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Published on: July 21, 2009
Cytologic detection of cervical abnormalities using liquid-based compared with conventional cytology: a randomized
Albertus G Siebers1, Paul J J M Klinkhamer, Marc Arbyn
1From the Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; PAMM Laboratories, Eindhoven, the Netherlands; Scientific Institute of Public Health, Brussels, Belgium, and European Cooperation on Development and Implementation of Cancer Screening and Prevention Guidelines, International Agency for Research on Cancer, Lyon, France; and Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
Liquid-based cytology showed no significant difference in test positivity rates compared to conventional methods. However, it did significantly reduce the number of unsatisfactory test results in cervical screening.
Area of Science:
- Gynecologic Oncology
- Cytopathology
- Public Health Screening
Background:
- Cervical cancer screening programs aim to detect precancerous lesions early.
- Liquid-based cytology (LBC) is a newer method compared to conventional cytology (CC).
- Evaluating the comparative effectiveness of LBC and CC is crucial for optimizing screening protocols.
Purpose of the Study:
- To compare the test positivity rates between liquid-based cytology and conventional cytology.
- To assess the impact of LBC on the rate of unsatisfactory cervical cytology tests.
Main Methods:
- A cluster randomized controlled trial involving 89,784 women aged 30-60 years within the Dutch national cervical screening program.
- Randomization was performed at the family practice level, comparing LBC (49,222 participants) with CC (40,562 participants).
- Per-protocol analysis was used to compare crude and adjusted odds ratios for test positivity.
Main Results:
- No statistically significant differences in test positivity rates were observed for atypical squamous cells of undetermined significance or more severe (OR 0.95), low-grade squamous intraepithelial lesion or more severe (OR 1.00), or high-grade squamous intraepithelial lesion or more severe (OR 0.97).
- Liquid-based cytology resulted in significantly fewer unsatisfactory tests (OR 0.30).
- Adjusting for covariates did not alter these findings.
Conclusions:
- Liquid-based cytology does not significantly alter cytologic test positivity rates compared to conventional cytology.
- Liquid-based cytology offers a significant advantage by reducing the incidence of unsatisfactory test preparations.
- These findings support the use of LBC in cervical screening programs to improve sample quality.
