Liquid Compared With Conventional Cervical Cytology

Arbyn, Marc; Bergeron, Christine; Klinkhamer, Paul J. J. M.; Martin-Hirsch, P; Siebers, Albertus G.; Bulten, Johan

doi:10.1097/01.aog.0000296488.85807.b3

Cited by 400 publications

(288 citation statements)

References 46 publications

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“…Earlier publications found an increased detection rate of HSIL as summarized in several reviews. [5][6][7] More recently, some HTAs and systematic reviews 8,11,12 using stringent criteria did not show superiority of LBC over CC. Additionally, two recent large randomized studies, which were situated within organized screening programs did not observe a higher relative sensitivity of LBC for histologically confirmed CIN compared with CC.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7] Health technology assessments (HTA) and meta-analysis reviews as well as two recent, large randomized trials which were conducted in the context of organized screening programs did not find a higher sensitivity of LBC for the detection of cervical intraepithelial neoplasia grade 2 and higher (CIN2þ). [8][9][10][11][12] LBC has advantages such as faster reading of slides, fewer unsatisfactory specimens, and the possibility to use residual liquid sample for testing of Human Papillomavirus (HPV) and other molecular markers. 9,11,13,14 A disadvantage is the higher cost of LBC.…”

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confidence: 99%

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A randomized trial comparing conventional cytology to liquid‐based cytology and computer assistance

Klug

Neis

Harlfinger³

et al. 2012

Intl Journal of Cancer

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Liquid-based cytology (LBC) has replaced conventional cytology (CC) for cervical cancer screening in some countries. However, it remains unclear whether LBC is superior to CC. A randomized controlled trial was conducted between August 2007 and March 2009 in Germany to compare LBC, alone and in combination with computer-assisted imaging technology (CAS), to CC in the detection of histologically confirmed cervical intraepithelial neoplasia (CIN). The main outcome measures were detection rates, relative sensitivities, positive predictive values (PPVs) and relative PPVs comparing LBC without and with CAS to CC. Primary histological outcome was CIN2 or higher. Included were 20,627 women participating in opportunistic cervical cancer screening at 20 gynecologic practices. The practices were randomized weekly to use LBC (n 5 11,331) or CC (n 5 9,296). Patients with positive findings were invited to expert colposcopy. The relative sensitivity of LBC versus CC using the CIN21 cut-off was 2.74 (95% confidence interval [CI] 1.66-4.53). The relative sensitivity of LBC/CAS versus CC for CIN21 was 3.17 (95% CI 1. 94-5.19). The PPV of LBC and CC for CIN21 was 48% and 38%, respectively. The PPV ratio did not differ significantly from unity. Differences between LBC and CC were smaller in some sensitivity and subgroup analyses; however, relative sensitivity of LBC remained increased. LBC without and with CAS compared with CC under the field conditions of an opportunistic screening system had a significantly higher sensitivity for the detection of CIN without deterioration of PPVs. Additional use of CAS did not further improve sensitivity of LBC. V C 2012 Wiley Periodicals, Inc.Key words: randomized controlled trial, early detection of cancer, uterine cervical neoplasm, Papanicolaou smear, liquid-based cytology, computer-assisted imaging technology Additional Supporting Information may be found in the online version of this article. Stefanie J. Klug, Jochem K€ onig and Hans Ikenberg had full access to all the data of the study. They take responsibility for the integrity of the data and the accuracy of the data analysis. Hans Ikenberg, Stefanie J. Klug, Klaus J. Neis and Werner Harlfinger take responsibility for the study concept and design. Werner Harlfinger and Klaus J. Neis take responsibility for the acquisition of data. Stefanie J. Klug, Jochem K€ onig, Veronika Weyer and Hans Ikenberg take responsibility for the analysis and interpretation of data. Stefanie J. Klug and Hans Ikenberg take responsibility for the drafting of the manuscript. All are responsible for the critical revision of the manuscript for important intellectual content. Jochem K€ onig, Veronika Weyer and Stefanie J. Klug did the statistical analysis. Werner Harlfinger, Klaus J. Neis, Armin Malter and Hans Ikenberg obtained funding. Sibylle Spieth, Friederike Brinkmann-Smetanay and Friedrich Kommoss had the administrative, technical or material support. Study supervision is by Hans Ikenberg, Werner Harlfinger, Klaus J. Neis and Stefanie J. Klug. Stefanie J. Klu...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

A randomized trial comparing conventional cytology to liquid‐based cytology and computer assistance

Klug

Neis

Harlfinger³

et al. 2012

Intl Journal of Cancer

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“…LBP is an alternative technique for transferring the cellular material collected from the transformation zone of the uterine cervix. In contrast to CPS, the cells are not directly spread on a slide, but rather into a vial containing fixative liquid (Arbyn et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Cervical Cytological Screening Results of 8,495 Cases in Turkey - Common Inflammation but Infrequent Epithelial Cell Abnormalities?

Daloglu

Karakaya²,

Balta³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…The effectiveness of the cervical programme therefore relies on multiple opportunities at identifying and treating CIN. The use of liquid based cytology (LBC) has shown a reduction in the number of inadequate smears, but a recent systematic review and meta-analysis by Arbyn et al found that LBC did not improve the detection of high grade CIN and that LBC was neither more sensitive nor specific than conventional cytology [3].…”

Section: Introductionmentioning

confidence: 99%

The detection of cervical intraepithelial neoplasia by electrical impedance spectroscopy: The effects of acetic acid and tissue homogeneity

Balasubramani¹,

Brown²,

Healey³

et al. 2009

Gynecologic Oncology

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Liquid Compared With Conventional Cervical Cytology

Abstract: Liquid-based cervical cytology is neither more sensitive nor more specific for detection of high-grade cervical intraepithelial neoplasia compared with the conventional Pap test.

Cited by 400 publications

References 46 publications

A randomized trial comparing conventional cytology to liquid‐based cytology and computer assistance

A randomized trial comparing conventional cytology to liquid‐based cytology and computer assistance

Cervical Cytological Screening Results of 8,495 Cases in Turkey - Common Inflammation but Infrequent Epithelial Cell Abnormalities?

The detection of cervical intraepithelial neoplasia by electrical impedance spectroscopy: The effects of acetic acid and tissue homogeneity

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