ABSTRACT
Background: Cervical carcinoma is the fourth most common malignancy worldwide and the fourth most common cause ofdeaths due to cancer worldwide. Conventional Papanicolaou (PAP) smears were used for screening led to a drastic reductionin a number of cervical carcinoma cases, but have high false negativity. Hence, newer methods like liquid-based cytology(LBC) were introduced.Aim: The aim of the study was to compare LBC with conventional PAP smear for cervical cancer screening.Materials and Methods: This study was done on randomly selected 100 patients attending the pilot screening project at atertiary care teaching institute in South India. The sample for conventional PAP smear was taken using Ayre’s spatula andslide prepared. The sample for LBC was taken using the cytobrush, and the sample was rinsed in the fixative provided by themanufacturer. The sample was then centrifuged and slide prepared. Both the slides were then stained using the rapid PAPstain. The slides were analyzed and the following results were obtained.Results: Most of the patients who attended the screening program were in the fourth decade of life. Dysplasia was diagnosedin 26% of cases and most were in the age group of 21–40 years. Most of the cases were in the socioeconomic Class II of themodified Prasad’s classification. Dysplasia was found more in the socioeconomic Class III (12% of cases). 90% of cases startedsexual activity before 25 years of age, and out of these 90 patients, 92.3% had dysplasia. Dysplasia was more in patients withparity 3(14% of cases). 46% of cases presented with white discharge per vaginum. The cytological abnormality was found in28 cases (28%) by LBC, whereas conventional Pap smear detected an abnormality in only 22 cases (22%). 96 cases (96%)were satisfactory for evaluation on LBC and 92 cases (92%) in conventional Pap smear. ASC was found in 12% of cases inconventional PAP whereas it was detected in only 6% of cases in LBC. Low-grade squamous intraepithelial lesion (LSIL) andhigh-grade squamous intraepithelial lesion (HSIL) were found in 8% and 2% of cases in conventional PAP smear whereas itwas found in 12% and 8% of cases in LBC. No carcinoma was found in conventional PAP smear whereas 2% of cases hadcarcinoma features in LBC. Sensitivity and specificity of PAP smear in detecting LSIL was 40% and 93% whereas for HSILit is 50% and 100%. Sensitivity and specificity of LBC in detecting LSIL is 66% and 94% whereas for HSIL it was 100% and96%. Overall sensitivity and specificity for conventional PAP smear is 55.5% and 83.7% whereas for LBC it is 83% and 86.5%,respectively. There was a medium level of correlation between conventional PAP smear and LBC (r = 0.59).Conclusion: LBC is strongly advocated in the best interest of public health especially in countries like India where more numberof people are in the lower socioeconomic status category. It improves the sample quality and reduces the likelihood of falsenegative results and hence improving the efficacy of the screening programs.