Historically, screening for pre-cancerous cells or other cells associated with uterine cervical cancer has been carried out using the Papanicolaou, or “Pap” test. To increase the number of cells collected during a Pap smear and to facilitate the preparation of slides for interpretation, liquid-based cytology (LBC) was developed and numerous papers have been published on the sensitivity or cost-effectiveness of this technique.
Recently, HPV DNA testing was developed as a primary screening procedure or as triage when the results of primary screening are equivocal. This technique opens new possibilities for the installation of a screening program in Quebec.

Compared to conventional cytology (CC), LBC still involves collection of cervical cells with a special brush but instead of smearing cells on a glass slide as in CC, they are placed in a sealed container filled with a preservative fluid. This container is then sent to a laboratory appropriately equipped to produce a slide.
The potential advantages of LBC mentioned by the manufacturers are better cell collection giving more uniform slides, a lower rate of unsatisfactory specimens and easier histologic interpretation. Another advantage is that HPV testing can be performed on the fluid remnant after cytologic examination, thus obviating the need for a patient visit when a second test is necessary. A major disadvantage of this technique is the higher costs for cytopathology laboratories.

Report aimed to evaluate the health and economic impact of switching to the systematic use of LBC instead of CC.