Actual frequency of unsatisfactory specimens and its changes by introducing The Bethesda System 2001 to cervical cancer screening

浩邦, 高野; 十九三, 河西; 篤子, 早田; 美津子, 立花; 康夫, 石塚; 真, 茂木; 譲, 小竹; 真紀夫, 生水; 寛, 佐々木; 忠夫, 田中

doi:10.5795/jjscc.50.158

Cited by 1 publication

(1 citation statement)

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“…After full‐text screening, 11 publications were excluded: five studies that did not adopt TBS, two studies that evaluated partially overlapping participants, one that assessed data from unclear settings, one that assessed data from hospital settings, one that assessed data from laboratory settings, and one review without original data. Finally, 17 studies (three direct, eight indirect, and one both comparison studies between CC and LBC, and five studies assessing CC only) including 1 497 451 unique healthy women were eligible.…”

Section: Resultsmentioning

confidence: 99%

Frequency of unsatisfactory cervical cytology smears in cancer screening of Japanese women: A systematic review and meta‐analysis

et al. 2018

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The Bethesda system (TBS) has been used for cervical cytological diagnosis in Japan since 2008. Evaluation of specimen adequacy is the most important aspect of quality assurance and for precise diagnosis in TBS. A systematic review and meta‐analysis were carried out to assess the unsatisfactory specimen rate in the primary cervical cancer screening setting in Japan. Ovid Medline and Ichushi‐Web databases were searched from inception through to May 2017. Prospective and retrospective studies that reported the proportion of unsatisfactory specimens in healthy asymptomatic Japanese women in a cervical cancer screening program were eligible for inclusion; 17 studies were included in the meta‐analysis. The random‐effects model meta‐analysis calculated summary estimates of the unsatisfactory rate of 0.60% (95% confidence interval [CI], 0.18‐1.96%; I 2 = 99%) for conventional cytology and 0.04% (95% CI, 0.00‐0.35%; I 2 = 99%) for liquid‐based cytology (LBC). However, comparative results between conventional and liquid‐based cytology, based on four direct and nine comparative studies, showed no significant difference (summary odds ratio = 3.5 × 10−2 favoring LBC [95% CI, 6.9 × 10−4‐1.7]; I 2 = 98%). In the subgroup analyses and meta‐regressions, use of non‐cotton devices for conventional cytology and use of a particular platform for LBC were associated with lower unsatisfactory rates. Meta‐regression also suggested chronological improvement in unsatisfactory rates for both tests. In Japanese cervical cancer screening programs, conventional cytology remains prevalent. Future research needs to focus on evaluating the impact of screening programs using LBC by comparing the accuracy, performance, and cost‐effectiveness with conventional cytology in the Japanese population.

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Section: Resultsmentioning

confidence: 99%