Use of the Thin Prep� Pap Test? in clinical practice

Guidos, Barbara J.; Selvaggi, Suzanne M.

doi:10.1002/(sici)1097-0339(199902)20:2<70::aid-dc5>3.0.co;2-e

Cited by 74 publications

(53 citation statements)

References 14 publications

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“…There was no difference in the specificity of the 2 methods. As found in previous studies, [12][13][14][15][16][17] LBC produced a substantially smaller proportion of ''satisfactory-but-limited-by'' results (27.9% vs. 6.5%), and a significantly higher proportion of unsatisfactory results (2.2% vs. 0.8%). All unsatisfactory LBC results were due to scant cellularity, perhaps reflecting high levels of cervical atrophy in our population of older women, aged 35-65.…”

Section: Discussionsupporting

confidence: 68%

“…Some previous studies have also found that LBC has a higher unsatisfactory rate, 13,[18][19][20] although others have not. 12,14,16,17,21 A number of meta-analyses and systematic reviews have assessed the results of previous studies comparing LBC and conventional cytology with differing conclusions regarding test performance depending on the study inclusion criteria. Although several have concluded, in contrast to our findings, that the accumulated evidence suggests that LBC improves the detection of high-grade disease, 7,22-24 they have also unanimously noted the dearth of high-quality research needed to adequately answer this question.…”

Section: Discussionmentioning

confidence: 99%

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Direct comparison of liquid‐based and conventional cytology in a South African screening trial

Taylor

Kuhn

Dupree

et al. 2005

Intl Journal of Cancer

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Our study directly compares the performance of liquid-based (LBC) and conventional cytology for detecting high-grade cervical intraepithelial neoplasia and cancer (CIN 21) in high-risk, previously unscreened women. As part of a larger randomized clinical trial assessing the efficacy and safety of a ''screen and treat'' program for cervical cancer prevention, 5,652 South African women, aged 35 to 65 years, were screened using either ThinPrep or conventional Papanicolaou cytology. The cytology method used (i.e., ThinPrep or conventional) was rotated on a 6-month basis for the duration of the study. Directly following collection of the cytology specimen, all women underwent colposcopy with endocervical curettage and biopsy of all colposcopic abnormalities. Assessment of cytology and histology results was blinded and results were compared using histology-confirmed CIN as the ''gold standard.'' The accuracy of LBC and conventional cytology was statistically equivalent, although the sensitivity of conventional cytology was at least 5 percentage points higher at all cutoff levels. For example, at a cytology cutoff level of low-grade squamous intraepithelial lesion, the sensitivity of LBC was 60.3% for CIN21 vs. 69.1% for conventional cytology and specificity was 94.1% and 94.5%, respectively. LBC specimens were significantly less likely to be ''satisfactory-but-limited-by'' (6.5% vs. 27.9%) but significantly more likely to be unsatisfactory (2.2% vs. 0.8%). Thus, in this high-risk population, the sensitivity of LBC is no greater than the sensitivity of conventional cytology. Because of the higher unit cost of LBC, low resource settings should carefully consider the potential benefits and drawbacks of LBC before adopting this new technology. ' 2005 Wiley-Liss, Inc.Key words: cervical cytology; papanicolaou (Pap) smear; liquidbased cytology; cervical intraepithelial neoplasia Conventional cytology, i.e., the Papanicolaou smear, has been the mainstay of cervical cancer screening since the 1960s and is credited with successfully reducing the incidence and mortality of invasive cervical cancer in many developed countries. 1,2 Nonetheless, the accuracy of this important screening tool remains controversial, with several large meta-analyses suggesting that both the sensitivity and specificity of cervical cytology is relatively low (30% to 87% sensitivity, 86% to 100% specificity). [3][4][5] As an alternative to conventional cytology, liquid based-cytology (LBC) was introduced in the mid-1990s. The purported advantages of LBC include a possible increase in the detection of high-grade cervical intraepithelial neoplasia (CIN 2,3 ), a reduction in the number of unsatisfactory and ''satisfactory-but-limited-by'' specimens, and providing residual cellular material for subsequent molecular testing (e.g., testing for ''high-risk'' types of HPV DNA). On the other hand, the unit cost of LBC methods is substantially more than that of conventional cytology. The substantial increase in unit cost is of particular concern in less-developed...

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Direct comparison of liquid‐based and conventional cytology in a South African screening trial

Taylor

Kuhn

Dupree

et al. 2005

Intl Journal of Cancer

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“…4 Recently the liquid-based Pap test has been introduced to overcome the drawbacks of the conventional Pap smear and has resulted in the reduction of limited and unsatisfactory specimens and improvement in the adequacy and detection rates for squamous intraepithelial lesions. 7 The liquid-based Pap test also has an advantage for HPV-DNA testing and immunocytochemistry in that residual liquid specimens that re- main after the cytology slide has been made can be used. In the current study, the detection of HPV subtypes was performed with PCR using DNA taken from the residual cells of liquid samples used for the liquidbased Pap smear.…”

Section: Discussionmentioning

confidence: 99%

“…6 The introduction of the Bethesda system has made the interpretation of findings more uniform and liquid-based technology has decreased the false-negative results found in cervical cytology. 7 In gynecologic cytology, many studies have shown that the liquid-based Pap test significantly increases the detection of squamous intraepithelial lesions compared with the conventional Pap test. 8 Conversely, it is well known that human papillomavirus (HPV) infection plays a crucial role in the development of various preneoplastic and neoplastic cervical lesions and the progression of these lesions largely depends on the infection of high-risk HPV subtypes such as HPV-16, HPV-18, HPV-31,etc.…”

mentioning

confidence: 99%

Usefulness of liquid-based cytology specimens for the immunocytochemical study of p16 expression and human papillomavirus testing

Yoshida

Fukuda

Sano

et al. 2004

Cancer

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“…Recent clinical series (1)(2)(3) have suggested that the ThinPrep PapTest™ (Cytyc Corporation, Boxborough, Massachusetts) is more sensitive than the traditional Pap smear for the detection of cervical squamous intraepithelial lesions (SIL). In addition, the ThinPrep Pap test has the added benefit that a residual sample, especially in problematic cases, can be used to test for human papillomavirus (HPV) DNA using the Hybrid Capture II technique (4).…”

mentioning

confidence: 99%

HPV DNA Testing of the Residual Sample of Liquid-Based Pap Test: Utility as a Quality Assurance Monitor

2001

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Use of the Thin Prep� Pap Test? in clinical practice

Cited by 74 publications

References 14 publications

Direct comparison of liquid‐based and conventional cytology in a South African screening trial

Direct comparison of liquid‐based and conventional cytology in a South African screening trial

Usefulness of liquid-based cytology specimens for the immunocytochemical study of p16 expression and human papillomavirus testing

HPV DNA Testing of the Residual Sample of Liquid-Based Pap Test: Utility as a Quality Assurance Monitor

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