Oncoprotein E6 as a Diagnostic Marker in Human Papillomavirus-Associated Cervical Cancer Screening

Background Cervical cancer remains a significant public health challenge in resource-limited settings due to inadequate access to resource-intensive screening methods. This study aimed to evaluate the performance of the OncoE6 cervical test using histology as a reference method. Method A facility-based cross-sectional study was conducted from November 2022 to June 2023. A total of 303 samples were collected from six hospitals across three regions of Ethiopia. The OncoE6 cervical test and Visual Inspection with Acetic Acid (VIA) were evaluated among women with negative and positive histology test results. Statistical analysis was performed using SPSS version 28 and MedCalc version 22.014. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Receiver Operating Characteristic (ROC) curve were calculated. Result The sensitivity of the OncoE6 test was 59.4% (95% CI: 49.5%-68.9%), and specificity was 98% (95% CI: 94.9%-99.4%). The PPV was 94.0% (95% CI: 85.51–97.68%), while the NPV was 81.8% (95% CI: 78.07–84.97%). The VIA sensitivity, specificity, PPV, and NPV against histology were 95.8% (95% CI: 88.14%-99.12%), 26.4% (95% CI: 16.70%-38.10%), 41.2% (95% CI: 37.69–44.79%), and 92.1% (95% CI: 78.21–97.40%), respectively. The ROC curve showed an AUC of 0.80 for OncoE6 (p < 0.001) and 0.61 for VIA (p < 0.001). OncoE6 positivity increased with higher lesion grades. Additionally, the Sensitivity and specificity of the parallel (either OncoE6 OR VIA positive) were 84.0% (95% CI: 75.57–90.37) and 72.1% (95% CI: 65.26–78.22), respectively. Conclusion In this study, a high specificity of OncoE6 and a high sensitivity of VIA were observed. Using both in a parallel approach improved screening performance and can strengthen cervical cancer screening in resource-limited settings, but further community-based evaluation is still needed.