Comparing the effectiveness of liquid based cytology with conventional PAP smear and colposcopy in screening for cervical cancer and it’s correlation with histopathological examination: a prospective study

Authors

  • N. Shanmugapriya Department of Obstetrics and Gynecology, Government Dharmapuri Medical College Hospital, Dharmapuri, Tamilnadu, India
  • P. Devika Department of Obstetrics and Gynecology, Government Dharmapuri Medical College Hospital, Dharmapuri, Tamilnadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20175238

Keywords:

Cervical cancer, Colposcopy, LBC, Molecular testing, PAP Smear, Unsatisfactory smears

Abstract

Background: Cervical cancer remains worldwide the second most common cancer among women and is unique among human cancers, entirely attributable to infection. Although routine cytological screening has resulted in large reduction in the cervical cancer burden in our country, still the incidence rates continue to be unabated for want of effective screening programs.

Methods: This is a prospective study which was conducted in the Department of Obstetrics and Gynecology. The study included 200 women who were randomly selected attending gynecology

OPD and who fulfilled the inclusion criteria. All the selected patients were subjected to pap smear, LBC and colposcopy and histopathology done for suspected cases.

Results: The differences of sensitivity and specificity between LBC, PAP smear and colposcopy in detection of premalignant lesions were analyzed using the chi square test. The sensitivity of LBC (89.5%) was significantly higher than sensitivity of PAP smear (47.37%). P <0.001. The specificity of PAP smear (95.06%) was higher than LBC (77.16%). The statistical analysis between LBC and PAP smear; LBC and colposcopy were significant (P=0.000<0.05).

Conclusions: Liquid based cytology increases the sensitivity of cervical cancer detection and its ability to do molecular testing using the same sample. LBC also improves sample quality by reducing the number of unsatisfactory smears, reduces the number of false negative smears, causes reduction in interobserver bias and less time consuming.

References

Purandare CN. Down staging cervical cancer in resource poor settings. J Obstet Gynecol India. 2010 Jun;60(3):205.

Kerkar RA, Kulkarni YV. Screening for cervical cancer: an overview. J Obstet Gynecol India. 2006 Mar;56(2):115-22.

Goldie SJ, Kuhn L, Denny L, Pollack A, Wright TC. Policy analysis of cervical cancer screening strategies in low-resource settings: clinical benefits and cost-effectiveness. JAMA. 2001 Jun 27;285(24):3107-15.

Shastri SS, Dinshaw K, Amin G, Goswami S, Patil S, Chinoy R, Kane S, Kelkar R, Muwonge R, Mahé C, Ajit D. Concurrent evaluation of visual, cytological and HPV testing as screening methods for the early detection of cervical neoplasia in Mumbai, India. Bulletin of the World Health Organization. 2005 Mar;83(3):186-94.

Khanna A, Gupta R, Kumar M. Comprehensive evaluation of cervical cancer. Indian J Prevent Soc Med. 2003;34(3-4):139-46.

Sherwani RK, Khan T, Akhtar K, Zeba A, Siddiqui FA, Rahman K, Afsan N. Conventional Pap smear and liquid based cytology for cervical cancer screening-A comparative study. J Cytol. 2007 Oct 1;24(4):167.

Ferris DG, HEIDERMANN NL, Litaker MS, Crosby JH, Macfee MS. Efficacy of liquid-based cervical cytology using direct-to-vial sample collection. J Fam Pract. 2000 Nov 1;49(11):1005.

Bergeron C, Bishop J, Lemarie A, Cas F, Ayivi J, Huynh B, Barrasso R. Accuracy of thin-layer cytology in patients undergoing cervical cone biopsy. Acta Cytologica. 2001;45(4):519-24.

Katyal S, Mehrotra R. Complementary procedures in cervical cancer screening in low resource settings. J Obstet gynecol India. 2011 Aug 1;61(4):436-8.

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Published

2017-11-23

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Original Research Articles