Could Alarmingly High Rates of Negative Diagnoses in Remote Rural Areas Be Minimized with Liquid-Based Cytology? Preliminary Results from the RODEO Study Team

Fregnani, José Humberto Tavares Guerreiro; Scapulatempo, Cristovam; Haikel, Raphael Luiz; Saccheto, Teóclito; Campacci, Natália; Mauad, Edmundo Carvalho; Longatto‐Filho, Adhemar

doi:10.1159/000343046

Cited by 8 publications

(8 citation statements)

References 27 publications

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“…The same proportion of invasive cancers was obtained with both methodologies. However, for settings with an elevated prevalence of high-grade lesions, LBC is proven to be more effective for detecting HSIL than conventional smears [10,11,12]. We hypothesize that these promising results would be even more relevant if LBC was applied in a large casuistic population.…”

Section: Discussionmentioning

confidence: 99%

“…This is not surprising, and the higher frequency of ASC-US in LBC is related to the ‘learning curve' period that can vary among cytotechnologists, dependent on their particular skills. The LBC preparation-associated ASC-US frequency tends to decrease over time and establish a slight superior baseline as compared with conventional smears [12]. Moreover, significant improvements are expected in accomplishing the correct diagnosis over time for intraepithelial lesions [23].…”

Section: Discussionmentioning

confidence: 99%

“…For over a decade, strong evidence indicating that Pap smears collected in liquid medium have a sensitivity and specificity similar to those of conventional cytology has been presented [8]. In addition, a number of recent publications have clearly demonstrated that LBC offers increased indexes of cytology positivity, and a consistent and remarkable reduction of unsatisfactory preparations [9,10,11,12]. Moreover, the best performance can be achieved with the use of computer-assisted screening programs, which is also feasible but not frequently employed globally with conventional Pap smears [13].…”

Section: Introductionmentioning

confidence: 99%

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Critical Analyses of the Introduction of Liquid-Based Cytology in a Public Health Service of the State of São Paulo, Brazil

et al. 2015

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Objective: The aim of this study was to compare the performance of the current conventional Pap smear with liquid-based cytology (LBC) preparations. Study Design: Women routinely undergoing their cytopathological and histopathological examinations at Fundação Oncocentro de São Paulo (FOSP) were recruited for LBC. Conventional smears were analyzed from women from other areas of the State of São Paulo with similar sociodemographic characteristics. Results: A total of 218,594 cases were analyzed, consisting of 206,999 conventional smears and 11,595 LBC. Among the conventional smears, 3.0% were of unsatisfactory preparation; conversely, unsatisfactory LBC preparations accounted for 0.3%. The ASC-H (atypical squamous cells - cannot exclude high-grade squamous intraepithelial lesion) frequency did not demonstrate any differences between the two methods. In contrast, the incidence of ASC-US (atypical squamous cells of undetermined significance) was almost twice as frequent between LBC and conventional smears, at 2.9 versus 1.6%, respectively. An equal percentage of high-grade squamous intraepithelial lesions were observed for the two methods, but not for low-grade squamous intraepithelial lesions, which were more significantly observed in LBC preparations than in conventional smears (2.2 vs. 0.7%). The index of positivity was importantly enhanced from 3.0% (conventional smears) to 5.7% (LBC). Conclusions: LBC performed better than conventional smears, and we are truly confident that LBC can improve public health strategies aimed at reducing cervical lesions through prevention programs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Critical Analyses of the Introduction of Liquid-Based Cytology in a Public Health Service of the State of São Paulo, Brazil

et al. 2015

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“…However, even in necrotic inflammatory or hemorrhagic smears malignancy can be underdiagnosed as demonstrated by early findings of RODEO study team. [6] Liquid based cytology is gaining popularity in non gynec FNAC, due to advantages of a cleaner background and reproducibility, better cellular morphology and ability to gain sample for ancillary techniques. [7] Compared to cell block MLBC technique has the advantage of viewing cell morphology comparable to conventional smear without presence of necrosis, hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of manual liquid-based cytology (MLBC) technique and direct smear technique (conventional) on fine-needle cytology/fine-needle aspiration cytology samples

