancer screening. Taiwanese Journal of Obstetrics and Gynecology, 58(4), 477–481. https://doi.org/10.1016/j.tjog.2019.05.008
Parums, D. V. (2025). A Review of Circulating Tumor DNA (ctDNA) and the Liquid Biopsy in Cancer Diagnosis, Screening, and Monitoring Treatment Response. Medical Science Monitor, 31. https://doi.org/10.12659/MSM.949300
Patrono, M. G., Calvo, M. F., Ariel Franco, J. V., Garrote, V., & Vietto, V. (2021). A systematic review and meta-analysis of the prevalence of therapeutic targets in cervical cancer. Ecancermedicalscience, 15. https://doi.org/10.3332/ecancer.2021.1200
Qin, L., & Ding, X. (2024). Effect of zoledronic acid on biological characteristics of cervical cancer cells. African Journal of Reproductive Health, 28(11), 46–55. https://doi.org/10.29063/ajrh2024/v28i11.5
Rayner, M., Welp, A., Stoler, M. H., & Cantrell, L. A. (2023). Cervical Cancer Screening Recommendations: Now and for the Future. Healthcare, 11(16), 2273. https://doi.org/10.3390/healthcare11162273
Sugiarniti, N. P. (2024). Faktor- Faktor yang Berhubungan dengan Motivasi Ibu melakukan Pemeriksaan Inspeksi Visual Asam Asetat (IVA) di Wilayah Kerja Puskesmas Giri Mulya. 2.
Teixeira, J. C., Vale, D. B., Discacciati, M. G., Campos, C. S., Bragança, J. F., & Zeferino, L. C. (2023). Cervical Cancer Screening with DNA-HPV Testing and Precancerous Lesions Detection: A Brazilian Population-based Demonstration Study. Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, 45(01), 021–030. https://doi.org/10.1055/s-0043-1763493
Tiersma, J. F., Evers, B., Bakker, B. M., Reijngoud, D. J., De Bruyn, M., De Jong, S., & Jalving, M. (2024). Targeting tumour metabolism in melanoma to enhance response to immune checkpoint inhibition: A balancing act. Cancer Treatment Reviews, 129, 102802. https://doi.org/10.1016/j.ctrv.2024.102802
Tomecka, P., Karwowska, A., Ku?nicki, J., Skinderowicz, K., Wojno, A., Markut, K., Typek, P., Ciesielska, U., Kulbacka, J., & Dr?g-Zalesi?ska, M. (2025). HPV Infection in Children and Adolescents—A Comprehensive Review. Journal of Clinical Medicine, 14(7), 2425. https://doi.org/10.3390/jcm14072425
Torode, J., Kithaka, B., Chowdhury, R., Simelela, N., Cruz, J. L., & Tsu, V. D. (2021). National action towards a world free of cervical cancer for all women. Preventive Medicine, 144, 106313. https://doi.org/10.1016/j.ypmed.2020.106313
WHO. (2022). Cervical cancer. Https://Www.Who.Int/News-Room/Fact-Sheets/Detail/Cervical-Cancer
W?oszek, E., Krupa, K., Skrok, E., Budzik, M. P., Depta?a, A., & Badowska-Kozakiewicz, A. (2025). HPV and Cervical Cancer—Biology, Prevention, and Treatment Updates. Current Oncology, 32(3), 122. https://doi.org/10.3390/curroncol32030122
World Health Organization. (2024). WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention: Use of dual-stain cytology to triage women after a positive test for human papillomavirus (HPV). Web Annex C. Evidence-to-decision framework for dual-stain cytology to triage women after a positive test for human papillomavirus (HPV). World Health Organization. https://doi.org/10.2471/B09020
Assi, T., Khoury, R., Ibrahim, R., Baz, M., Ibrahim, T., & Le Cesne, A. (2023). Overview of the role of liquid biopsy in cancer management. Translational Oncology, 34, 101702. https://doi.org/10.1016/j.tranon.2023.101702
Boukovala, M., Westphalen, C. B., & Probst, V. (2024). Liquid biopsy into the clinics: Current evidence and future perspectives. The Journal of Liquid Biopsy, 4, 100146. https://doi.org/10.1016/j.jlb.2024.100146
Bouvard, V., Wentzensen, N., Mackie, A., Berkhof, J., Brotherton, J., Giorgi-Rossi, P., Kupets, R., Smith, R., Arrossi, S., Bendahhou, K., Canfell, K., Chirenje, Z. M., Chung, M. H., Del Pino, M., De Sanjosé, S., Elfström, M., Franco, E. L., Hamashima, C., Hamers, F. F., … Lauby-Secretan, B. (2021). The IARC Perspective on Cervical Cancer Screening. New England Journal of Medicine, 385(20), 1908–1918. https://doi.org/10.1056/NEJMsr2030640
Campitelli, M., Jeannot, E., Peter, M., Lappartient, E., Saada, S., De La Rochefordière, A., Fourchotte, V., Alran, S., Petrow, P., Cottu, P., Pierga, J.-Y., Lantz, O., Couturier, J., & Sastre-Garau, X. (2012). Human Papillomavirus Mutational Insertion: Specific Marker of Circulating Tumor DNA in Cervical Cancer Patients. PLoS ONE, 7(8), e43393. https://doi.org/10.1371/journal.pone.0043393
Chona, E. Z., Msengi, E. A., Gosse, R. A., & Ambikile, J. S. (2023). The lived experiences and caring needs of women diagnosed with cervical cancer: A qualitative study in Dar es Salaam, Tanzania. PLOS ONE, 18(8), e0289925. https://doi.org/10.1371/journal.pone.0289925
Daniko, J. L., & Sugiharto, S. (2019). Gambaran hasil pemeriksaan Pap Smear LBC dan Tes HPV untuk deteksi dini lesi prekanker dan kanker serviks di Rumah Sakit Medistra Desember 2015 – Januari 2017. 1(2).
