title: Primary screening with liquid-based cytology in an unscreened population in rural China, with an emphasis on reprocessing unsatisfactory samples.
abstract: OBJECTIVE
  To determine the sensitivity and specificity of liquid-based cytology in a high-risk, unscreened population.
  
  
  METHODS
  A cross-sectional comparative trial of multiple screening techniques. This report focuses on the performance of liquid-based cytology using biopsy as the standard.
  
  
  RESULTS
  In total, 1,997 women were screened. All subjects had a minimum of five cervical biopsies. Of the subjects, 4.3% had CIN 2 on biopsy. The ThinPrep Pap with ASCUS as positive had a sensitivity for CIN 2 of 94% and specificity of 78%; the sensitivity for CIN 3 was 98% and for cancer, 100%. The unsatisfactory rate due to bloody specimens was 7.9% (158/1,997). After reprocessing, the unsatisfactory rate was 0.15% (3/1,997).
  
  
  CONCLUSIONS
  Reprocessing effectively recovers ThinPrep samples otherwise unsatisfactory due to blood and mucus. The ThinPrep Pap test is a highly sensitive screening test when used in a high-risk, unscreened population.
authors.affiliation: Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, 9500 Euclid Avenue, A-81, Cleveland, Ohio 44195, USA.
authors.forename: Jerome L
authors.initials: JL
authors.lastname: Belinson
authors.forename: Qiong-Jing
authors.initials: QJ
authors.lastname: Pan
authors.forename: Charles
authors.initials: C
authors.lastname: Biscotti
authors.forename: Ling-Ying
authors.initials: LY
authors.lastname: Wu
authors.forename: Robert G
authors.initials: RG
authors.lastname: Pretorius
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.forename: Paul
authors.initials: P
authors.lastname: Elson
authors.forename: Shou-De
authors.initials: SD
authors.lastname: Rong
authors.forename: Wen-Hua
authors.initials: WH
authors.lastname: Zhang
authors.forename: You-Lin
authors.initials: YL
authors.lastname: Qiao
mesh_terms: D000328:Adult; D000465:Algorithms; D001706:Biopsy; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004107:Dilatation and Curettage; D005260:Female; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D011230:Precancerous Conditions / Q000473:pathology; D012306:Risk; D012423:Rural Health; D012680:Sensitivity and Specificity; D014245:Trichomonas Infections / Q000453:epidemiology / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000517:prevention & control; D002575:Uterine Cervicitis / Q000453:epidemiology / Q000473:pathology; D014626:Vaginal Smears / Q000191:economics / Q000379:methods*; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology