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Mark Schiffman, MD, MPH; Diane Solomon, MD

JAMA. 2009;302(16):1809-1810.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Automated, liquid-based cytology has virtually replaced conventional Papanicolaou (Pap) smears in the United States. However, in this issue of JAMA, Siebers et al¹ demonstrate in a large randomized clinical trial that the most common liquid-based cytology method is no better for detection of cervical precancer than well-performed Pap smears. This trial confirms a recent meta-analysis that also showed no incremental improvement in accuracy using liquid-based cytology.²

Siebers et al randomized 246 Dutch family practices including almost 90 000 women to either liquid-based cytology or conventional Pap smears. Two laboratories participated; 1 laboratory already had 1 year of previous experience interpreting liquid-based cytology. The precancer outcomes (ie, detection of cervical cancer precursors) were defined by histology or repeat cytology, tracked by registry linkage over an 18-month period, and carefully confirmed by reviewers masked to the screening method.

The 2 cytology methods provided similar risk . . . [Full Text of this Article]

Author Affiliations: Division of Cancer Epidemiology and Genetics (Dr Schiffman), and Division of Cancer Prevention (Dr Solomon), National Cancer Institute, National Institutes of Health, Bethesda, Maryland.

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