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Liquid-Based Cytology

New technologies have been developed for the performance of cytology screening. While the procedure for the collection of cells is the same, the process by which the sample is prepared allows for the examination of a single layer of cells under the microscope instead of a clump of cells, which may improve the accuracy of the reading. These liquid-based cytology tests include the ThinPrep (Cytyc Corporation), the SurePath (TriPath Care Technologies) and the AutoCyte PREP (ARUP Laboratories). These tests may be more sensitive than the traditional Pap test, however, they are more expensive and have a lower specificity. Another benefit, however is that liquid-based cytology permits testing of specimens for HPV, which may be useful in guiding management for women whose tests reveal atypical squamous cells. If liquid-based cytology is used, screening recommendations are reduced to every 2 years. Insurance does not always cover the extra cost of liquid-based cytology, so women may have some out of pocket expense for this type of screening.

HPV DNA Testing

HPV DNA is present in virtually all cervical cancer. Because of this association between HPV and the risk of cervical cancer, several organizations, including the American Cancer Society, have recommended HPV DNA testing in conjunction with cytology as a screening option for women aged 30 years and older. If both HPV DNA testing and cervical cytology are negative, screening can be repeated in 3 years.

It is important that women continue screening even if they have received the HPV vaccine.