Age-specific patterns of unsatisfactory results for conventional Pap smears and liquid-based cytology: Data from two randomised clinical trials

Philip E. Castle, J. Bulten, M. Confortini, P. Klinkhamer, A. Pellegrini, Ag Siebers, G. Ronco, M. Arbyn

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective To investigate the rate of unsatisfactory cervical cell samples in liquid-based cytology (LBC) versus conventional cytology (CC) by age. Design Randomised clinical trials. Setting Population-based cervical cancer screening in the Netherlands and Italy. Population Asymptomatic women invited for screening enrolled in two randomised trials: Netherlands ThinPrep® versus conventional cytology (NETHCON; 39 010 CC, 46 064 LBC) and New Technologies in Cervical Cancer Screening (NTCC; 22 771 CC, 22 403 LBC). Methods Comparison of categorical variables using Pearson's chi-square test, logistic regression and trend tests. Main outcome measures Proportion of unsatisfactory samples, ratio of LBC versus CC, and variation by 5-year group. Results In NETHCON, a lower percentage of LBC samples were judged to be unsatisfactory compared with CC samples (0.33 versus 1.11%). There was no significant trend in unsatisfactory results by age group for conventional cytology (Ptrend = 0.54), but there was a trend towards an increasing percentage of unsatisfactory results with increasing age for LBC (Ptrend < 0.001). In NTCC, a lower percentage of LBC samples were judged to be unsatisfactory compared with conventional cytology (2.59 versus 4.10%). There was a decrease in the unsatisfactory results by age group with conventional cytology (P trend < 0.001) and with LBC (Ptrend = 0.01), although the latter trend arose from the 55-60-years age group (Ptrend = 0.62 when excluding this group). Conclusions The clinical trial in which the results were collected and the cytologic method used were the most important determinants of unsatisfactory cytology. In all situations, the proportion of unsatisfactory samples was lower in LBC compared with CC. The effects of age depended on the criteria used to define unsatisfactory results.

Original languageEnglish (US)
Pages (from-to)1067-1073
Number of pages7
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume117
Issue number9
DOIs
StatePublished - 2010
Externally publishedYes

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Papanicolaou Test
Cell Biology
Randomized Controlled Trials
Age Groups
Early Detection of Cancer
Uterine Cervical Neoplasms
Netherlands

Keywords

  • Cervical cancer screening
  • conventional cytology
  • liquid-based cytology
  • Pap smear
  • specimen adequacy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Age-specific patterns of unsatisfactory results for conventional Pap smears and liquid-based cytology : Data from two randomised clinical trials. / Castle, Philip E.; Bulten, J.; Confortini, M.; Klinkhamer, P.; Pellegrini, A.; Siebers, Ag; Ronco, G.; Arbyn, M.

In: BJOG: An International Journal of Obstetrics and Gynaecology, Vol. 117, No. 9, 2010, p. 1067-1073.

Research output: Contribution to journalArticle

Castle, Philip E. ; Bulten, J. ; Confortini, M. ; Klinkhamer, P. ; Pellegrini, A. ; Siebers, Ag ; Ronco, G. ; Arbyn, M. / Age-specific patterns of unsatisfactory results for conventional Pap smears and liquid-based cytology : Data from two randomised clinical trials. In: BJOG: An International Journal of Obstetrics and Gynaecology. 2010 ; Vol. 117, No. 9. pp. 1067-1073.
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abstract = "Objective To investigate the rate of unsatisfactory cervical cell samples in liquid-based cytology (LBC) versus conventional cytology (CC) by age. Design Randomised clinical trials. Setting Population-based cervical cancer screening in the Netherlands and Italy. Population Asymptomatic women invited for screening enrolled in two randomised trials: Netherlands ThinPrep{\circledR} versus conventional cytology (NETHCON; 39 010 CC, 46 064 LBC) and New Technologies in Cervical Cancer Screening (NTCC; 22 771 CC, 22 403 LBC). Methods Comparison of categorical variables using Pearson's chi-square test, logistic regression and trend tests. Main outcome measures Proportion of unsatisfactory samples, ratio of LBC versus CC, and variation by 5-year group. Results In NETHCON, a lower percentage of LBC samples were judged to be unsatisfactory compared with CC samples (0.33 versus 1.11{\%}). There was no significant trend in unsatisfactory results by age group for conventional cytology (Ptrend = 0.54), but there was a trend towards an increasing percentage of unsatisfactory results with increasing age for LBC (Ptrend < 0.001). In NTCC, a lower percentage of LBC samples were judged to be unsatisfactory compared with conventional cytology (2.59 versus 4.10{\%}). There was a decrease in the unsatisfactory results by age group with conventional cytology (P trend < 0.001) and with LBC (Ptrend = 0.01), although the latter trend arose from the 55-60-years age group (Ptrend = 0.62 when excluding this group). Conclusions The clinical trial in which the results were collected and the cytologic method used were the most important determinants of unsatisfactory cytology. In all situations, the proportion of unsatisfactory samples was lower in LBC compared with CC. The effects of age depended on the criteria used to define unsatisfactory results.",
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T1 - Age-specific patterns of unsatisfactory results for conventional Pap smears and liquid-based cytology

