Improving cervical cytology screening in a remote, high risk population.
prospective_cohort · Level II
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Abstract
OBJECTIVE: To evaluate the use of the ThinPrep method to reduce rates of unsatisfactory Papanicolaou (Pap) smears in women in remote communities. DESIGN: Prospectively collected samples were split and screened conventionally and by ThinPrep at the Queensland Cytology Service. PATIENTS: Three hundred women having cervical smears taken by a Mobile Women's Health Service nurse or at the antenatal and sexual health clinics of a remote north Queensland community. MAIN OUTCOME MEASURE: Number of Pap smears reported as unsatisfactory for evaluation and requiring a repeat smear request. RESULTS: 17.3% of conventionally prepared smears were technically unsatisfactory, compared with 6.3% prepared with ThinPrep. The overall rate of unsatisfactory smears was only 4.3% when both ThinPrep and conventional smears were assessed for a combined report. CONCLUSION: A significant reduction in the proportion of unsatisfactory Pap smears is possible with the ThinPrep method. Targeted use of ThinPrep in communities with high rates of unsatisfactory smears may prove cost-effective.