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LBC has meant fewer repeat smear tests

A round-up of letters

  • From Chris Hughes, Practice nurse, Widnes, Cheshire

I was surprised to read about the Australian study that suggested the inadequate smear rate was no lower in liquid-based testing than in the conventional pap smear (News, 19 January).

Only yesterday we ran an audit on the last six-month period since starting liquid-based smears, and compared it with the same period the year before.

Like-for-like on the same number of smear tests performed, we showed a remarkable improvement in our inadequate smear rate. I relayed this information to our local cytology lab and they reinforced this by stating that their overall inadequate smear detection rate had dropped from 12 per cent to 1 per cent since changing over to liquid-based cytology.

Maybe the Aussies don't do everything bigger and better?

  • Richard Winder, Deputy director, NHS Cancer Screening Programmes

I read your article Doubts over new smear test, reporting research published in The Lancet which compares the use of liquid-based cytology (LBC) for cervical screening against the traditional pap smear method.

The NHS Cervical Screening Programme began introducing LBC in 2003 following a recommendation by the National Institute for Health and Clinical Excellence.

The recommendation was based on strong research evidence from pilot studies in England. Latest statistics show that LBC is already delivering benefits to women and has reduced the rate of inadequate results by up to 90 per cent in the first three laboratories in England where it was introduced1.

As a result, fewer women are having to return for a repeat test because the first cannot be read.

Once liquid-based cytology is fully implemented, women will also receive their results faster, reducing anxiety and uncertainty.

LBC makes it easier for laboratory staff to read the slides. This means that women are less likely to have to go back to their doctor or nurse for another test because the first one couldn't be read properly.

The reduction in inadequate samples will also reduce the pressure on a skilled workforce. Nationally, the workload will be reduced from 4.2 million slides per annum to 3.9 million slides per annum.

1. Health and Social Care Information Centre Statistical Bulletin ­ NHS Cervical Screening Programme, England: 2004-05

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