News: New report supports Liquid Based Cytology for cervical cancer screening
Cervical Screening Wales has published an initial assessment of the performance on the roll out and success of Liquid Based Cytology (LBC), in Wales.
The evaluation concluded that LBC is safely established, functioning well, providing acceptable results and will provide a positive platform for the future development of the cervical screening programme. The implementation was also achieved within budget and in twelve months, which was within the target timescale.
Prior to the introduction of Liquid Based Cytology (LBC), the screening process used in cervical cytology had remained largely unchanged for over fifty years. A wooden spatula was used to obtain cells from the cervix, which were then spread onto a glass slide before processing and subsequent microscopical examination in the laboratory. This conventional smear test was simple, easily performed and relatively inexpensive. The procedure was, however, potentially open to variation and inconsistencies.
LBC utilises an improved sampling device, the Rovers® Cervex-Brush®, to collect the cell sample from the cervix. Following sampling, the head of the brush sampler is immediately transferred to a vial containing a preservative fluid (a collection and transport medium). This simpler method of collecting the cells in a preservative fluid, rather than spreading the sample on to a glass slide enable samples to be processed in the laboratory where greater control over the quality of the finished slide can be achieved. This process reduces the number of samples that have an inadequate number of cells for reporting.
Screening Services Wales Director, Dr. Hilary Fielder said: “One of the key achievements of Liquid Based Cytology is the dramatic fall in the unsatisfactory results rate from about 9 percent, in 2003 to the current rate of less than 2 percent. Now, more than 7 in every 100 women who, in the past would have been asked to return for a repeat sample, are now receiving their results straightaway. This is a valuable saving of time for women and the nurses and doctors in primary care.”
The analysis of performance information gathered post LBC implementation shows a reduction in unsatisfactory samples, an improved Positive Predictive Value (PPV), maintained primary screener sensitivity and specificity, a reduction in colposcopy referrals, a reduction in laboratory turnaround times and potentially a more efficient use of staff and resources.
Introduction of this technology in Wales, was recommended by the National Institute for Clinical Excellence (NICE) and the recommendation has been accepted by the National Assembly for Wales.
All Wales Programme Manager for Cervical Screening Wales, Bryan Rose said: “The achievements highlighted in this report are a credit to the staff of Cervical Screening Wales and in Primary Care. Their hard work made delivering a new and improved screening service within the timescale targets and budget possible. Now, 15,000 more women every year will receive a better and faster screening service.”