Abstract
Objective: The aim of this study was to compare the performance of the current conventional Pap smear with liquid-based cytology (LBC) preparations. Study Design: Women routinely undergoing their cytopathological and histopathological examinations at Fundação Oncocentro de São Paulo (FOSP) were recruited for LBC. Conventional smears were analyzed from women from other areas of the State of São Paulo with similar sociodemographic characteristics. Results: A total of 218,594 cases were analyzed, consisting of 206,999 conventional smears and 11,595 LBC. Among the conventional smears, 3.0% were of unsatisfactory preparation; conversely, unsatisfactory LBC preparations accounted for 0.3%. The ASC-H (atypical squamous cells - cannot exclude high-grade squamous intraepithelial lesion) frequency did not demonstrate any differences between the two methods. In contrast, the incidence of ASC-US (atypical squamous cells of undetermined significance) was almost twice as frequent between LBC and conventional smears, at 2.9 versus 1.6%, respectively. An equal percentage of high-grade squamous intraepithelial lesions were observed for the two methods, but not for low-grade squamous intraepithelial lesions, which were more significantly observed in LBC preparations than in conventional smears (2.2 vs. 0.7%). The index of positivity was importantly enhanced from 3.0% (conventional smears) to 5.7% (LBC). Conclusions: LBC performed better than conventional smears, and we are truly confident that LBC can improve public health strategies aimed at reducing cervical lesions through prevention programs.
Journal Section:
Editor's choice
References
1.
Ferlang J, Shin HR, Forman D, Forman D, Mathers C, Parkin DM: Estimates of the worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127:2893-2917.
[PubMed]
2.
Arbyn M, Castellsague M, de Sanjose S, Bruni L, Saraiya M, Bray F, Ferlay J: Worldwide burden of cervical cancer in 2008. Ann Oncol 2011;22:2675-2686.
[PubMed]
3.
INCA: ESTIMATIVA 2014: incidência de câncer no Brasil. http://www.inca.gov.br/estimativa/2014/.
4.
Lynge E, Antilla A, Arbyn M, Segnan N, Ronco G: What's next? Perspectives and future needs of cervical screening in Europe in the era of molecular testing and vaccination. Eur J Cancer 2009;45:2714-2721.
[PubMed]
5.
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.
[PubMed]
6.
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.
[PubMed]
7.
Schmitt FC, Longatto-Filho A, Valent A, Vielh P: Molecular techniques in cytopathology practice. J Clin Pathol 2008;61:258-267.
[PubMed]
8.
Isidean SD, Franco EL: Embracing a new era in cervical cancer screening. Lancet 2014;383:493-494.
[PubMed]
9.
Arbyn M, Bergeron C, Klinkhamer P, Martin-Hirsch P, Siebers AG, Bulten J: Liquid compared with conventional cervical cytology: a systematic review and meta-analysis. Obstet Gynecol 2008;111:167-177.
[PubMed]
10.
Zheng B, Austin RM, Liang X, Li Z, Chen C, Yan S, Zhao C: Bethesda System reporting rates for conventional Papanicolaou tests and liquid-based cytology in a large Chinese, college of American pathologists-certified independent medical laboratory: analysis of 1,394,389 Papanicolaou test reports. Arch Pathol Lab Med 2015;139:373-737.
[PubMed]
11.
Scapulatempo C, Fregnani JH, Campacci N, Possati-Resende JC, Longatto-Filho A, Rodeo Study Team: The significance of augmented high-grade squamous intraepithelial lesion detection on Pap test examination: partial results from the RODEO study team. Acta Cytol 2013;57:489-494.
[PubMed]
12.
Fregnani JH, Scapulatempo C, Haikel RL Jr, Saccheto T, Campacci N, Mauad EC, Longatto-Filho A, RODEO Study Team: Could alarmingly high rates of negative diagnoses in remote rural areas be minimized with liquid-based cytology? Preliminary results from the RODEO Study Team. Acta Cytol 2013;57:69-74.
[PubMed]
13.
Saieg MA, Motta TH, Fodra ME, Scapulatempo C, Longatto-Filho A, Stiepcich MM: Automated screening of conventional gynecological cytology smears: feasible and reliable. Acta Cytol 2014;58:378-382.
[PubMed]
14.
