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Dates: 2001 - completed 2004
Funding: Department of Health
Collaborators: Cancer Screening Evaluation Unit, Institute of Cancer Research
Information: Rose Legood

Liquid Based Cytology (LBC) is a new technique for collecting cytological samples in order to detect cervical cancer. With conventional cytology a smear taker takes a sample that is applied directly to a slide for microscopic investigation. With LBC, samples are collected in liquid vials and the slide is prepared semi-automatically at the laboratory. Potentially the advantages of LBC include a reduction in the number of inadequate slides, increased sensitivity of the test and increased productivity of smear readers.

In addition to assessing LBC, the pilot sites are also evaluating the use of Human Papilloma Virus (HPV) testing in the management of women with mild or borderline smear results. Over 95% of women who develop cervical cancer test positive for HPV. By testing women for this virus, those with a negative result can potentially be excluded from unnecessary preventative treatment at colposcopy clinics.

The health economics input into the evaluation of the pilot studies includes detailed costing of the two technologies, modelling of the costing implications of rolling out the technology nationwide and development of cost-effectiveness models to assess the cost per life year saved.


Legood, R, Wolstenholme, J, and Gray, A (2009). From cost-effectiveness information to decision-making on liquid-based cytology: Mind the gap.

Health Policy, 89(2):193-200.

Legood, R, Gray, A, Wolstenholme, J, and Moss, S (2006). Lifetime effects, costs and cost-effectiveness of testing for human papillomavirus to manage low grade cytological abnormalities: results of the NHS pilot studies. BMJ 332(7533):79-85.

Moss, S, Gray, A, Legood, R, Vessey, M, Patnick, J, and Kitchener, H (2006). Effect of testing for human papillomavirus as a triage during screening for cervical cancer: observational before and after study. BMJ 332(7533):83-5.