Pawar¹,

Gadkari²,

Swami³

et al. 2014

J Cytol

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Background:Liquid-based cytology technique enables cells to be suspended in a liquid medium and spread in a monolayer, making better morphological assessment. Automated techniques have been widely used, but limited due to cost and availability.Aim:The aim was to establish manual liquid-based cytology (MLBC) technique on fine-needle aspiration cytology (FNAC) material and compare its results with conventional technique.Materials and Methods:In this study, we examined cells trapped in needles hub used for the collection of FNAC samples. 50 cases were examined by the MLBC technique and compared with the conventional FNAC technique. By centrifugation, sediment was obtained and imprint was taken on defined area. Papanicolaou (Pap) and May-Grünwald Giemsa (MGG) staining was done. Direct smears and MLBC smears were compared for cellularity, background, cellular preservation, and nuclear preservation. Slides were diagnosed independently by two cytologists with more than 5 years’ experience. Standard error of proportion was used for statistical analysis.Results:Cellularity was low in MLBC as compared with conventional smears, which is expected as remnant material in the needle hub was used. Nuclei overlap to a lesser extent and hemorrhage and necrosis was reduced, so cell morphology can be better studied in the MLBC technique. P value obtained was <0.05.Conclusion:This MLBC technique gives results comparable to the conventional technique with better morphology. In a set up where aspirators are learners, this technique will ensure adequacy due to remnant in needle hub getting processed

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“…This creates a huge advantage considering that most of the women examined by BCH live in rural and remote areas, which makes a recall due to poor quality preparation a critical issue [17] . Additionally, to reduce to a minimum the possibility of cytological errors (not shown in this work), BCH implemented a computer-guided screening, which assists the cytotechnicians in the primary reading of the slides [18] .…”

Section: Discussionmentioning

confidence: 99%

Organized Cervical Cancer Screening Program in Barretos, Brazil: Experience in 18 Municipalities of São Paulo State

Possati-Resende

Vazquez²,

Biot³

et al. 2017

Acta Cytologica

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Objectives: The aim of this report is to demonstrate the Barretos Cancer Hospital initiative of organizational, laboratorial, and human resources training in the implementation of an organized cervical screening program in low-resource settings. Methods: We developed a computational program to report all epidemiological, clinical, and laboratorial findings, and to trace all necessary information to recruit women for regular screening or for referral for complementary exams after liquid-based Pap test analyses. Results: All Pap tests were collected in liquid medium and in 2014 more than 160,000 tests were analyzed and 2,900 colposcopy examinations were performed. From 2012 to 2015, the percentage of exams collected increased from 54.6% in 2012 to 62.4% in 2013, 68.4% in 2014, and 71% in 2015. Per 1,000 Pap tests, 0.4 cases of invasive cancer were diagnosed; for in situ carcinoma, 1.9 cases were identified. More importantly, between 2011 and 2015, 89.4% of all carcinomas were detected at clinical stage 0 or I (in situ carcinoma), and only 5% at stages III and IV. Conclusions: Since the organized system was implemented, 98% of women have attended their recall for colposcopy. So far, we have not reached the target of 70% of women for this proposal, as recommended by the international standards.

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Could Alarmingly High Rates of Negative Diagnoses in Remote Rural Areas Be Minimized with Liquid-Based Cytology? Preliminary Results from the RODEO Study Team

Cited by 8 publications

References 27 publications

Critical Analyses of the Introduction of Liquid-Based Cytology in a Public Health Service of the State of São Paulo, Brazil

Critical Analyses of the Introduction of Liquid-Based Cytology in a Public Health Service of the State of São Paulo, Brazil

Comparative study of manual liquid-based cytology (MLBC) technique and direct smear technique (conventional) on fine-needle cytology/fine-needle aspiration cytology samples

Organized Cervical Cancer Screening Program in Barretos, Brazil: Experience in 18 Municipalities of São Paulo State

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