Objective: It was the aim of this study to compare diagnostic performances of the BD SurePath™ liquid-based Papanicolaou test (LBC) and the conventional Papanicolaou test (CPT) in cervical samples of women from remote rural areas of Brazil. Study Design: Specimens were collected by mobile units provided by Barretos Cancer Hospital. This report evaluates the manual screening arm of the RODEO study. Of 12,048 women seen between May and December 2010, 6,001 were examined using LBC and 6,047 using CPT. Results: Comparative (LBC vs. CPT) outcomes were: all abnormal tests, 2.1 versus 1.0%; ASC-US (atypical squamous cells of unknown significance), 0.7 versus 0.1%; ASC-H (atypical squamous cells with possible high-grade squamous intraepithelial lesions) and AGC (atypical glandular cells), 0.4 versus 0.3%; LSIL (low-grade squamous intraepithelial lesions), 0.7 versus 0.3%; HSIL (high-grade squamous intraepithelial lesions), 0.4 versus 0.2%, and unsatisfactory, 0.03 versus 0.08%. The LBC arm detected significantly more lesions (ASC-US+) than CPT (p < 0.001); however, when we divided the diagnoses into two groups, ASC-H– (negative/ASC-US/LSIL) and ASC-H+ (ASC-H/AGC/HSIL), the difference was not statistically important (p = 0.213). Conclusions: With inherent difficulties in patient recruitment and patient compliance with cancer screening, best test performance including human papillomavirus test capability are vitally necessary in Brazil’s struggle to reduce cervical cancer.

Mauad EC, Nicolau SM, Moreira LF, et al: Adherence to cervical and breast cancer programs is crucial to improving screening performance. Rural Remote Health 2009;9:1241.
Mauad EC, Gomes UA, Nogueira JL, et al: Prevention of cervical cancer in a poor population in Brazil. Fam Pract 2002;19:189–192.
Mauad EC, Nicolau SM, Gomes UA, et al: Can mobile units improve the strategies for cervical cancer prevention? Diagn Cytopathol 2010;38:727–730.
Longatto-Filho A, Schmitt FC: Gynecological cytology: too old to be a pop star but too young to die. Diagn Cytopathol 2007;35:672–673.
Gamarra CJ, Valente JG, Silva GA: Correction for reported cervical cancer mortality data in Brazil, 1996–2005. Rev Saude Publica 2010;44:629–638.
Longatto-Filho A, Schmitt FC: Cytology education in the 21st century: living in the past or crossing the Rubicon? Acta Cytol 2010;54:654–656.
Solomon D, Davey D, Kurman R, Moriarty A, O’Connor D, Prey M, Raab S, Sherman M, Wilbur D, Wright T Jr, Young N, Forum Group Members, Bethesda 2001 Workshop: The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA 2002;287:2114–2119.
Azevedo e Silva G, Girianelli VR, Gamarra CJ, Bustamante-Teixeira MT: Cervical cancer mortality trends in Brazil, 1981–2006. Cad Saude Publica 2010;26:2399–2407.
Longatto-Filho A, Pereira SM, Di Loreto C, et al: DCS liquid-based system is more effective than conventional smears to diagnosis of cervical lesions: study in high-risk population with biopsy-based confirmation. Gynecol Oncol 2005;97:497–500.
Davey E, Barratt A, Irwig L, et al: Effect of study design and quality on unsatisfactory rates, cytology classifications, and accuracy in liquid-based versus conventional cervical cytology: a systematic review. Lancet 2006;367:122–132.
Arbyn M, Bergeron C, Klinkhamer P, et al: Liquid compared with conventional cervical cytology: a systematic review and meta-analysis. Obstet Gynecol 2008;111:167–177.
Longatto-Filho A, Maeda MY, Erzen M, et al: Conventional Pap smear and liquid-based cytology as screening tools in low-resource settings in Latin America: experience of the Latin American screening study. Acta Cytol 2005;49:500–506.
Forouzanfar MH, Foreman KJ, Delossantos AM, Lozano R, Lopez AD, Murray CJ, Naghavi M: Breast and cervical cancer in 187 countries between 1980 and 2010:a systematic analysis. Lancet 2011;378:1461–1484.
Brotherton JM, Fridman M, May CL, Chappell G, Saville AM, Gertig DM: Early effect of the HPV vaccination programme on cervical abnormalities in Victoria, Australia: an ecological study. Lancet 2011;377:2085–2092.
Sarian LO, Derchain S, Shabalova I, Tatti S, Naud P, Longatto-Filho A, Syrjänen S, Syrjänen K, Members of the Latin American Screening Study (LAMS), New Independent States of the Former Soviet Union (NIS) groups: Optional screening strategies for cervical cancer using stand alone tests and their combinations among low- and medium-income populations in Latin America and Eastern Europe. J Med Screen 2010;17:195–203.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.