Applications of automation in cervical cancer screening

To increase the sensitivity of the cervical Papanicolaou (Pap) smear, several automated devices now are commercially available. In the last 2 years, the U.S. Food and Drug Administration approved three of these devices, each of which operates differently from the others. The ThinPrep 2000 is a method whereby the traditional Pap smear is substituted by a liquid-based smear collection technique that allows the preparation of thin layers, which addresses the problems of obscuring blood, inflammation, and overlapping cells on traditional smears. The AutoPap 300 QC is a rescreening device that selects from a batch of negative smears the 10% most likely abnormal smears for manual rescreening. The PAPNET Testing System is a neural network-based semiautomated screening system used for adjunctive testing of negative Pap smears. The system selects and displays the most abnormal-looking cells for review by the cytotechnologist, thus improving the detection of missed abnormalities. The effectiveness of the introduction of these devices for cervical cancer detection is discussed.