Unsatisfactory SurePath liquid‐based Papanicolaou tests

Alsharif, Mariam; McKeon, Dan M.; Gulbahce, H. Evin; Savik, Kay; Pambuccian, Stefan E.

doi:10.1002/cncy.20009

Cited by 26 publications

(23 citation statements)

References 46 publications

(43 reference statements)

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“…This indicates that women with unsatisfactory results by either LBC or CP were not at higher risk for cervical abnormalities during the 18 months of followup in this trial. In contrast to our results, Alsharif et al 20 found that unsatisfactory SurePath tests had a higher risk of significant abnormalities on follow-up. However, a significant verification bias might have influenced their results.…”

Section: Resultscontrasting

confidence: 99%

See 1 more Smart Citation

Causes and Relevance of Unsatisfactory and Satisfactory but Limited Smears of Liquid-Based Compared With Conventional Cervical Cytology

Siebers¹,

Klinkhamer²,

Vedder³

et al. 2012

Archives of Pathology &Amp; Laboratory Medicine

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N Context.-Recent randomized controlled trials have shown a significant decrease in unsatisfactory rates for liquid-based cytology (LBC) compared with conventional Papanicolaou test (CP). The underlying causes and relevance of unsatisfactory results for LBC and CP have never been compared within the setting of a randomized controlled trial.Objective.-To examine differences in causes and relevance of unsatisfactory and satisfactory but limited by (SBLB) results for LBC and CP.Design.-Data from the Netherlands ThinPrep Versus Conventional Cytology (NETHCON) trial were used, involving 89 784 women. Causes and relevance of unsatisfactory and SBLB results were analyzed.Results.-The primary cause for unsatisfactory results for CP and LBC was scant cellularity. Other causes for unsatisfactory CPs were virtually eliminated with LBC. The same was true for SBLB subcategories, with the exception of SBLB absence of transformation zone component and SBLB scant cellularity. The SBLB absence of transformation zone component showed a statistically significant 22% and SBLB scant cellularity a 12% nonsignificant increase with LBC. The detection rates of abnormalities found during 18 months of follow-up of unsatisfactory test results did not differ significantly between the 2 study arms, nor did they differ from the initial test positivity rates from the NETHCON trial.Conclusions.-Liquid-based cytology shows an almost complete elimination of most causes for unsatisfactory CP, with scant cellularity remaining as the sole cause for unsatisfactory LBC. On the other hand, with LBC a significant increase of smears without a transformation zone component was noted. Women with an unsatisfactory test result are not at increased risk for cervical abnormalities either with LBC or with CP.Trial Registration.-Nederlands Trial Register, NTR1032, www.trialregister.nl.(Arch Pathol Lab Med. 2012;136:76-83; doi: 10.5858/ arpa.2011-0113-OA) L iquid-based cytology (LBC) has been largely adopted as an alternative to cervical cancer screening with conventional Papanicolaou tests (CP) in many Western countries. However, recent evidence from 2 randomized controlled trials (RCTs) 1,2 and a meta-analysis comparing the performance of LBC and CP 3 supports the conclusion of equal accuracy for both methods. Yet the RCT has shown a significant decrease in unsatisfactory rates for LBC as compared with CP. 4 Unsatisfactory tests account for a number of screening failures, and are a source of distress to women and a waste of resources.5 It is assumed that LBC decreases the unsatisfactory rate by reducing the number of cases that are inadequate because of obscuring inflammatory cells and blood or because of inhomogeneous distribution or bad fixation of cells. However, to our knowledge differences in the underlying causes and relevance of unsatisfactory smear results for LBC as compared with CP have never been investigated within the setting of an RCT. The aim of the study is to examine the underlying causes for inadequacy in LBC and CP, using the data of the Neth...

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Section: Resultscontrasting

confidence: 99%

“…They also showed that a large majority of the US laboratories used the Bethesda 2001 criteria for specimen cellularity. More recently, Alsharif et al 20 investigated causes and significance of unsatisfactory results with SurePath and also found scant cellularity as primary cause of an unsatisfactory test result.…”

Section: Resultsmentioning

confidence: 99%

Causes and Relevance of Unsatisfactory and Satisfactory but Limited Smears of Liquid-Based Compared With Conventional Cervical Cytology

Siebers¹,

Klinkhamer²,

Vedder³

et al. 2012

Archives of Pathology &Amp; Laboratory Medicine

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“…Recently, Alsharif et al reported a low insufficiency rate (0.23%) for the SurePath Pap test. 14 In contrast, ThinPrep, using a filter to remove nondiagnostic debris, was designed to optimize cell density for cytology slide preparation during specimen processing. Therefore, specimens with low cellularity may lead to sample insufficiency for a subsequent Hybrid Capture 2 testing.…”

Section: Discussionmentioning

confidence: 99%

Hybrid capture 2 human papillomavirus DNA testing for women with atypical squamous cells of undetermined significance papanicolaou results in SurePath and ThinPrep specimens