Das, A., Bararia, A., Mukherjee, S., & Sikdar, N. (2024). Chronic pancreatitis as a driving factor for pancreatic cancer: An epidemiological understanding. World Journal of Clinical Oncology, 15(12), 1459–1462. https://doi.org/10.5306/wjco.v15.i12.1459
Ekawati, F. M., Listiani, P., Idaiani, S., Thobari, J. A., & Hafidz, F. (2024). Cervical cancer screening program in Indonesia: Is it time for HPV-DNA tests? Results of a qualitative study exploring the stakeholders’ perspectives. BMC Women’s Health, 24(1), 125. https://doi.org/10.1186/s12905-024-02946-y
Güzel, C., Van Sten-van’t Hoff, J., De Kok, I. M. C. M., Govorukhina, N. I., Boychenko, A., Luider, T. M., & Bischoff, R. (2021). Molecular markers for cervical cancer screening. Expert Review of Proteomics, 18(8), 675–691. https://doi.org/10.1080/14789450.2021.1980387
Hafidz, F., Icanervilia, A., Rizal, M., Listiani, P., Setyaningsih, H., Sasanti, M., Ekawati, F., Atthobari, J., Utami, T., Trirahmanto, A., Tjokroprawiro, B., Harsono, A., Masytoh, L., Haryani, W., Subekti, Y., & Nadjib, M. (2024). Economic Evaluation of Cervical Cancer Screening by HPV DNA, VIA, and Pap smear Methods in Indonesia. Asian Pacific Journal of Cancer Prevention, 25(9), 3015–3022. https://doi.org/10.31557/APJCP.2024.25.9.3015
Human Papillomavirus (HPV) Questions and Answers. (2025). 4(8). http://www.immunize.org/catg.d/p4207.pdf
Kemenkes RI. (2021). Tingginya Angka Kasus Serviks di Indonesia Akibat Screening Rendah. Https://Upk.Kemkes.Go.Id/New/Pelaksanaan-Skrining-Kanker-Payudara-Dan-Kanker-Leher-Rahim-Melalui-Sister-Klinik-Upk-Kemenkes-Ri-Di-Kementerian-Kelautan-Dan-Perikanan.
Macios, A., & Nowakowski, A. (2022a). False Negative Results in Cervical Cancer Screening—Risks, Reasons and Implications for Clinical Practice and Public Health. Diagnostics, 12(6), 1508. https://doi.org/10.3390/diagnostics12061508
Macios, A., & Nowakowski, A. (2022b). False Negative Results in Cervical Cancer Screening—Risks, Reasons and Implications for Clinical Practice and Public Health. Diagnostics, 12(6), 1508. https://doi.org/10.3390/diagnostics12061508
Marchamah, Dwi Nur Siti; Arumsari, Wahyuni. 2023. “Sustainability of Community Movement Innovation That Cares for Mothers and Toddlers for High Risk Pregnant Women.” Media Ilmu Kesehatan 12(3): 245–59. doi:https://doi.org/10.30989/mik.v12i3.1255.
