The cervical smear test

Cervical cytology (the cervical smear test) has saved many thousands of lives since it was introduced in the 1940s. However, the cervical smear may miss some abnormal cells (a false negative result), and some cells may be classified as abnormal when they are not (a false positive result). These errors can occur because:

• the spatula or brush used to take the sample may miss the area of the cervix where the abnormal cells are located,  
• the abnormal cells can be picked-up by the spatula or brush but may not be transferred to the microscope slide or vial,
• the abnormal cells can be transferred to the microscope slide but may not be found by the person screening the slide on the microscope,
• the abnormal cells that are found may have developed for other reasons and not because they are pre-cancer or cancer.

Because of this, cervical cytology provides the best protection against cervical cancer when it is used within an organised screening programme with good quality control procedures and mechanisms to ensure that women are regularly screened at the recommended interval.

Liquid based cytology (LBC)

LBC offers several advantages over the traditional cervical smear that can provide greater reliability:

• Whereas the traditional cervical smear is prepared using some of the cells recovered from your cervix, the LBC procedure requires that the sampling brush is sent to the laboratory in the preservative medium so all of the cells are available for processing.
• The LBC process helps to remove the blood and mucus that can make screening the slide more difficult and this can reduce the false negative rate. This also helps to reduce the number of inadequate or unsatisfactory tests so it is less likely you will need to return to the clinic for a repeat test.

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© 2009 European Cervical Cancer Association