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BJOG. 2008 Oct;115(11):1375-81. doi: 10.1111/j.1471-0528.2008.01865.x.

A randomised comparison of SurePath liquid-based cytology and conventional smear cytology in a colposcopy clinic setting.

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  • 1Department of Obstetrics and Gynaecology, University of Otago, Christchurch, New Zealand. peter.sykes@otago.ac.nz

Abstract

OBJECTIVE:

The objective of this study was to compare the sensitivity of cervical cytology using conventional smears and SurePath liquid-based cytology (LBC).

DESIGN:

Prospective randomised evaluation of diagnostic test.

SETTING:

A single institution colposcopy clinic.

POPULATION:

Women attending first visit colposcopy appointments were offered entry into the study.

METHODS:

Cervical cytology samples from 913 women of age 16-75 years were randomly processed as SurePath LBC or conventional smears. Conventional smears were taken for 453 women and a SurePath LBC taken for 451 women. Cytology results were correlated with colposcopic findings and histology from colposcopic biopsies, treatment and follow up.

MAIN OUTCOME MEASURES:

To compare the sensitivity of SurePath LBC and conventional smears for histologically proven abnormality. Other outcome measures include a comparison of their sensitivity for high-grade abnormalities and their satisfactory rate.

RESULTS:

Accounting for all randomised samples, there was a trend towards improved sensitivity for SurePath LBC (79.1 versus 73.7%, P = 0.1). However, excluding unsatisfactory cytology (and samples not taken) eliminated this trend; the sensitivity for both LBC and conventional smears for any epithelial abnormality was 81%. With a threshold of atypical squamous cells of uncertain significance (ASC-US), both SurePath LBC and conventional smears had a sensitivity of 92% for high-grade lesions. SurePath LBC was less likely to be reported as unsatisfactory (2.7 versus 9.1%, P < 0.0001).

CONCLUSIONS:

In this context, with a threshold of ASC-US, both SurePath LBC and conventional smears offer high sensitivity for the detection of CIN2/3, but SurePath LBC is less likely to be reported as unsatisfactory.

[PubMed - indexed for MEDLINE]
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