Causes and Relevance of Unsatisfactory and Satisfactory but Limited Smears of Liquid-Based Compared With Conventional Cervical Cytology

Siebers, Albertus G.; Klinkhamer, Paul J. J. M.; Vedder, Judith E. M.; Arbyn, Marc; Bulten, Johan

doi:10.5858/arpa.2011-0113-oa

Cited by 37 publications

(24 citation statements)

References 24 publications

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“…This is consistent with a previous study concluding that LBC eliminates most sources of unsatisfactory tests with the exception of scant cellularity, which is the main reason for unsatisfactory LBC tests [23]. In particular, obscuring factors, which were the cause of a large proportion of the unsatisfactory CS test results, were found to be less frequent in the LBC method.…”

Section: Discussionsupporting

confidence: 92%

Comparison of Unsatisfactory Samples from Conventional Smear versus Liquid-Based Cytology in Uterine Cervical Cancer Screening Test

Jeong

Hong

Chae

et al. 2017

J Pathol Transl Med

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BackgroundCervical cytology for uterine cervical cancer screening has transitioned from conventional smear (CS) to liquid-based cytology (LBC), which has many advantages. The aim of this study was to compare the proportion of unsatisfactory specimens from CS versus LBC at multiple institutions including general hospitals and commercial laboratories. MethodsEach participating institution provided a minimum of 500 Papanicolaou (Pap) test results for analysis. Pap tests were classified according to the participating institution (commercial laboratory or general hospital) and the processing method (CS, ThinPrep, SurePath, or CellPrep). The causes of unsatisfactory results were classified as technical problems, scant cellularity, or complete obscuring factors. ResultsA total of 38,956 Pap test results from eight general hospitals and three commercial laboratories were analyzed. The mean unsatisfactory rate of LBC was significantly lower than that of CS (1.26% and 3.31%, p = .018). In the LBC method, samples from general hospitals had lower unsatisfactory rates than those from commercial laboratories (0.65% vs 2.89%, p = .006). The reasons for unsatisfactory results were heterogeneous in CS. On the other hand, 66.2% of unsatisfactory results in LBC were due to the scant cellularity. ConclusionsUnsatisfactory rate of cervical cancer screening test results varies according to the institution and the processing method. LBC has a significantly lower unsatisfactory rate than CS.

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Section: Discussionsupporting

confidence: 92%

Comparison of Unsatisfactory Samples from Conventional Smear versus Liquid-Based Cytology in Uterine Cervical Cancer Screening Test

Jeong

Hong

Chae

et al. 2017

J Pathol Transl Med

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“…The studies done by Siebers et al [19] and Gupta N et al [17] found scant cellularity as the sole cause for unsatisfactory LBC, similar to our study.…”

Section: Discussionsupporting

confidence: 92%

Evaluation of cervical smears by Conventional and Liquid Based Cytology

Srivastava

Arora

2017

APALM

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Background: Cervical cancer is the second most common cancer. Screening for cervical cancer is done by Pap [Papanicolaou] test by Conventional Pap Smear [CPS] or by newer technique Liquid Based Cytology [LBC]. The aim of the study was to learn and compare cervical lesions on both the techniques. Methods:This was a prospective study conducted over a 2 months period. Cervical smears were taken from 625 patients. On 25/625 patients both CPS and LBC were done. CPS and LBC were done on 300/625 patients each. The smears were processed and stained with Papanicolaou stain. Smears were studied for adequacy, cell types, inflammatory/ haemorrhagic background, organisms and reactive changes. The cervical lesions were categorised according to the Bethesda System of classification. The two techniques were compared based on certain defined parameters. Results:The techniques of CPS and LBC were learnt and cervical cells were appreciated on smears. Various epithelial abnormalities could be identified. Inflammation, bacterial vaginosis, candidiasis and reactive changes were noted. Out of 25 cases taken for comparison, 24 [96%] and 25 [100%] cases were satisfactory on CPS and LBC respectively.CPS showed more cases of severe inflammation and hemorrhagic background as compared to LBC. Conclusions:We conclude that both CPS and LBC are effective screening modalities for cervical lesions. Despite better performance of LBC in many aspects, it was felt that CPS is an equally effective tool in our settings due to the cost constraints.

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“…44,45 Now that most U.S. cytology is done using liquid-based media, which can control for most obscuring factors in processing, unsatisfactory results arise largely from insufficient squamous cells. 46 Evidence is sparse governing management of women with unsatisfactory cytology obtained as part of co-testing, although risk for high-grade disease in women with negative HPV tests appears to be low. 47 Unsatisfactory results arise largely from insufficient squamous cells.…”

Section: Management Of Abnormal Screening Tests Unsatisfactory Cytologymentioning

confidence: 99%

2012 Updated Consensus Guidelines for the Management of Abnormal Cervical Cancer Screening Tests and Cancer Precursors

Massad

Einstein

Huh

et al. 2013

Obstetrics &Amp; Gynecology

683

477

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A group of 47 experts representing 23 professional societies, national and international health organizations, and federal agencies met in Bethesda, MD, September 14-15, 2012, to revise the 2006 American Society for Colposcopy and Cervical Pathology Consensus Guidelines. The group's goal was to provide revised evidence-based consensus guidelines for managing women with abnormal cervical cancer screening tests, cervical intraepithelial neoplasia (CIN) and adenocarcinoma in situ (AIS) following adoption of cervical cancer screening guidelines incorporating longer screening intervals and co-testing. In addition to literature review, data from almost 1.4 million women in the Kaiser Permanente Northern California Medical Care Plan provided evidence on risk after abnormal tests. Where data were available, guidelines prescribed similar management for women with similar risks for CIN 3, AIS, and cancer. Most prior guidelines were reaffirmed. Examples of updates include: Human papillomavirus-negative atypical squamous cells of undetermined significance results are followed with co-testing at 3 years before return to routine screening and are not sufficient for exiting women from screening at age 65 years; women aged 21-24 years need less invasive management, especially for minor abnormalities; postcolposcopy management strategies incorporate co-testing; endocervical sampling reported as CIN 1 should be managed as CIN 1; unsatisfactory cytology should be repeated in most circumstances, even when HPV results from co-testing are known, while most cases of negative cytology with absent or insufficient endocervical cells or transformation zone component can be managed without intensive follow-up.

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Causes and Relevance of Unsatisfactory and Satisfactory but Limited Smears of Liquid-Based Compared With Conventional Cervical Cytology

Cited by 37 publications

References 24 publications

Comparison of Unsatisfactory Samples from Conventional Smear versus Liquid-Based Cytology in Uterine Cervical Cancer Screening Test

Comparison of Unsatisfactory Samples from Conventional Smear versus Liquid-Based Cytology in Uterine Cervical Cancer Screening Test

Evaluation of cervical smears by Conventional and Liquid Based Cytology

2012 Updated Consensus Guidelines for the Management of Abnormal Cervical Cancer Screening Tests and Cancer Precursors

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