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A controlled prospective comparison of automated and manual reading of cytology in primary cervical screening

Dates: 2005-2009
Funding: HTA Programme
Collaborators: Henry Kitchener, University of Manchester;
Rosa Legood, London School of Hygiene and Tropical Medicine
Information: Alastair Gray

Cervical screening by cytology (smear tests) has proved an effective means of reducing death rate from cervical cancer and the introduction of Liquid Based Cytology (LBC) will benefit both women and cytoscreeners.

The use of automated technology may bring further benefits by making identification of abnormal cells easier. Instead of scanning an entire slide the cytoscreeners will be directed to 15-22 locations on a slide by computerised software.

MAVARIC was a diagnostic accuracy study set up in August 2005 to compare two automated cervical screening technologies with manual screening. Samples from women undergoing primary cervical screening were read using one of two automated technologies and compared with manual screening. The economic component included the collection of data on the costs and productivity implications of automated reading and the extrapolation of trial results using a Markov model to estimate the long term cost effectiveness of this technique. A manuscript detailing the economic analysis has been submitted for publication.


Kitchener, HC, Blanks, R, Dunn, G, Gunn, L, Desai, M, Albrow, R, Mather, J, Rana, DN, Cubie, H, Moore, C, Legood, R, Gray, A, and Moss, S (2011). Automation-assisted versus manual reading of cervical cytology (MAVARIC): a randomised controlled trial.

Lancet Oncol, 12(1):56-64.

Kitchener, HC, Blanks, R, Cubie, H, Desai, M, Dunn, G, Legood, R, Gray, A, Sadique, Z, and Moss, S (2011). MAVARIC - a comparison of automation-assisted and manual cervical screening: a randomised controlled trial. Health Technol Assess, 15(3):iii-iv, ix-xi, 1-170.