Comparison of conventional and liquid-based cytology: do the diagnostic benefits outweigh the financial aspect?

Abstract

We aimed to compare the efficiency of conventional cytology (CC) and new liquid-based cytology (LBC) techniques in the assessment and the accuracy of Pap smears reported as abnormal by histological examinations. Materials and methods: A total of 3488 women who were undergoing routine cervical screening (1308 CC and 2180 LBC) were included in the initial screening. The results were assessed as either satisfactory or unsatisfactory. Satisfactory results were subdivided as negative, atypical squamous cells of undetermined significance (ASCUS), atypical squamous cells for which high-grade lesions could not be excluded (ASC-H), low-grade squamous intraepithelial lesion (LGSIL), high-grade squamous intraepithelial lesion (HGSIL), and cancer. Results: These data show that the rate of unsatisfactory results for the LBC technique (0.05%) was lower than for the CC group (0.5%). Except for ASCUS and cancer cytology, all other atypical cytology results were diagnosed more frequently with CC than with LBC. The rates of detected ASC-H and HGSIL were higher with CC than LBC, and the difference was statistically significant (P < 0.05). Conclusion: LBC has higher satisfaction rates than CC. LBC also detected more true-abnormal cases when compared with CC. The residual specimens from the LBC technique can be used to detect human papillomavirus DNA through immunocytochemistry, if needed. However, the benefits of LBC do not seem to justify the cost. It seems that CC should be the first choice for developing countries with lower incomes.