Comparison of liquid-based cytology and conventional papnicolaou smear as a screening tool in high-risk females

Abstract

Introduction: Cervical cancer is the second most common cancer in women in India. Certain high-risk behavior is associated with an increased incidence of cervical cancers. Detection of its premalignant lesions is of utmost importance, which can be easily done by screening methods such as conventional Pap (CP) and liquid-based cytology (LBC). Aim: The aim of the present study was to ascertain the effectiveness of CP and LBC as screening methods in high-risk group females and to determine if any one method is superior to the other. Materials and methods: This study was conducted over a period of 6 months at SN Medical College, Agra. All high-risk group females were included in the study and paired samples for CP and LBC were collected from such patients. A total of 40 such cases were encountered during our study period. Patients having abnormal vaginal bleeding with known uterine or hormonal cause and known case of invasive carcinoma cervix were excluded from the study. Results: A maximum number of cases were in the reproductive age group, most common age of presentation being 31-40 years (35%) followed by 20-30 years (32.5%). A majority of patients were presented with a history of early sexual activity (<18 years) (52.5%), followed by multiparity (25%). Overall CP had 100% sensitivity while LBC had a sensitivity of 91.6%. However, LBC detected one additional case of ASCUS and two additional cases of HSIL over CP. So LBC detected more cases but with a slightly decreased sensitivity over CP. Conclusion: Both the screening methods are very effective and sensitive in the detection of premalignant lesions with slight discordance of grade on histology. Thus, we conclude that cervical cytology is very effective in the detection of premalignant lesions with the sensitivity of almost 100%. In developing countries such as India, where finances pose a major problem, conventional method is as good as LBC.