title: Comparison of the conventional cervical smear and liquid-based cytology: results of a controlled, prospective study in the Abruzzo Region of Italy.
abstract: OBJECTIVE
  To compare conventional cervical testing (CCT) and liquid-based cytology (LBC) within a randomized trial performed during 2001-2002 in the Abruzzo Region of Italy, including a cost-outcome comparative analysis.
  
  
  METHODS
  Study subjects were recruited in the framework of a controlled, randomized study organized in the Abruzzo Region. Women aged 2 6-64 years were randomized to an active arm (LBC) or control arm (CC1). The particip ating laboratories had no previous ex perience with LBC.
  
  
  RESULTS
  The inadequacy rate was 4.3% in CCT and 1.3% in the LBC arm (D < 0.001). Atypical squamous cells of undetermined sign ifi cance and atypical glands of undetermined significance reports were more frequent at CCT vs. LBC. A small, insignificant excess of low grade squamous intraepithelial lesions or high grade squamous epithelial lesions+ reports was observed in the LBC arm. The cervical intraepithelial neoplasia 2+ (CIN2+) detection rate was not statistically different in the 2 arms (CCT=0.54%, LBC= 0.66%, p = 0.28). In the overall series positive predictive value was slightly but not significantly higher in the LBC arm. LBC increased costs by 4.2% per both screened women and CIN2+ detected.
  
  
  CONCLUSIONS
  The study reflects the introductory phase of LBC in laboratories without prior LBC experience. In this setting LBC reduced the inadequacy rate and decreased reading and was at least as sensitive as and more specific than CCT. Utilization of LBC in organized screening programs will be based on local feasibility, considering that the high cost of LBC is only partially compensated for by other benefits, such as residual cellular material, available for molecular testing, including human papillomavirus testing.
authors.affiliation: Pathology Unit, Annunziata Hospital, Cervical Cancer Screening Program, Abruzzo Region, Sulmona.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Maccallini
authors.forename: Claudio
authors.initials: C
authors.lastname: Angeloni
authors.forename: Donatella
authors.initials: D
authors.lastname: Caraceni
authors.forename: Carmine
authors.initials: C
authors.lastname: Fortunato
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Venditti
authors.forename: Giannina
authors.initials: G
authors.lastname: Di Gabriele
authors.forename: Chiara
authors.initials: C
authors.lastname: Antonelli
authors.forename: Amedeo
authors.initials: A
authors.lastname: Lattanzi
authors.forename: Donella
authors.initials: D
authors.lastname: Puliti
authors.forename: Stefano
authors.initials: S
authors.lastname: Ciatto
authors.forename: Massimo
authors.initials: M
authors.lastname: Confortini
authors.forename: Cristina
authors.initials: C
authors.lastname: Sani
authors.forename: Marco
authors.initials: M
authors.lastname: Zappa
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D003584:Cytological Techniques / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology*; D014626:Vaginal Smears / Q000191:economics / Q000379:methods