Trials That Matter: Liquid-Based Cervical Cytology: Disadvantages Seem to Outweigh Advantages
Authors: George F. Sawaya, Harold C. Sox
Journal: Annals of Internal Medicine (2007)

Editorials6 November 2007Trials That Matter: Liquid-Based Cervical Cytology: Disadvantages Seem to Outweigh AdvantagesGeorge F. Sawaya, MD and Harold C. Sox, MD, EditorGeorge F. Sawaya, MDFrom the University of California, San Francisco, San Francisco, CA 94143 (Dr. Sawaya).Search for more papers by this author and Harold C. Sox, MD, EditorFrom the University of California, San Francisco, San Francisco, CA 94143 (Dr. Sawaya).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-9-200711060-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Liquid-based cytology is a technique for preserving and preparing cells for cytologic study. As applied to cervical cytology, cells are obtained by scraping the external cervix uteri with a spatula and by rotating a cytobrush in the endocervix. Instead of being spread onto a glass slide and fixed, the samples are suspended in a vial of liquid preservative. In the laboratory, processing removes debris and places a thin layer of cells onto slides that are stained and read similarly to conventional cytology. Systematic reviews have concluded that the quality of the evidence about liquid-based cytology has not been good enough ...References1. Davey E, Barratt A, Irwig L, Chan SF, Macaskill P, Mannes P, 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;367:122-32. [PMID: 16413876] CrossrefMedlineGoogle Scholar2. Hartmann KE, Nanda K, Hall S, Myers E. Technologic advances for evaluation of cervical cytology: is newer better? Obstet Gynecol Surv. 2001;56:765-74. [PMID: 11753179] CrossrefMedlineGoogle Scholar3. Sawaya GF, Washington AE. Cervical cancer screening: which techniques should be used and why? Clin Obstet Gynecol. 1999;42:922-38. [PMID: 10572705] CrossrefMedlineGoogle Scholar4. U.S. Preventive Services Task Force. Cervical cancer screening. Accessed at www.ahrq.gov/clinic/uspstf/uspscerv.htm on 30 August 2007. Google Scholar5. Ronco G, Cuzick J, Pierotti P, Cariaggi MP, Dalla Palma P, Naldoni C, et al. Accuracy of liquid based versus conventional cytology: overall results of new technologies for cervical cancer screening: randomised controlled trial. BMJ. 2007;335:28. [PMID: 17517761] CrossrefMedlineGoogle Scholar6. Cytyc Corporation. The Thin-Prep Pap test. Accessed at www.thinprep.com/thinprep/cervical-cancer.html on 30 August 2007. Google Scholar7. American Cancer Society. American Cancer Society guideline for the early detection of cervical neoplasia and cancer. CA Cancer J Clin. 2002;52:342-62. [PMID: 12469763] CrossrefMedlineGoogle Scholar8. Obwegeser JH, Brack S. Does liquid-based technology really improve detection of cervical neoplasia? A prospective, randomized trial comparing the ThinPrep Pap Test with the conventional Pap Test, including follow-up of HSIL cases. Acta Cytol. 2001;45:709-14. [PMID: 11575648] CrossrefMedlineGoogle Scholar9. Noller KL, Bettes B, Zinberg S, Schulkin J. Cervical cytology screening practices among obstetrician-gynecologists. Obstet Gynecol. 2003;102:259-65. [PMID: 12907097] MedlineGoogle Scholar10. Saint M, Gildengorin G, Sawaya GF. Current cervical neoplasia screening practices of obstetrician/gynecologists in the US. Am J Obstet Gynecol. 2005;192:414-21. [PMID: 15695980] CrossrefMedlineGoogle Scholar11. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin number 66, September 2005. Management of abnormal cervical cytology and histology. Obstet Gynecol. 2005;106:645-64. [PMID: 16135610] MedlineGoogle Scholar12. ASCCP-Sponsored Consensus Conference. 2001 Consensus Guidelines for the management of women with cervical cytological abnormalities. JAMA. 2002;287:2120-9. [PMID: 11966387] CrossrefMedlineGoogle Scholar13. Sawaya GF. A 21-year-old woman with atypical squamous cells of undetermined significance. JAMA. 2005;294:2210-8. [PMID: 16264163] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the University of California, San Francisco, San Francisco, CA 94143 (Dr. Sawaya).Disclosures: None disclosed.Corresponding Author: George F. Sawaya, MD, University of California, San Francisco, 3333 California Street, Suite 335, San Francisco, CA 94143-0856; e-mail, [email protected]ucsf.edu.Current Author Addresses: Dr. Sawaya: University of California, San Francisco, 3333 California Street, Suite 335, San Francisco, CA 94143-0856.Dr. Sox: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByStellenwert von Zytologie, Biopsie und HPV-TestFrom cost-effectiveness information to decision-making on liquid-based cytology: Mind the gapFemale GenitaliaAccess of Black, Hispanic, and Nonprivately Insured Women to Liquid-Based Cytology, Human Papillomavirus DNA Testing, and On-Site Colposcopy in the United States 6 November 2007Volume 147, Issue 9Page: 668-669KeywordsCancer treatmentCell biologyCellsCervical cancer screeningClinical laboratoriesHuman papillomavirusResearch laboratoriesSpecificitySystematic reviews ePublished: 6 November 2007 Issue Published: 6 November 2007 CopyrightCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...