A randomised comparison of SurePath liquid-based cytology and conventional smear cytology in a colposcopy clinic setting
Article first published online: 15 SEP 2008
© 2008 The Authors Journal compilation © RCOG 2008 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 115, Issue 11, pages 1375–1381, October 2008
How to Cite
Sykes, P., Harker, D., Miller, A., Whitehead, M., Neal, H., Wells, J. and Peddie, D. (2008), A randomised comparison of SurePath liquid-based cytology and conventional smear cytology in a colposcopy clinic setting. BJOG: An International Journal of Obstetrics & Gynaecology, 115: 1375–1381. doi: 10.1111/j.1471-0528.2008.01865.x
- Issue published online: 15 SEP 2008
- Article first published online: 15 SEP 2008
- Accepted 25 June 2008.
- Cervical cytology;
- liquid-based cytology;
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.