Featured Research

from universities, journals, and other organizations

Alternative To Pap Test Does Not Appear To Be Better For Detecting Cervical Cancer

Date:
January 6, 2010
Source:
JAMA and Archives Journals
Summary:
A Dutch study that included nearly 90,000 women finds that liquid-based cytology, a commonly used alternative to conventional Pap tests, is not superior to Pap tests for the detection of cervical cancer precursors or cancer, according to a new study.

A Dutch study that included nearly 90,000 women finds that liquid-based cytology, a commonly used alternative to conventional Pap tests, is not superior to Pap tests for the detection of cervical cancer precursors or cancer, according to a study in the October 28 issue of JAMA.

Due to false-negative and false-positive test results, the papanicolaou (Pap) test is considered suboptimal. For the liquid-based cytology (use of cells), the cervical cells are collected with a traditional sampling device and rinsed into a vial with preservation solution rather than being smeared on a slide, according to background information in the article. Despite numerous studies, some uncertainty remains about its diagnostic accuracy.

Albertus G. Siebers, M.Sc., of Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands, and colleagues compared the screening performance of Pap tests and liquid-based cytology in terms of test positivity rates, histological detection rates and positive predictive values (PPVs). The randomized controlled trial involved 89,784 women ages 30 to 60 years who participated in a Dutch cervical screening program at 246 family practices. One hundred twenty-two practices were assigned to use liquid-based cytology and screened 49,222 patients and 124 practices were assigned to use the conventional PAP test and screened 40,562 patients. Patients were screened for cervical intraepithelial neoplasia (CIN) and were followed up for 18 months, through January 2008.

The researchers found that the adjusted detection rate ratios for CIN grade 1+ was 1.01; for CIN grade 2+, 1.00; for CIN grade 3+, 1.05; and for carcinoma, 1.69. "The adjusted positive predictive value ratios, considered at several cytological cutoffs and for various outcomes of CIN did not differ significantly from unity."

"Because of randomization, it can plausibly be assumed that the prevalence of CIN was equal in both study groups. Therefore, the lack of difference in detection rates and PPV in this trial demonstrates that liquid-based cytology is neither more sensitive nor more specific in detecting cervical cancer precursors than the conventional Pap smear."

"As shown in a previous publication, no differences were found in the cytological test positivity rates between methods. Nevertheless, these cytological findings contribute insufficient evidence to claim equal diagnostic accuracy. Both the intention-to-treat and per protocol analyses demonstrated that liquid-based cytology was not superior to Pap test regarding detection rates of histologically confirmed outcomes. The same was found for the PPVs. Altogether, these findings provide strong evidence that the performance of liquid-based cytology is not superior to that of the conventional Pap test when applied within a well-organized and quality-controlled cervical screening program," the authors write.

Editorial: Screening and Prevention Methods for Cervical Cancer

In an accompanying editorial, Mark Schiffman M.D., M.P.H., and Diane Solomon, M.D., of the National Cancer Institute, Bethesda, Md., comment on the findings of this study.

"It is a challenging time to be a clinician or health planner dedicated to cervical cancer prevention. Even though an increasingly powerful set of prevention tools is available, no combination of vaccination, cytology, HPV testing, colposcopy, and novel methods will be suitable for all settings. Even in the most wealthy regions, using vaccination, cytology, and HPV testing without careful planning would invite waste and, more importantly, overtreatment. For those designing rational cervical cancer prevention programs, Siebers et al have convincingly simplified one aspect of a complex health policy puzzle. Physicians and other health professionals can choose either liquid-based cytology or conventional Pap smear as they discuss how cytology fits into the larger picture."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal References:

  1. Albertus G. Siebers; Paul J. J. M. Klinkhamer; Johanna M. M. Grefte; Leon F. A. G. Massuger; Judith E. M. Vedder; Angelique Beijers-Broos; Johan Bulten; Marc Arbyn. Comparison of Liquid-Based Cytology With Conventional Cytology for Detection of Cervical Cancer Precursors: A Randomized Controlled Trial. JAMA, 2009; 302 (16): 1757-1764 [link]
  2. Mark Schiffman; Diane Solomon. Screening and Prevention Methods for Cervical Cancer. JAMA, 2009; 302 (16): 1809-1810 [link]

Cite This Page:

JAMA and Archives Journals. "Alternative To Pap Test Does Not Appear To Be Better For Detecting Cervical Cancer." ScienceDaily. ScienceDaily, 6 January 2010. <www.sciencedaily.com/releases/2009/10/091027161528.htm>.
JAMA and Archives Journals. (2010, January 6). Alternative To Pap Test Does Not Appear To Be Better For Detecting Cervical Cancer. ScienceDaily. Retrieved August 20, 2014 from www.sciencedaily.com/releases/2009/10/091027161528.htm
JAMA and Archives Journals. "Alternative To Pap Test Does Not Appear To Be Better For Detecting Cervical Cancer." ScienceDaily. www.sciencedaily.com/releases/2009/10/091027161528.htm (accessed August 20, 2014).

Share This




More Health & Medicine News

Wednesday, August 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola-Hit Sierra Leone's Freetown a City on Edge

Ebola-Hit Sierra Leone's Freetown a City on Edge

AFP (Aug. 19, 2014) Residents of Sierra Leone's capital voice their fears as the Ebola virus sweeps through west Africa. Duration: 00:56 Video provided by AFP
Powered by NewsLook.com
101-Year-Old Working Man Has All The Advice You Need

101-Year-Old Working Man Has All The Advice You Need

Newsy (Aug. 19, 2014) Herman Goldman has worked at the same lighting store for almost 75 years. Find out his secrets to a happy, productive life. Video provided by Newsy
Powered by NewsLook.com
Researcher Testing on-Field Concussion Scanners

Researcher Testing on-Field Concussion Scanners

AP (Aug. 19, 2014) Four Texas high school football programs are trying out an experimental system designed to diagnose concussions on the field. The technology is in response to growing concern over head trauma in America's most watched sport. (Aug. 19) Video provided by AP
Powered by NewsLook.com
American Ebola Patient Apparently Improving, Outbreak Is Not

American Ebola Patient Apparently Improving, Outbreak Is Not

Newsy (Aug. 19, 2014) Nancy Writebol, an American missionary who contracted Ebola, is apparently getting better, according to her husband. The outbreak, however, is not. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins