Cervical screening in Western Kazakhstan: Liquid-based cytology 'Cell Scan' versus azur-eosin staining.
OBJECTIVE
To assess the effectiveness of the current cervical cancer screening tools in Western Kazakhstan.


METHODS
Smears taken through (i) conventional cytology using azur-eosin staining and (ii) liquid-based cytology (LBC) 'Cell Scan' in the general female population and in women first diagnosed with cervical cancer were collected throughout the region. ROC-analysis with curve construction and weighted Cohen's κ calculation were applied. A total of 494 cytological pairs were collected, including 94 sets with histology findings.


RESULTS
The conventional (azur-eosin staining) technique contained 0.2% non-informative material and LBC 'Cell Scan' had 5.9%. Area under the curve was 0.95 for the conventional technique and 0.92 for 'Cell Scan' (p > 0.05). The conventional smears showed κ 0.62, sensitivity 90.4% at specificity 90.0% for CIN2+, while LBC 'Cell Scan' smears showed κ 0.47, sensitivity 83.3% at specificity 92.5%.


CONCLUSIONS
In this analysis it was not possible to prove that the LBC 'Cell Scan' technique was superior to its predecessor, azur-eosin staining. These findings highlight the need to modify the current screening programme according to updated international scientific evidence on effective screening design, such as the use of HPV DNA testing with Pap smear triage in women aged 30 or older. Further research, and a Health Technology Assessment, are necessary if we wish to establish a national standardized screening programme using the available technology appropriately.
['Balmagambetova|Saule|S|0000-0003-4080-5383', 'Gabutti|Giovanni|G|', 'Koyshybaev|Arip|A|', 'Acuti Martellucci|Cecilia|C|0000-0002-4308-2144', 'Urazayev|Olzhas|O|', 'Sakiyeva|Kanshaiym|K|', 'Bekova|Karlygash|K|']
D000293:Adolescent D000328:Adult D019540:Area Under Curve D001399:Azure Stains D003584:Cytological Techniques D055088:Early Detection of Cancer D004801:Eosine Yellowish-(YS) D005260:Female D005456:Fluorescent Dyes D006801:Humans D007623:Kazakhstan D008875:Middle Aged D065006:Papanicolaou Test D012372:ROC Curve D013194:Staining and Labeling D002583:Uterine Cervical Neoplasms D014626:Vaginal Smears D055815:Young Adult
cervical screening Kazakhstan cytology azur-eosin staining ‘Cell Scan’ preservative fluids