Role of Conventional Pap Smear in Current Times

Abstract

Abstract Cervical cancer is the fourth most common malignancy among females after breast, colon, and lung cancers and a leading cause of mortality among gynecologic malignancies. Over 85% of new cases are diagnosed in resource-limited countries. Several screening techniques have been developed to detect precancerous changes timely. The most common of which is conventional Pap smear (CPS). It is based on the cytological and morphology assessment of exfoliated cervical cells to detect preinvasive lesions of the cervix. Despite high specificity, a single Pap test has a low-to-moderate sensitivity. CPS can have false-negative and false-positive results because of inadequate sampling and slide preparation and errors in laboratory detection and interpretation. To overcome these shortcomings, liquid-based cytology (LBC) was introduced. LBC can be a better alternative to CPS because of a lower rate of unsatisfactory smears. The liquid reserve can be used for ancillary testing, such as human papillomavirus DNA tests (as reflex test and co-test). The cost of this technique is a limiting factor. In most of the developed countries, CPS is replaced by the LBC. There are several studies with conflicting results, and no method has been shown to be superior in terms of all parameters. Relevant studies were searched using PubMed/MEDLINE and Google Scholar. This article puts forward the results of various studies comparing the efficacy of CPS and LBC and highlights the advantages and disadvantages of both methods.