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Trials That Matter: Liquid-Based Cervical Cytology: Disadvantages Seem to Outweigh Advantages

George F. Sawaya, MD; and Harold C. Sox, MD, Editor
[+] Article, Author, and Disclosure Information

From the University of California, San Francisco, San Francisco, CA 94143 (Dr. Sawaya).

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: George F. Sawaya, MD, University of California, San Francisco, 3333 California Street, Suite 335, San Francisco, CA 94143-0856; e-mail, sawayag@obgyn.ucsf.edu.

Current Author Addresses: Dr. Sawaya: University of California, San Francisco, 3333 California Street, Suite 335, San Francisco, CA 94143-0856.

Dr. Sox: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.

Ann Intern Med. 2007;147(9):668-669. doi:10.7326/0003-4819-147-9-200711060-00012
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Liquid-based cytology is a technique for preserving and preparing cells for cytologic study. As applied to cervical cytology, cells are obtained by scraping the external cervix uteri with a spatula and by rotating a cytobrush in the endocervix. Instead of being spread onto a glass slide and fixed, the samples are suspended in a vial of liquid preservative. In the laboratory, processing removes debris and places a thin layer of cells onto slides that are stained and read similarly to conventional cytology. Systematic reviews have concluded that the quality of the evidence about liquid-based cytology has not been good enough to judge its performance relative to conventional cytology (12). The lack of large randomized studies comparing the 2 techniques is an important evidence gap (1, 3). In 2003, the U.S. Preventive Services Task Force (USPSTF) found the evidence insufficient to make a recommendation about using liquid-based cytology (4).

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