Recommendations from others
The US Preventive Services Task Force concludes that the evidence is insufficient to recommend for or against the routine use of new technologies to screen for cervical cancer. They acknowledge that ThinPrep may have improved sensitivity over conventional Pap smears but may possibly have lower specificity. The Task Force notes that ThinPrep could be cost-effective with longer screening intervals and can be helpful for the management of ASCUS.9
No current screening guidelines specifically recommend newer Pap test technologies in favor of conventional Pap tests. These associations include American Cancer Society, American Academy of Family Physicians, American College of Preventive Medicine, and American College of Gynecology.
CLINICAL COMMENTARY
ThinPrep’s high sensitivity and viral typing may be advantageous in some cases
Jon O. Neher, MD
Valley Medical Center Family Practice Residency, Renton, Wash
Because the ThinPrep is expensive and not endorsed by major medical policy groups, it is not time for family physicians to switch to the ThinPrep en masse.However, I think 2 groups will be looking carefully at this technology.
First, in settings where annual follow-up is unreliable or impractical, the ThinPrep’s high sensitivity will definitely be advantageous. Second, physicians who want to use HPV-based colposcopy guidelines will appreciate the ThinPrep’s viral typing capabilities, although the unresolved issue of screening frequency will remain a problem. Advertising pressures, advocacy groups, and payer response will also shape this ongoing discussion.