Liquid-based cytologic specimen studies to screen for cervical dysplasia in rural El Salvador

Objective: To evaluate an alternative tool (ThinPrep; Cytye Corporation, Boxborough, Mass, USA) for cervical cancer screening in rural El Salvador. Methods: Cervical samples were obtained from 471 women attending health fairs in rural El Salvador. The samples were read by American and Salvadoran pathologists after a 1-week training course in liquid-based cytologic studies in the United States. Results: The system evaluated detected a significantly higher number of high-grade and above lesions than conventional cytologic studies (P = 0.01). There were 0.4% and 1.7% of high-grade lesions and above detected with conventionally prepared slides in the United States and El Salvador, respectively, and 3.2% and 3.8% of such lesions detected with liquid-based samples in the United States and El Salvador. Intra-observer agreement among the pathologists reading the samples was substantial for the ThinPrep system, with a κ value of 0.6. Conclusion: A short workshop is effective in training pathologists to use ThinPrep. In the studied population, liquid-based studies appear to offer significant advantages over conventional cytologic studies for detecting high-grade lesions.