Navarro C, Fonseca AJ, Sibajev A, Souza CI, Araújo DS, Teles DA, Carvalho SG, Cavalcante KW, Rabelo WL: Cervical cancer screening coverage in a high-incidence region. Rev Saude Publica 2015;49:1-8.
[PubMed]
15.
Allemani C, Weir HK, Carreira H, et al: Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet 2015;385:977-1010.
[PubMed]
16.
The NHS Information Centre, Screening and Immunisations Team: Cervical screening programme, England, 2011. http://www.cancerscreening.nhs.uk/cervical/cervical-statistics-bulletin-2010-11.pdf.
17.
Nygård JF, Skare GB, Thoresen SØ: The cervical cancer screening programme in Norway, 1992-2000: changes in Pap smear coverage and incidence of cervical cancer. J Med Screen 2002;9:86-91.
[PubMed]
18.
Renshaw AA, Young NA, Birdsong GG, Styer PE, Davey DD, Mody DR, Colgan TJ: Comparison of performance of conventional and ThinPrep gynecologic preparations in the College of American Pathologists Gynecologic Cytology Program. Arch Pathol Lab Med 2004;128:17-22.
[PubMed]
19.
Ronco G, Cuzick J, Pierotti P, Cariaggi MP, Dalla Palma P, Naldoni C, Ghiringhello B, Giorgi-Rossi P, Minucci D, Parisio F, Pojer A, Schiboni ML, Sintoni C, Zorzi M, Segnan N, Confortini M: Accuracy of liquid based versus conventional cytology: overall results of new technologies for cervical cancer screening: randomised controlled trial. BMJ 2007;335:28.
[PubMed]
20.
Longatto-Filho A, Naud P, Derchain SF, Roteli-Martins C, Tatti S, Hammes LS, Sarian LO, Eržen M, Branca M, de Matos JC, Gontijo R, Maeda MY, Lima T, Costa S, Syrjänen S, Syrjänen K: Performance characteristics of Pap test, VIA, VILI, HR-HPV testing, cervicography, and colposcopy in diagnosis of significant cervical pathology. Virchows Arch 2012;460:577-585.
[PubMed]
21.
Siebers AG, Arbyn M, Melchers WJ, van Kemenade FJ, Vedder JE, van der Linden H, van Ballegooijen M, Bekkers RL, Bulten J: Effectiveness of two strategies to follow-up ASC-US and LSIL screening results in The Netherlands using repeat cytology with or without additional hrHPV testing: a retrospective cohort study. Cancer Causes Control 2014;25:1141-1149.
[PubMed]
22.
Vanni T, Legood R, Franco EL, Villa LL, Luz PM, Schwartsmann G: Economic evaluation of strategies for managing women with equivocal cytological results in Brazil. Int J Cancer 2011;129:671-679.
[PubMed]
23.
Cummings MC, Marquart L, Pelecanos AM, Perkins G, Papadimos D, O'Rourke P, Ross JA: Which are more correctly diagnosed: conventional Papanicolaou smears or Thinprep samples? A comparative study of 9 years of external quality-assurance testing. Cancer Cytopathol 2015;123:108-116.
[PubMed]
24.
Stein MD, Fregnani JH, Scapulatempo C, Mafra A, Campacci N, Longatto-Filho A, RODEO Study Team from Barretos Cancer Hospital: Performance and reproducibility of gynecologic cytology interpretation using the FocalPoint system: results of the RODEO Study Team. Am J Clin Pathol 2013;140:567-571.
[PubMed]
25.
Wilbur DC, Black-Schaffer WS, Luff RD, Abraham KP, Kemper C, Molina JT, Tench WD: The Becton Dickinson FocalPoint GS Imaging System: clinical trials demonstrate significantly improved sensitivity for the detection of important cervical lesions. Am J Clin Pathol 2009;132:767-775.
[PubMed]
26.
Monsonego J, Hudgens MG, Zerat L, Zerat JC, Syrjänen K, Smith JS: Risk assessment and clinical impact of liquid-based cytology, oncogenic human papillomavirus (HPV) DNA and mRNA testing in primary cervical cancer screening (The FASE Study). Gynecol Oncol 2012;125:175-180.
[PubMed]
© 2015 S. Karger AG, Basel
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.
2015
You do not currently have access to this content.
