W. Mann et al., PAPANICOLAOU SMEAR SCREENING AUGMENTED BY A MAGNIFIED CHEMILUMINESCENT EXAM, International journal of gynaecology and obstetrics, 43(3), 1993, pp. 289-296
OBJECTIVES: Since the adequacy of screening for cervical cancer and pr
e-cancer with Papanicolaou smear alone has been questioned, a number o
f adjunctive rests have been evaluated. This study evaluated whether a
magnified chemiluminescent visual screening exam can improve cervical
screening when performed coincident with cytologic sampling. METHODS:
Patients were evaluated using the Papanicolaou smear, magnified chemi
luminescent visual exam (MCE) and colposcopy at 10 study centers. Scre
ening with either Papanicolaou smear alone or in combination with MCE
(Pap and MCE), was evaluated using colposcopy directed biopsy as the h
ighest diagnostic standard. RESULTS: The Papanicolaou smear alone dete
cted 9/29 (31%) of women with significant pathology (cervical neoplasi
a) on biopsy, whereas the combination of the Pap and MCE detected 24/2
9 (83%) of the women (P < 0.001). Patients in whom both tests results
were negative (negative Pap and MCE) were extremely unlikely to harbor
significant pathology (1% of those screened). Pap and MCE was especia
lly helpful in the detection of low grade cervical lesions when compar
ed with the Papanicolaou smear alone. CONCLUSIONS: These data indicate
that MCE enhances the sensitivity of cervical screening. MCE appears
to be particularly useful as a triage instrument in women with otherwi
se negative Papanicolaou smears. Further studies of cost effectiveness
of this combined screening protocol using non-colposcopists is warran
ted.