A comparison of liquid-based cytology and Pap smear as a screening method for cervical cancer

Abstract

Abstract.The implementation of population-based screening for cervical cancer with Pap smear in the early sixties was set to detect and treat precancerous lesions, hopefully preventing a subsequent invasive cervical cancer. Epidemiological data indicate that organized screening has a major impact on morbidity and mortality from cervical cancer. The limited sensitivity of a single smear necessitates repeated smears in organized program. It is suggested that liquid-based cytology improves the sensitivity. The aim of this split-sample study was to compare ThinPrep liquid-based cytology with conventional Pap smear, relying on a laboratory with long-term experience of the latter. In total, 137 women with atypical Pap smear in population-based cervical screening were enrolled for the splitsample study. The performance of both techniques (ThinPrep liquid-based cytology and conventional Pap smear) were compared and validated by a histological follow-up. Women without representative histological biopsy were excluded from the study. Pap smear had sensitivity for detection of CIN2-3 of 47% compared to 66% for liquid-based material. The concordance of the two sampling techniques with the histological diagnosis was 37% and 53%, respectively, this difference being statistically significant. The proportion of reports on atypical squamous cells of undetermined significance (ASCUS) was significantly less in the liquidbased material, 4.3% compared to 8% of the conventional smears. This improved sensitivity in combination with the possibility to perform reflex testing such as HPV DNA or p16 immunocytochemistry without renewed sampling gives ThinPrep a substantial advantage and makes the liquid-based technique interesting.

Use of flow cytometry as a quality control device for liquid‐based cervical cytology specimens

“…One of the most critical steps in the cervical cancer screening involves the exclusion of false negative or unsatisfactory results. As already reported (7–9), LBC outweighs conventional Pap screening in the marked decrease of unsatisfactory slides as well as in the reduction of the time needed for the slide screening. Although the liquid‐based preparation for cervical cytology keeps cells in suspension and makes possible a more rapid, specific, and sensitive analysis, the incidence of unsatisfactory slides can be as high as 5% (10).…”

Comparison of the oestrogen and progesterone receptor status in primary breast carcinomas as evaluated by immunohistochemistry and immunocytochemistry: a consecutive series of 267 patients

“…ThinPrep™ (Hologic, Inc., Marlborougch, MA, USA), which was initially introduced as an alternative method for conventional cervical cytology smears, 4,5 is a technique in which cytological aspirates or brush samples are collected in a liquid vial 4 . The liquid is mechanically filtered through a membrane, from which a monolayer of cells is transferred to a slide.…”

Human papillomavirus ‘reflex’ testing as a screening method in cases of minor cytological abnormalities

“…Liquid-based cytology (LBC) has shown higher sensitivity for high-grade cervical lesions than conventional cytology (Strander et al, 2007;Zhu et al, 2007). The proportion of abnormal findings increases when conventional Pap smears are replaced by LBC for screening.…”