wow, pretty damning, and it's by Arbyn and the European folks...doesn't bode well for lbp as the next step in the EU
<<In 2007, only eight studies and one well-conducted randomized trial are available that allow unbiased evaluation of the accuracy of liquid-based cytology for histologically confirmed CIN 2 or worse. Pooling of these studies indicated that liquid-based cytology is neither more sensitive nor more specific than conventional Pap and these findings were rather consistent over study design, clinical settings, and liquid-based cytology systems.>>
<<The review reveals a surprising lack of high-quality studies performed in screening settings. The recent landmark Italian randomized trial, however, is an exception and deserves focused attention.4 Over 45,000 women aged 25–60 years were randomized to either liquid-based or conventional cytology. Colposcopy was performed in all women with atypical squamous cells of undetermined significance or worse. In comparing these techniques head-to-head, two important clinical questions were answered. First, liquid-based tests were more likely to be interpreted as abnormal and equivocal. Second, despite more positive tests, liquid-based cytology did not lead to detection of more high-grade cervical intraepithelial neoplasia (CIN). In other words, all extra-positive tests appeared to be falsely positive. Arbyn's meta-analysis of summary data showed similar results.>>
<<Although navigating the ever-mounting morass of new information is daunting, clinicians should be aware that help is available. For example, the U.S. Preventive Services Task Force systematically reviews evidence and issues recommendations that are designed to maximize benefits and minimize harms. Of note, the Preventive Services Task Force considers evidence about liquid-based cytology and HPV testing to be insufficient to make a recommendation.9 However, evidence from large-scale randomized trials using HPV testing for screening is emerging.>>
and the preliminary conclusions of the one study cited by arbyn and sawaya that was done properly, the ronco study:
<<CONCLUSIONS: HPV testing, if used as screening test, should be applied alone, with cytology triage essential in younger women but preferable at all ages. Follow-up data will allow analysis of the safety of prolonging screening intervals and the relative persistence of lesions detected with different methods.>>
horse is out of the barn in the US but eventually, as we predicted long ago, the EU will likely move to hpv reflex pap...but who knows when!!!
lol, can't wait to read it...it does and it doesn't matter i guess...it doesn't matter because lbp is soc here no matter what now, in part because of great sales and marketing, but also because of convenience and less sblb's which isn't trivial, and testing out of the vial
it does matter because if you want to prove you're using the most sensitive test you better, grudgingly, admit that you have to dwp
happy new year to you KC and to one and all of the old faithful....to everyone a healthy and fulfilling 2008!