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To the Editor: In his Clinical Crossroads article regarding atypical squamous cells of undetermined significance (ASC-US), Dr Sawaya¹ suggests that research provides insufficient information to determine whether liquid-based or conventional cervical cytology screening should be preferred. He refers to the US Preventive Services Task Force 2003 conclusion that the published literature is inadequate to conclude which method is better.²

However, Coste et al³ evaluated liquid-based cytology (LBC) and conventional cytology, comparing both screening tests to the gold standard of colposcopy. They found that conventional cytology was both more sensitive than LBC (more often identifying cervical neoplasia when present) and also more specific than LBC (more often identifying significant cervical neoplasia as absent when a woman did not have cervical neoplasia). Conventional cytology had an estimated 92% accuracy for identifying whether a woman had cervical neoplasia compared with an estimated 89% accuracy with LBC. For every 1000 women screened, using conventional . . . [Full Text of this Article]

Brian Budenholzer, MD
budenholzer.b@ghc.org
Group Health Cooperative
Spokane, Wash

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