Effectiveness of liquid-based cytology and Papanicolaou tests in a low risk population

Objective To compare sensitivity and effectiveness of ThinPrep vs. Pap Test and determine whether the Hybrid Capture System II (HCII) for detection of human papillomavirus (HPT) could increase the sensitivity and effectiveness of cervical screening in a low risk population. Study Design We present a comparative observer, blind, "split sample" study of ThinPrep and Papanicolaou staining in a population of 2,026 consecutive women. Results Conventional Papanicolaou stain detected lesions in 62 cases (3.06%.), including 1 atypical glandular cell of undetermined significance (A GUS), 34 atypical squamous cells of undetermined significance (ASCUS) (1.73% of atypias), 20 (0.99%) low squamous intraepithelial lesions (LSIL), and 7 (0.35%) high grade squamous intraepithelial lesions (HSIL). ThinPrep detected lesions in 63 cases (3.11%), including 26 (1.28%) ASCUS, 27 (1.33%) LSIL and 10 (0.49%) HSIL. Despite this overall similarity, only 3 5 had a coincident cytopathologic result by both methods. The ic concordance index between ThinPrep and Pap was 0.546. Sensitivity and specificity were 74.6 and 45.0 in TbinPrep and 69.5 and 25.0 in Papanicolaou-stained smears. High risk HPV(HR-HPT) was positive in 13 of 20 ASCUS and in 21 of 22 SIL. Conclusion Technologies now widely available such as Thin Prep and viral detection aim to improve accuracy of screening.