The promise and risk of a new technology

Dupree, William B.; Suprun, F.I.A.C. Harry Z.; Beckwith, David G.; Shane, John J.; Lucente, Vincent

doi:10.1002/(sici)1097-0142(19980825)84:4<202::aid-cncr4>3.0.co;2-o

Cited by 46 publications

(2 citation statements)

References 35 publications

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“…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. 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.…”

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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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: 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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“…The clinical and scientific allure of liquid based technology has been explored extensively. 5 Most western countries have switched over from CPS to LBC, even though sensitivity and specificity is almost similar in various comparison studies. The reason for this may be consistently increased rates of satisfactory results for epithelial abnormalities on LBC, clarity of microscopy, improved sample processing, and small area to be screened.…”

Section: Discussionmentioning

confidence: 97%

Comparative study of conventional papanicolaou smears and liquid based direct-to-vial thin-layer preparation in the detection of microorganisms in cervical smears

2020

ACHR

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Introduction: In addition to its primary benefit as a cancer screening test, other benefits of Pap test include detection of cervicovaginal microorganisms. Very few studies have been performed in our country to compare Liquid based cytology (LBC) and Conventional papanicolaou smear (CPS) for detection of cervicovaginal infection by microorganisms. Materials and Methods: Our study focuses on non neoplastic findings which correlate to the presence of Microorganisms-Trichomonas Vaginalis, Candida Species, Bacterial Species, Actinomycosis Species, and Herpes simplex virus. Papanicolaou smear by conventional and liquid based cytology have been used to study effectiveness of each method in diagnostic cytology. A comparative prospective study from March 2017 to May 2017 of 45 split samples for comparing effectiveness of liquid based Thin-layer preparation with that of conventional papanicolaou (Pap) smears to demonstrate microorganisms in cervicovaginal smears was undertaken. These two methods have been compared for reporting the presence of microorganisms, essential for a complete diagnostic evaluation of cervicovaginal specimens by the 2001 Bethesda system under the specific category of "Organisms". Results: Altered Flora (AF) Bacterial Vaginosis (BV) in CPS and by LBC were reported. Candidal infection, Trichomonas infection and Leptothrix were compared in CPS and LBC preparations. The comparison showed that Candidal hyphae were more easily seen on LBC while the Candidal yeast forms are more easily detected on CPS. Trichomonas & shift of vaginal flora are detected more easily on CPS than on LBC preparations. Conclusion: Our findings suggest utility of both methods for the detection of microorganisms commonly seen in cervical cytology practice.

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Comparison of Liquid-Based Cytology With Conventional Cytology for Detection of Cervical Cancer Precursors

Siebers¹,

Klinkhamer²,

Grefte³

et al. 2009

JAMA

224

126

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The promise and risk of a new technology

Cited by 46 publications

References 35 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

Comparative study of conventional papanicolaou smears and liquid based direct-to-vial thin-layer preparation in the detection of microorganisms in cervical smears

Comparison of Liquid-Based Cytology With Conventional Cytology for Detection of Cervical Cancer Precursors

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