The impact of liquid-based cytology in decreasing the incidence of cervical cancer

Abstract

Major advances in screening have lowered the death rate from cervical cancer in the United States. One of the first major advances in cervical cancer screening was the Papanicolaou (Pap) test. The second major advance was liquid-based cytology (LBC). This review presents a wide range of data, discusses the strengths and weaknesses of the available information regarding Pap technologies, and reviews the meta-analyses, which have examined the differences in clinical performance. The review concludes with information on new and future developments to further decrease cervical cancer deaths.

Keywords: Cervical cancer detection; Liquid-based cytology; Papanicolaou test.

Figures

Figure 1

Decrease in cervical cancer incidence rates in the United States over the past quarter century. Data from SEER Cancer Statistics Review, 1975–2005.

Figure 2

ThinPrep® System (Hologic, Inc, Marlborough, MA) sample processing and analysis. Processing a Thin-Prep Pap test sample for analysis involves three essential steps: (i) Rotation of the filter within the sample vial creates currents in the fluid that separate debris and disperse mucus yet preserve cell morphology; (ii) A gentle vacuum (controlled by software for the ThinPrep Processor) created within the filter collects cells on the exterior surface of the membrane; (iii) After the cells are collected on the membrane, the filter is inverted and gently pressed against the microscope slide. Natural attraction and slight positive air pressure cause the cells to adhere to the slide, resulting in an even distribution of cells in a defined circular area.