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- Title
Liquid-based cytology versus conventional Papanicolaou smear in an organized screening program.
- Authors
Strander, Björn; Andersson-Ellström, Agneta; Milsom, Ian; Rådberg, Thomas; Ryd, Walter
- Abstract
BACKGROUND. The objective of this study was to evaluate whether liquid-basedcytology (LBC) can improve high-standard cervical cancer screening cytology further. The primary endpoint was histopathologic high-grade lesions in current andsubsequent screening rounds. The secondary endpoints were cytologic diagnosisand inadequate samples.METHODS. Women were randomized to smear taking by conventional Papanicolaou (Pap) smear or LBC according to the time of appointment. Eight thousandeight hundred ten conventional Pap smears and 4674 LBC samples wereincluded. Evaluations of atypical cytology and referral to colposcopy and treatment were performed as routine procedures. Histopathologic diagnoses wereretrieved from a regional database 8 months after the study was closed. Themean follow-up was 2 years and 9 months.RESULTS. Inadequate samples were observed in 0.3% of LBC samples versus 0.7%of Pap smears (P = .002). The total fraction of nonbenign diagnoses in cytologywas 4.5% versus 3.5%, respectively (P<.001). Histopathologic evaluation wasmade on 570 patients constituting 4.6% of the LBC samples and 4% of the Papsmears. Forty percent more high-grade lesions were identified as a result of LBCsampling (1.20% vs 0.85%; P = .05). The influence of the sampling method wassignificant for all variables (odds ratio [OR], 1.60; 95% confidence interval [95%CI], 1.12-2.28) for high-grade lesions that were identified by histology whenadjusting for age and screening unit in a logistic regression model. At the secondfollow-up 2 years and 1 month later, the OR was decreased only slightly (1.51;95% CI, 1.13-2.01).CONCLUSIONS. In the ongoing cervical screening program of western Sweden, liquid cytology produced a significantly higher yield of histologic high-grade lesionscompared with conventional Pap smears.
- Subjects
CYTOLOGY; CERVICAL cancer; MEDICAL screening; PAP test; COLPOSCOPY
- Publication
Cancer (0008543X), 2007, Vol 111, Issue 5, p285
- ISSN
0008-543X
- Publication type
Article
- DOI
10.1002/cncr.22953