COMPARATIVE EVALUATION OF CONVENTIONAL PAP SMEAR AND LIQUID-BASED CYTOLOGY FOR CERVICAL CANCER SCREENING IN A CROSS-SECTIONAL STUDY

Ghazala Arshad; Saba Ijaz; Shahneela Moosa; Azra; Kanta Bai Ahuja; Sanobar Baloch

Authors

Ghazala Arshad Women Medical officer, Liaquat University of Medical and Health Sciences Jamshoro Pakistan. Author
Saba Ijaz Consultant Gynaecology and Obs, Services Institute of Medical Sciences / Services Hospital Lahore Pakistan. Author
Shahneela Moosa Assistant Professor Gynaecology and Obs, Ghulam Muhammad Mehar Medical College Hospital Sukkur Pakistan. Author
Azra Associate Professor Gynaecology and Obs, Suleman Roshan Medical College Tando Adam Pakistan. Author
Kanta Bai Ahuja Professor Gynaecology and Obs, Pir Abdul Qadir Shah Jellani Institute of Medical Science (PAQSJIMS) Gambat Pakistan. Author
Sanobar Baloch Associate Professor Gynaecology and Obs, Indus Medical College Tando Muhammad Khan Pakistan. Author

Abstract

Objective: To compare liquid-based cytology (LBC) and conventional Pap smear (CPS) in the detection of cervical cancer.

Study Design: This was a cross-sectional study.

Place and Duration of Study: This research was conducted at Liaquat University of Medical and Health Sciences Jamshoro from February 2025 to February 2026

Methods: Total 200 women aged 20-65 years with symptomatic presentation indicative of cervical pathology were included. CPS and LBC were used to collect cervical samples. Smear adequacy, endocervical cell presence, and cytological findings were assessed. Histopathological findings were used as a reference standard where available. SPSS version 26 was used to analyze the data. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were computed. The p-value of <0.05 was found to be statistically significant.

Results: The mean age of participants was 44.9±6.5 years. LBC demonstrated a significantly higher rate of satisfactory smears (n=188, 94.0%) compared to CPS (n=166, 83.0%) (p<0.001). Endocervical cells were more frequently detected in LBC (n=112, 56.0%) than CPS (n=78, 39.0%) (p<0.001). For LSIL, LBC had higher sensitivity (88.0%) and specificity (99.0%) compared to CPS (72.0% and 98.0%). In the case of HSIL, LBC showed better sensitivity (77.0% and 99.0%) and specificity (62.0% and 98.5%) than CPS. PPV and NPV were consistently higher with LBC.

Conclusion: LBC demonstrated better performance than CPS in terms of smear adequacy and diagnostic accuracy. It may be considered a more effective method for cervical cancer screening. Additional large-scale studies using HPV testing are recommended.