Improving cervical cytology screening in a remote, high risk population

Objective: To evaluate the use of the ThinPrep method to reduce rates of un satisfactory Papanicolaou (Pap) smears in women in remote communities. Design: Prospectively collected samples were split and screened conventiona lly and by ThinPrep at the Queensland Cytology Service. Patients: Three hundred women having cervical smears taken by a Mobile Wome n's Health Service nurse or at the antenatal and sexual health clinics of a remote north Queensland community. Main outcome measure: Number of Pap smears reported as unsatisfactory for e valuation and requiring a repeat smear request. Results: 17.3% of conventionally prepared smears were technically unsatisfa ctory, compared with 6.3% prepared with ThinPrep. The overall rate of unsat isfactory smears was only 4.3% when both ThinPrep and conventional smears w ere assessed for a combined report. Conclusion: A significant reduction in the proportion of unsatisfactory Pap smears is possible with the ThinPrep method. Targeted use of ThinPrep in c ommunities with high rates of unsatisfactory smears may prove cost-effectiv e.