Review of available scientific and technical evidence regarding liquid-based cytology.
DOI:
https://doi.org/10.19230/jonnpr.1378Keywords:
Cervical Cancer, cervical intraepithelial neoplasia, Liquid-based citology, Papanicolaou test, Cervical cancer screening, Prevention of cervical cancer, Cervical Cancer diagnostic techniquesAbstract
Introduction. Cervical cancer can be prevented by early diagnosis and treatment of patients with abnormal results, thus decreasing their incidence and mortality. In contrast to conventional techniques (Papanicolau), diagnostic techniques have been developed based on the preservation of the sample in a stabilizing solution (liquid-based cytology). The different methods of liquid-based cytology used in the screening of cervical cancer against the Papanicolau technique are evaluated.
Material and methods. A systematic review of the literature has been performed (2010-2015). The search was developed by including MeSH terms as cervical intraepithelial neoplasia and papilloma virus infection in the MedLine, Embase, Cochrane Library, CRD, LILACS and IBECS databases. Inclusion criteria were adult women screened for cervical cancer using liquid-based cytology techniques, compared with conventional methods.
Results. 464 references were found related to the reliability-precision of the test, of which 13 were included in the report. A health technology assessment report was conducted in 2013 by the Agency for Health Technology Assessment of Andalusia (AETSA). The quality of the studies was moderate and moderate-low. AETSA found studies that included more than 700,000 women between 14 and 90 years old, who were screened by liquid-based cytology, compared to the conventional one. Studies have shown that liquid-based cytology techniques reduce the percentage of unsatisfactory samples compared to conventional ones. The analysis of detection of cellular abnormalities and diagnostic validity indexes showed significant differences when comparing both methods.
Conclusions. The studies analyzed presented methodological limitations. Hence, the results should be interpreted with caution. Liquid-based cytology did not present greater diagnostic capacity than conventional methods, but it reduced, with statistically significant results, the number of samples unsatisfactory compared to conventional cytology.
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