Authors' objectives:

To provide guidance on the use of liquid-based cytology for cervical screening.

Authors' recommendations: Guidance 1.1 Research evidence suggests that Liquid Based Cytology (LBC) could provide significant and important benefits. However, the quality of the evidence is variable and some areas of uncertainty remain. Although there is insufficient evidence to justify the nationwide introduction of LBC technology at this time, it is likely that LBC will have the effect of reducing the number of false negative test results as well as the number of unsatisfactory specimens. In addition, it may decrease the time needed for examination of specimens by cytologists. 1.2 In order to establish its contribution, a programme of pilot implementation projects of LBC should be undertaken, accompanied by a full review of the results at each stage. This should be done before consideration is given to the general introduction of this technology nationally. These projects should evaluate all the effects, costs and practical implications of introducing LBC technology into the cervical screening programme, including the following: 1.2.1 - the effect on test results (proportions of tests classified as inadequate, negative, borderline/mild dyskaryosis, moderate dyskaryosis, severe dyskaryosis or worse) and the consequent need for repeat screening, recall in less than three years and additional diagnostic investigation; 1.2.2 - the extent to which productivity improvements in cytology laboratories are realised in routine practice, the acceptability of LBC to laboratory staff and their needs for training, and the identification of quality assurance guidance prior to full implementation; 1.2.3 - the impact in the primary care setting with regard to the training of screening personnel, avoidance of repeat visits and ease of implementation; 1.2.4 - the logistical implications of implementing LBC, including transport of specimens, storage, waste disposal and laboratory throughput. 1.3 The proposed pilots should be designed to complement the Scottish LBC demonstration projects and trials of other cervical screening technologies, such as screening for Human Papillomavirus. The Institute recommends initial implementation on a regional scale to ensure proper testing of the effects of LBC, but the design of the pilot studies needs careful consideration in order to provide adequate and robust data. The Institute also recommends that the NHS Research and Development Programme should be asked to advise on the number and design of the pilot studies.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.nice.org.uk/page.aspx?o=TA005

Year Published: 2000

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: National Institute for Clinical Excellence

Contact Address: MidCity Place, 71 High Holborn, London WC1V 6NA, UK. Tel: +44 020 7067 5800; Fax: +44 020 7067 5801

Contact Name: nice@nice.nhs.uk

Contact Email: nice@nice.nhs.uk

Copyright: National Institute for Clinical Excellence (NICE)