NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE

Health Technology Appraisal

Liquid based cytology for cervical screening

Scope

Objective: to review the clinical and cost effectiveness of liquid based cytology for cervical screening, and to update guidance issued to the NHS in England and Wales in June 2002.¹

Background: the Institute issued guidance on the use of liquid based cytology (LBC) for cervical screening in June 2000. At this time, the evidence was felt to be insufficient to justify the nationwide introduction of LBC. The Institute therefore recommended that a programme of pilot implementation projects be undertaken to evaluate the effects, costs and practical implications of introducing LBC into the NHS. The date set for revision of this guidance was May 2003, the point by which the Institute's Guidance Executive will consider an update of the original assessment report, together with comments on it from consultees. The review date was set on the basis of the Institute's judgement of the pace of change in the evidence base at the time the original guidance was issued, and on the anticipated date that the outcome of the pilot studies would be available. The review will update the original guidance to reflect any new evidence that has become available, and in particular, the results of the pilot studies.

Technology: LBC is a way of preparing cervical material for cytological examination. Samples are collected in a similar fashion to the standard Pap smear using a special spatula or 'broom-like' device. The head of the device is rinsed or broken off into a vial of preservative fluid before being transported to a laboratory for examination. A number of both manual and automated slide preparation systems are currently available.

¹ National Institute for Clinical Excellence (2000). Guidance on the use of liquid based cytology for cervical screening. NICE Technology Appraisal Guidance No. 5. London: National Institute for Clinical Excellence. Available from: www.nice.org.uk