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Government smear test switch will cut workload

GPs' cervical screening workload could be cut significantly under a Government plan to introduce a new screening technique.

The National Institute for Clinical Excellence announced last week that it favours a switch from Pap smears to

liquid-based cytology (LBC).

The initial cost of the switch would be up to £10.3 million, including GP training.

National pilots involving 200,000 women revealed that the rate of inadequate samples was only around 2 per cent

using LBC compared with around 8 per cent for Pap smears. A consultation for an LBC smear took an average of eight-and-a-half minutes ­ five minutes less than a Pap smear.

NICE will consult on the plan until mid-May with official approval likely in August. National roll-out could begin in autumn next year, although full national implementation could take up to four years.

LBC involves using a sampling device that is rinsed in preservative solution to keep cells more viable.

The NICE report acknow-

ledges there are concerns about LBC, warning: 'There is no way of verifying that a sufficient number of cervical cells has been harvested. Poor sampling techniques, resulting in the collection of too few cells, could mean abnormalities may be missed, resulting in some false-negatives.'

But Staffordshire GP Dr Sunil Angris, a member of the NICE committee that made the recommendation, said poor technique was a problem with both LBC and Pap.

He added: 'Studies show that LBC is more likely to pick up high-grade lesions and there is no evidence that it is worse at picking up lower ones. Women do not die of cases of low-grade abnormalities. LBC gives a better chance of picking up the ones that matter.'

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