T2 - Data from two randomised clinical trials

AU - Castle, Philip E.

AU - Bulten, J.

AU - Confortini, M.

AU - Klinkhamer, P.

AU - Pellegrini, A.

AU - Siebers, Ag

AU - Ronco, G.

AU - Arbyn, M.

PY - 2010

Y1 - 2010

N2 - Objective To investigate the rate of unsatisfactory cervical cell samples in liquid-based cytology (LBC) versus conventional cytology (CC) by age. Design Randomised clinical trials. Setting Population-based cervical cancer screening in the Netherlands and Italy. Population Asymptomatic women invited for screening enrolled in two randomised trials: Netherlands ThinPrep® versus conventional cytology (NETHCON; 39 010 CC, 46 064 LBC) and New Technologies in Cervical Cancer Screening (NTCC; 22 771 CC, 22 403 LBC). Methods Comparison of categorical variables using Pearson's chi-square test, logistic regression and trend tests. Main outcome measures Proportion of unsatisfactory samples, ratio of LBC versus CC, and variation by 5-year group. Results In NETHCON, a lower percentage of LBC samples were judged to be unsatisfactory compared with CC samples (0.33 versus 1.11%). There was no significant trend in unsatisfactory results by age group for conventional cytology (Ptrend = 0.54), but there was a trend towards an increasing percentage of unsatisfactory results with increasing age for LBC (Ptrend < 0.001). In NTCC, a lower percentage of LBC samples were judged to be unsatisfactory compared with conventional cytology (2.59 versus 4.10%). There was a decrease in the unsatisfactory results by age group with conventional cytology (P trend < 0.001) and with LBC (Ptrend = 0.01), although the latter trend arose from the 55-60-years age group (Ptrend = 0.62 when excluding this group). Conclusions The clinical trial in which the results were collected and the cytologic method used were the most important determinants of unsatisfactory cytology. In all situations, the proportion of unsatisfactory samples was lower in LBC compared with CC. The effects of age depended on the criteria used to define unsatisfactory results.

AB - Objective To investigate the rate of unsatisfactory cervical cell samples in liquid-based cytology (LBC) versus conventional cytology (CC) by age. Design Randomised clinical trials. Setting Population-based cervical cancer screening in the Netherlands and Italy. Population Asymptomatic women invited for screening enrolled in two randomised trials: Netherlands ThinPrep® versus conventional cytology (NETHCON; 39 010 CC, 46 064 LBC) and New Technologies in Cervical Cancer Screening (NTCC; 22 771 CC, 22 403 LBC). Methods Comparison of categorical variables using Pearson's chi-square test, logistic regression and trend tests. Main outcome measures Proportion of unsatisfactory samples, ratio of LBC versus CC, and variation by 5-year group. Results In NETHCON, a lower percentage of LBC samples were judged to be unsatisfactory compared with CC samples (0.33 versus 1.11%). There was no significant trend in unsatisfactory results by age group for conventional cytology (Ptrend = 0.54), but there was a trend towards an increasing percentage of unsatisfactory results with increasing age for LBC (Ptrend < 0.001). In NTCC, a lower percentage of LBC samples were judged to be unsatisfactory compared with conventional cytology (2.59 versus 4.10%). There was a decrease in the unsatisfactory results by age group with conventional cytology (P trend < 0.001) and with LBC (Ptrend = 0.01), although the latter trend arose from the 55-60-years age group (Ptrend = 0.62 when excluding this group). Conclusions The clinical trial in which the results were collected and the cytologic method used were the most important determinants of unsatisfactory cytology. In all situations, the proportion of unsatisfactory samples was lower in LBC compared with CC. The effects of age depended on the criteria used to define unsatisfactory results.

KW - Cervical cancer screening

KW - conventional cytology

KW - liquid-based cytology

KW - Pap smear

KW - specimen adequacy

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