Siddiqi

Spataro

McIntire

et al. 2009

Cancer Cytopathology

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BACKGROUND:Human papillomavirus (HPV) DNA testing using Hybrid Capture 2 assay with ThinPrep Papanicolaou (Pap) collection is the only US Food and Drug Administration‐approved method for the triage of women with atypical squamous cells of undetermined significance (ASCUS). Although SurePath Pap collection has been used for Hybrid Capture 2 HPV DNA testing, clinical validation of this method has been scarce.METHODS:From a cervical cancer‐screening program in Mississippi, we analyzed data from screenings of 8380 women with ASCUS Pap results who underwent reflex Hybrid Capture 2 HPV DNA tests during a course of 4 years. Of these, 4145 were screened with the ThinPrep collection system, and 4235 were screened with SurePath. Results of follow‐up biopsies within 3 months of Pap tests were available for the ThinPrep group (229 cases) and the SurePath group (455 cases). Hybrid Capture 2 positive rates and the follow‐up biopsy results from both groups were compared.RESULTS:Hybrid Capture 2 detected high‐risk HPV DNA in 68.8% of ThinPrep and 66.7% of SurePath‐collected specimens (P = .37). Detection rates for CIN2+ and CIN3+ were also comparable between ThinPrep (21.4%, 3.1%) and SurePath (15.4%, 4.2%) using Hybrid Capture 2 (P = .06, P = .45). In ThinPrep‐collected specimens, 4.4% were quantitatively insufficient for Hybrid Capture 2 testing. Significantly more equivocal Hybrid Capture 2 results were observed in SurePath (11.4%) than in ThinPrep specimens (3.2%). However, 67.4% of women with equivocal Hybrid Capture 2 results had negative 1‐year Pap cytology follow‐up in the SurePath group.CONCLUSIONS:Hybrid Capture 2 positive rates and CIN2‐3 detection rates were comparable for the SurePath and ThinPrep Pap collection systems, thus supporting the use of SurePath for Hybrid Capture 2 testing. Cancer (Cancer Cytopathol) 2009. © 2009 American Cancer Society.

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“…A recent study conducted in the United States found that women who had unsatisfactory cytology results were older, menopausal, and/or posthysterectomy than those who did not have unsatisfactory results. 3 Various studies like those by The ASCUS is an intriguing, often confusing cytological entity in the management of cervical cancer. The false reporting of ASCUS is increased with the use of Pap smear due to misinterpretation of inflammatory and reparative processes as ASCUS in smears.…”

Section: Discussionmentioning

confidence: 99%

Liquid-based Cytology vs Conventional Cytology as a Screening Tool for Cervical Cancer in Postmenopausal Women

Singh¹,

Singh²,

Qureshi³

et al. 2017

Journal of South Asian Federation of Obstetrics and Gynaecology

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Aim: To evaluate and compare the efficacy of liquid-based cytology (LBC) with conventional cytology (CS) as a screening tool for cervical cancer in postmenopausal women. Materials and methods:This was an observational crosssectional study conducted over one year. Subjects were recruited from patients attending the outpatient department of the Department of Obstetrics and Gynecology, King George's Medical University, Lucknow, Uttar Pradesh, India. Pap smear and LBC were taken in all subjects. In cases with suspected lesions, the discrepancy between Pap smear and LBC and colposcopy was found.Results: Pap smear reported 14.3% inadequate smears in women with postmenopausal changes and 5% inadequate smears in women without postmenopausal changes. In contrast, LBC reported no inadequate smear. This difference was statistically significant (p = 0.011). Cervical neoplasia was ruled out in 53.6% cases by Pap smear and 75.8% cases by LBC. The difference was statistically significant (p = 0.002). Conclusion:Liquid-based cytology offers better results in detecting cervical pathology when compared with Pap smear. Liquid-based cytology could be better as a screening method, especially in postmenopausal women in which the screening is challenging due to menopause-induced anatomical and hormonal changes.Clinical significance: Cervical cancer is the most common genital cancer among Indian women. Postmenopausal women are at higher risk for developing cervical cancer. Low estrogenic state poses a challenge for detection of cervical cancer by CS in postmenopausal women. We investigated LBC as a better cervical cancer screening tool in this age group.

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Unsatisfactory SurePath liquid‐based Papanicolaou tests

Cited by 26 publications

References 46 publications

Causes and Relevance of Unsatisfactory and Satisfactory but Limited Smears of Liquid-Based Compared With Conventional Cervical Cytology

Causes and Relevance of Unsatisfactory and Satisfactory but Limited Smears of Liquid-Based Compared With Conventional Cervical Cytology

Hybrid capture 2 human papillomavirus DNA testing for women with atypical squamous cells of undetermined significance papanicolaou results in SurePath and ThinPrep specimens

Liquid-based Cytology vs Conventional Cytology as a Screening Tool for Cervical Cancer in Postmenopausal Women

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