Rejected and unsatisfactory specimens: A comparative study of liquid-based (SurePath) preparations and conventional pap smears for cervicovaginal screening

Abstract

Background: The liquid-based preparation (LBP) has become the primary method for cervicovaginal screening. Methods: We conducted a retrospective study with the objective of comparing LBP with the conventional Pap smear (CP). Results: Of the smears that were collected using CP, a total of 312 (0.17%) specimens were classified as "Rejected" and 1,040 (0.55%) as "Unsatisfactory." The proportion of specimens collected using LBP that were categorized as "Rejected" or "Unsatisfactory" were 0.27% (n=369) and 0.22% (n=302), respectively. Independent of the technique, cellular inadequacy (n=1,150, 85.7%) and mis-/no labeling (n=647, 93.8%) were the 2 primary reasons for such classification. With LBP, the laboratory absorbed an additional $2,812.80 in total direct cost. Conclusion: Implementation of LBP has yielded a significant decline in the proportion of "Unsatisfactory," but an increase in the proportion of "Rejected," specimens. With LBP, the direct cost increased; however, in cost-benefit analysis of health services, all direct and indirect costs should be included.