ThinPrep versus the conventional Papanicolaou test: a review of specimen adequacy, sensitivity, and cost-effectiveness

Cervical cancer is one of the most common female malignancies worldwide. In the United States, the mortality from cervical cancer has decreased 70–80% since the introduction of the conventional Papanicolaou smear. Despite its success, the conventional Papanicolaou smear has a sensitivity of only 51% and a false negative rate of 5–10%. The ThinPrep smear has been shown to improve the adequacy of cervical cytology, thereby increasing the sensitivity and decreasing the false negative rate of cervical cancer screening. The ThinPrep has the theoretical potential to reduce the incidence of invasive disease by 28%, increase life-expectancy, and decrease the lifetime costs associated with diagnosis and management of cervical abnormalities. Unfortunately, absent or suboptimal screening is associated with 50–60% of cancer cases. Ultimately, it will take not only improving the sensitivity of the Pap test, but also increasing the participation in screening programs, especially in high-risk populations, in order to continue to reduce the morbidity and mortality associated with cervical cancer.