Comparison of Conventional Pap Smear and Liquid Based Cytology in Screening of Cervical Cancer

WHO has started a worldwide program to expand prevention, screening and treatment efforts to eradicate cervical cancer as a public health issue in the 21st century. A delayed diagnosis and a poor prognosis for cervical cancer may result from a lack of knowledge of screening procedures, risk factors and symptoms. There was relatively little knowledge of symptoms and risk factors in both rural and urban settings. Therefore many awareness programmes and screening are highly required to diagnose cervical cancer in prior.1 The American College of Obstetricians and Gynecologists (ACOG) guidelines 2021, recommends the screening for cervical cancer from 21 years of age and then every 3 years.18

 Cervical cancer is preceded by squamous intraepithelial lesions which can be detected before it becomes invasive and this serves as the basis of the cytological screening. The abnormal cells shed by the cervical lesions can be detected on cytological examination. In cervical cancer screening, the papanicoloau smear also known as pap smear plays a significant role on the morbidity and mortality from cervical cancer. Ayre’s spatula and cyto brush are used to collect sample from cervix. The samples are fixed using ethyl alcohol and stained with papanicoloau stain for microscopic examination. The pap test detects most cervical neoplasia during the usually prolonged premalignant or early occult malignant phases.3

 Liquid-based cytology (LBC), the monolayer slide preparation method has proven to be more effective than traditional pap smears due to its enhanced fixation, reduced obscuring factors and consistent cell transfer. In LBC, samples are collected by completely immersing the sampling device into the vial containing preservative fluid, whereby the cells are preserved and fixed simultaneously. This enhances the quality of screening by preserving the morphology of the cells to be examined.4

 Prevention of cervical cancer lies mainly in early detection and thus regular screening is recommended. The present study is undertaken to compare the conventional pap smear and liquid based cytology in cervical cancer screening.