Abstract
Cervical cancer is the second most frequent cancer in women worldwide, and it is the disease that causes more disability-adjusted life years. Since the introduction of the Papanicolaou test (Pap test) in the 1940s, it has been demonstrated to have a high-yield diagnosis of cervical preneoplastic and neoplastic changes in women worldwide. The Pap test has been subjected to many modifications since the time of its inception to date. However, there is the paucity of data about the environmental impact generated by the use of its toxic-carcinogenic reagents such as hydrochloric acid, ammonia, mercury oxide, and, principally, xylene used for cellular clearing. The aim of this study was to validate the ecologically friendly modification of the Papanicolaou stain (Eco-Pap) for the diagnosis of cervical cancer. A prospective research was performed at the Hospital Nacional Docente Madre-Niño “San Bartolomé” in Lima, Peru, since 2015. Reagent handling strategies were divided into three phases: we used Harris’s progressive hematoxylin (for nuclear staining), a polychromatic solution (a mix of EA-36/O-G to suppress the use of many alcohol baths), and direct mounting (with Entellan solution). The cellular details were analyzed by the Quality Index Staining, an external QC, and under the requirements of Bethesda System 2014. We have evaluated a total of 72,901 cervical smears stained with Eco-Pap. The validation of Eco-Pap against the conventional Pap stain was optimal (κ = 0.89; 95% CI, 0.87% to 0.92%), showing a sensibility and specificity of 88.3% (95% CI, 85.1% to 90.0%) and 98.7% (95% CI, 98% to 99.2%), respectively (P < .05). Eco-Pap reduced dramatically the environmental pollution caused by 72 L of xylene, hydrochloric acid, and ammonia (6 L each) and mercury oxide (1.5 g). The Eco-Pap is an innovative and efficient staining method, reducing the use of toxic reagents with carcinogenic potential during cervical cancer screening by exfoliative cytology.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
