ThinPrep detection of cervical and endometrial adenocarcinoma: a retrospective cohort study.

BACKGROUND: The current study was performed to compare the accuracy of the ThinPrep trade mark Papanicoloau (Pap) test with that of the conventionally prepared Pap smear in detecting cervical and endometrial adenocarcinomas.

METHODS: The subject group consisted of all ThinPrep cases of atypical glandular cells of undetermined significance (AGCUS) or adenocarcinoma diagnosed between March 1998 and March 2000. Conventional smears collected between January 1996 and January 1998, before laboratory conversion to the ThinPrep system, comprised the control group. Histologic follow-up was obtained.

RESULTS: One hundred eighty-six (0.17%) of 112,058 ThinPrep Pap tests were interpreted as AGCUS/adenocarcinomas, compared with 77 (0.09%) of 83,464 conventional smears (P < 0.001). The overall sensitivity of a ThinPrep AGCUS/adenocarcinoma smear in detecting either cervical or endometrial adenocarcinoma was increased (72.0% vs. 41.5%; P < 0.001). The ThinPrep Pap test was more sensitive in detecting endometrial adenocarcinomas (65.2% vs. 38.6%; P = 0.010) and there was a trend for a higher sensitivity in detecting cervical adenocarcinomas (87.1% vs. 55.5%; P = 0.108).

CONCLUSION: The ThinPrep Pap test is a more sensitive method of detecting cervical and endometrial adenocarcinomas than the conventional Pap smear.