04/30/2003

Stick to conventional tests!

New cervical smear tests are not better

France - Researchers have found new cervical smear tests to be unreliable and conclude that these should not replace conventional tests (PAP smears). Their study also emphasises the need to improve the 'hard evidence' in studies of new technologies. It also has implications for the regulation of medical devices and clinical practice, as well as hospital laboratory economics.

The French study involved 828 women, referred to hospital due to abnormalities detected in previous smears, and 1,757 women attending for routine smears. Each had a conventional cervical smear test, then the remaining sample was tested by two new methods - monolayer cytology and human papillomavirus DNA testing - tests which are replacing conventional smear tests in several countries.

PAP smear tests consistently showed better sensitivity and specificity than monolayer cytology - which is also more expensive. The researchers also pointed out that human papillomavirus testing performed no better than conventional smear tests, and they conclude that this test should be further evaluated.

* Pub: British Medical Journal. Volume 326, pp 733-6. ‘Cross sectional study of conventional cervical smear’, by Philippe Vielh, pathologist and President of the French Society of Clinical Cytology, Curie Institute, Paris, and Professor of Medical Statistics, Joel Coste, of the Public Hospital, and Cochin-Port Royal Medical Faculty, Paris V University.