Introduction/Background Cervical Cancer is the fourth most common cancer affecting women worldwide. It is curable if detected early by screening. In this part of the world, where conventional screening method is used, it becomes important to analyse the newer LBC for screening.
Methodology This was a prospective observational study over a period of one year. 457 subjects between 21–65 years were recruited who underwent cytology screening by both conventional Pap Smear and LBC. The following parameters were compared for both methods: a) Sensitivity and Specificity (histopathology as the gold standard) b) Number of unsatisfactory smears c) Ease of test- duration required for sample interpretation
Cytology report of ASCUS+ was taken as positive. All subjects with positive cytology underwent colposcopy-directed biopsy
Results Out of 457 samples, 4.3% were positive by conventional method and 7.2% by LBC. Conventional PAP Smear had an unsatisfactory rate of 14%. There were no unsatisfactory smears in LBC. On evaluating High-Grade Conventional Pap Smears for CIN 2 +, the Sensitivity was 14.2%, Specificity 97.5%, PPV 33.3%, NPV 91.8% with accuracy of 91.1% whereas high-grade LBC for the detection of CIN 2 or worse, the Sensitivity was 100%, Specificity 96.4%, PPV 70%, NPV 100% with Accuracy of 96.6%. Conventional Smears were screened in 4 minutes/slide and LBC in 2.2 minutes/slide respectively(P<0.05).
Conclusion There is a significant reduction in the number of unsatisfactory smears with LBC when compared to conventional cytology. On comparing the Cytology of high-grade smears for CIN 2+, LBC had more Sensitivity, Positive Predictive Value and Negative Predictive Value with a high Accuracy even though Specificity was comparable. The most accurate results are got by LBC when a high-Grade Cytology threshold is used to detect High Grade Biopsies. LBC has the best balance of Sensitivity and Specificity. LBC also requires lesser time for interpretation of results.
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