Effectiveness and cost effectiveness of automated and semi-automated cervical screening devices: a systematic review of the literature.
- M Broadstock
- The New Zealand medical journal
OBJECTIVE To compare the AutoCyte Prep system (Burlington, North Carolina) with conventional cervical cytology in a university medical center laboratory. STUDY DESIGN Split-sample conventional and AutoCyte Preps were examined for 2,156 cases. Same-patient conventional and Prep slides were submitted to separate cytotechnologists blindly. The results were compared on review by a cytopathologist. The Prep slides were subsequently scanned on the AutoCyte Screen automated interactive system, with manual review of the flagged cases. The results were compared with anatomic pathology follow-up when available. RESULTS Of the 158 squamous intraepithelial lesions (SILs) found by both methods, 78% were found by AutoCyte Prep, while 59% were found by conventional smear (P < .01). Among the discordant cases, thin-layer slides revealed 88% more LSIL lesions (P < .05), a comparable number of high grade SIL lesions and a single case of adenocarcinoma that was ambiguous on the conventional slide. The addition of AutoCyte assisted primary screening demonstrated a net benefit, recovering additional cases referenced as atypical glandular cells of undetermined significance and as high grade SIL. CONCLUSION The AutoCyte Prep system affords excellent cellular presentations and superior sensitivity for SILs when compared to the conventional technique. The use of AutoCyte Screen, for primary screening demonstrated performance equivalent to manual screening, with a significant improvement in sensitivity when measured against biopsy results.