Evaluating Cervical Cytology Techniques: A Comparative Study of Conventional Pap Smear and Liquid-Based Cytology in Cervical Cancer Screening: A Cytomorphological Study in a Tertiary Care Hospital in Northeast India

Abstract

Background and Aim: Cervical cancer remains a major public health concern, although timely screening can substantially reduce morbidity
and mortality. Conventional pap smear (CPS) is widely used for cervical screening, while liquid-based cytology (LBC) offers technical advantages
in specimen preparation and cellular visualisation. This study compared the cytomorphological findings and specimen quality obtained by the
two techniques.
Materials and Methods: We conducted a prospective observational comparative study over one year at a tertiary care hospital in Northeast
India. A total of 160 women attending the gynaecology and cervical screening services were included. Both CPS and LBC evaluated cervical
samples from each participant. The preparations were assessed for specimen adequacy, background clarity, benign cytological changes and
epithelial abnormalities according to the Bethesda System.
Results: Most participants belonged to the 31 to 40-year age group (32.5%), followed by 41–50 years (30.0%). Vaginal discharge was the
most frequent clinical complaint (37.5%). LBC demonstrated better specimen adequacy, with satisfactory preparations in 98.1% compared
with 93.1% for CPS. LBC more frequently showed a clean background (86.9%) than CPS (67.5%), whereas CPS more often showed blood
obscuration. LBC identified ASC-US and LSIL more frequently, while both techniques detected squamous cell carcinoma equally, as observed
cytological frequencies.
Conclusion: LBC provided better specimen adequacy and background clarity and facilitated recognition of several cytological abnormalities
and infective changes. CPS remains a practical and economical screening method, while LBC may be advantageous where appropriate laboratory
infrastructure is available.