Milano, G., Guarducci, G., Nante, N., Montomoli, E., & Manini, I. (2023). Human Papillomavirus Epidemiology and Prevention: Is There Still a Gender Gap? Vaccines, 11(6), 1060. https://doi.org/10.3390/vaccines11061060
Mufidah, I., & Maulidiyah, E. C. (2022). PENGARUH GAME BELAJAR MEMBACA TERHADAP KEMAMPUAN MEMBACA PERMULAAN USIA 5-6 TAHUN. 10(4). https://jurnal.uns.ac.id/kumara
Nassar, S. I., Suk, A., Nguyen, S. A., Adilbay, D., Pang, J., & Nathan, C.-A. O. (2024). The Role of ctDNA and Liquid Biopsy in the Diagnosis and Monitoring of Head and Neck Cancer: Towards Precision Medicine. Cancers, 16(18), 3129. https://doi.org/10.3390/cancers16183129
Nutthachote, P., Oranratanaphan, S., Termrungruanglert, W., Triratanachat, S., Chaiwongkot, A., Baedyananda, F., & Bhattarakosol, P. (2019). Comparison of detection rate of high risk HPV infection between self-collected HPV testing and clinician-collected HPV testing in cervical cancer screening. Taiwanese Journal of Obstetrics and Gynecology, 58(4), 477–481. https://doi.org/10.1016/j.tjog.2019.05.008
Parums, D. V. (2025). A Review of Circulating Tumor DNA (ctDNA) and the Liquid Biopsy in Cancer Diagnosis, Screening, and Monitoring Treatment Response. Medical Science Monitor, 31. https://doi.org/10.12659/MSM.949300
Patrono, M. G., Calvo, M. F., Ariel Franco, J. V., Garrote, V., & Vietto, V. (2021). A systematic review and meta-analysis of the prevalence of therapeutic targets in cervical cancer. Ecancermedicalscience, 15. https://doi.org/10.3332/ecancer.2021.1200
Qin, L., & Ding, X. (2024). Effect of zoledronic acid on biological characteristics of cervical cancer cells. African Journal of Reproductive Health, 28(11), 46–55. https://doi.org/10.29063/ajrh2024/v28i11.5
Rayner, M., Welp, A., Stoler, M. H., & Cantrell, L. A. (2023). Cervical Cancer Screening Recommendations: Now and for the Future. Healthcare, 11(16), 2273. https://doi.org/10.3390/healthcare11162273
Sugiarniti, N. P. (2024). Faktor- Faktor yang Berhubungan dengan Motivasi Ibu melakukan Pemeriksaan Inspeksi Visual Asam Asetat (IVA) di Wilayah Kerja Puskesmas Giri Mulya. 2.
Teixeira, J. C., Vale, D. B., Discacciati, M. G., Campos, C. S., Bragança, J. F., & Zeferino, L. C. (2023). Cervical Cancer Screening with DNA-HPV Testing and Precancerous Lesions Detection: A Brazilian Population-based Demonstration Study. Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, 45(01), 021–030. https://doi.org/10.1055/s-0043-1763493
Tiersma, J. F., Evers, B., Bakker, B. M., Reijngoud, D. J., De Bruyn, M., De Jong, S., & Jalving, M. (2024). Targeting tumour metabolism in melanoma to enhance response to immune checkpoint inhibition: A balancing act. Cancer Treatment Reviews, 129, 102802. https://doi.org/10.1016/j.ctrv.2024.102802
Tomecka, P., Karwowska, A., Ku?nicki, J., Skinderowicz, K., Wojno, A., Markut, K., Typek, P., Ciesielska, U., Kulbacka, J., & Dr?g-Zalesi?ska, M. (2025). HPV Infection in Children and Adolescents—A Comprehensive Review. Journal of Clinical Medicine, 14(7), 2425. https://doi.org/10.3390/jcm14072425
Torode, J., Kithaka, B., Chowdhury, R., Simelela, N., Cruz, J. L., & Tsu, V. D. (2021). National action towards a world free of cervical cancer for all women. Preventive Medicine, 144, 106313. https://doi.org/10.1016/j.ypmed.2020.106313
WHO. (2022). Cervical cancer. Https://Www.Who.Int/News-Room/Fact-Sheets/Detail/Cervical-Cancer
W?oszek, E., Krupa, K., Skrok, E., Budzik, M. P., Depta?a, A., & Badowska-Kozakiewicz, A. (2025). HPV and Cervical Cancer—Biology, Prevention, and Treatment Updates. Current Oncology, 32(3), 122. https://doi.org/10.3390/curroncol32030122
World Health Organization. (2024). WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention: Use of dual-stain cytology to triage women after a positive test for human papillomavirus (HPV). Web Annex C. Evidence-to-decision framework for dual-stain cytology to triage women after a positive test for human papillomavirus (HPV). World Health Organization. https://doi.org/10.2471/B09020
Published
2025-07-19
How to Cite
MAYASARI, Septia Puji.
Komparasi Efikasi Skrining Kanker Serviks Menggunakan HPV DNA Testing, Pap Smear, Dan Liquid Biopsy: Tinjauan Sistematis.
Indonesian Journal of Health Community, [S.l.], v. 6, n. 1, p. 33-41, july 2025.
ISSN 2775-9997.
Available at: <https://e-journal.ivet.ac.id/index.php/ijheco/article/view/3893>. Date accessed: 28 july 2025.
doi: https://doi.org/10.31331/ijheco.v6i1.3893.
Section
Articles
