Given that about 80% of Pap smears in the US are now utilizing a liquid based Pap (LBP) technology (Saint, 2005), how helpful are they to insure accurate results? Numerous studies have found that LBP alone have increased the rates of diagnosis of severe dysplasia and cancer (Schledermann, 2006). In a review of many studies Cox (2004), found the ability to identify abnormal cells from conventional Pap smears was 71% compared to 81% for LBP.
In addition to changes in the way that cells can be collected, the prepared slides can have supplementary interpretations. Automated, computerized readings of the slides (e.g., AutoPAP® or PAP Net®) can be done before, or after, the human cytologist examines the slide.
Paradoxically, increasing PAP smear sampling among low risk women actual increases your chance of getting a “false positive” one day. For example (DeMay, 2000), if you get a yearly PAP between the ages of 18 to 78, and one assumes a 5% incidence of false positives, you would have a 95% chance of getting a false positive report during that time.
As you can ascertain, Pap smear results may not be perfect. Even with the use of the newer liquid based techniques, perhaps 35% of concerning diagnoses (e.g., CIN 3 or even cancer) might be missed (ACOG, 2005). Consequently there has been increased interest and use of HPV testing — often using the same cells in the liquid PAP smear vials.
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