title: Could alarmingly high rates of negative diagnoses in remote rural areas be minimized with liquid-based cytology? Preliminary results from the RODEO Study Team.
abstract: OBJECTIVE
  It was the aim of this study to compare diagnostic performances of the BD SurePath™ liquid-based Papanicolaou test (LBC) and the conventional Papanicolaou test (CPT) in cervical samples of women from remote rural areas of Brazil.
  
  
  METHODS
  Specimens were collected by mobile units provided by Barretos Cancer Hospital. This report evaluates the manual screening arm of the RODEO study. Of 12,048 women seen between May and December 2010, 6,001 were examined using LBC and 6,047 using CPT.
  
  
  RESULTS
  Comparative (LBC vs. CPT) outcomes were: all abnormal tests, 2.1 versus 1.0%; ASC-US (atypical squamous cells of unknown significance), 0.7 versus 0.1%; ASC-H (atypical squamous cells with possible high-grade squamous intraepithelial lesions) and AGC (atypical glandular cells), 0.4 versus 0.3%; LSIL (low-grade squamous intraepithelial lesions), 0.7 versus 0.3%; HSIL (high-grade squamous intraepithelial lesions), 0.4 versus 0.2%, and unsatisfactory, 0.03 versus 0.08%. The LBC arm detected significantly more lesions (ASC-US+) than CPT (p < 0.001); however, when we divided the diagnoses into two groups, ASC-H- (negative/ASC-US/LSIL) and ASC-H+ (ASC-H/AGC/HSIL), the difference was not statistically important (p = 0.213).
  
  
  CONCLUSIONS
  With inherent difficulties in patient recruitment and patient compliance with cancer screening, best test performance including human papillomavirus test capability are vitally necessary in Brazil's struggle to reduce cervical cancer.
authors.affiliation: Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil.
authors.forename: José Humberto T G
authors.initials: JH
authors.lastname: Fregnani
authors.forename: Cristovam
authors.initials: C
authors.lastname: Scapulatempo
authors.forename: Raphael L
authors.initials: RL
authors.lastname: Haikel
authors.forename: Teóclito
authors.initials: T
authors.lastname: Saccheto
authors.forename: Natália
authors.initials: N
authors.lastname: Campacci
authors.forename: Edmundo C
authors.initials: EC
authors.lastname: Mauad
authors.forename: Adhemar
authors.initials: A
authors.lastname: Longatto-Filho
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000175:diagnosis; D012424:Rural Population; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D014626:Vaginal Smears / Q000379:methods*