Comparison of Sample Adequacy and Reporting Quality Between Conventional Pap Smear and Liquid-Based Cytology Evaluates Unsatisfactory Rates, Obscuring Factors, And Cellular Preservation

Abstract

Background: Cervical cytology is a key screening tool for early detection of cervical cancer. Conventional Pap Smear (CPS), though widely used, has limitations related to sample adequacy and obscuring factors. Liquid-Based Cytology (LBC) was introduced to overcome these drawbacks.

Objectives: To compare sample adequacy and reporting quality between CPS and LBC, with emphasis on unsatisfactory rates, obscuring factors, and cellular preservation.

Materials and Methods: This prospective comparative study was conducted over 24 months at JIIU’s Indian Institute of Medical Science and Research, Jalna. A total of 350 cervical samples were collected and processed using both CPS and LBC techniques. Smears were evaluated according to the Bethesda System 2014. Statistical analysis was performed, and a p-value <0.05 was considered significant.

Results: LBC showed a significantly higher rate of satisfactory smears (95.4%) compared to CPS (84.6%). Unsatisfactory smears and obscuring factors were significantly lower in LBC. Cellular preservation and background clarity were superior in LBC. Detection of epithelial abnormalities was modestly higher with LBC.

Conclusion: Liquid-Based Cytology provides improved sample adequacy and reporting quality compared to Conventional Pap Smear. LBC may serve as a reliable alternative to CPS in tertiary care settings with adequate resources.