{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T18:35:33Z","timestamp":1773858933080,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,5,8]],"date-time":"2013-05-08T00:00:00Z","timestamp":1367971200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Papanicolaou (Pap) testing has transitioned from conventional preparations (CPs) to liquid\u2010based preparations (LBPs) because of the perceived superiority of LBPs. Many studies conclude that LBPs reduce unsatisfactory Pap tests; however, some believe that the evidence substantiating this claim is weak. The authors studied the effect of the transition from CPs to LBPs on the proportion of unsatisfactory Pap tests in 4 health care systems in the United States participating in the National Institutes of Health\u2010funded Screening Effectiveness and Research in Community\u2010Based Healthcare (SEARCH) project.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The study cohort consisted of 548,174 women ages 21 to 65 years who had 1443,725 total Pap tests between 2000 and 2010. Segmented regression analysis was used to estimate the effect of adopting LBPs on the proportion of unsatisfactory Pap tests after adjusting for age.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Three sites that implemented SurePath LBP experienced significant reductions in unsatisfactory Pap tests (estimated effect: site 1, \u22122.46%; 95% confidence interval [CI], \u22121.47%, \u22123.45%; site 2, \u22121.78%; 95% CI, \u22121.54%, \u22122.02%; site 3, \u22128.25%; 95% CI, \u22127.33%, \u22129.17%). The fourth site that implemented ThinPrep LBP did not experience a reduction in unsatisfactory Pap tests. The relative risk of an unsatisfactory Pap test in women aged \u226550 years increased after the transition to LBPs (SurePath: relative risk, 2.1; 95% CI, 1.9\u20102.2; ThinPrep: relative risk, 1.7; 95% CI, 1.5\u20102.0).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The observed changes in the proportion of unsatisfactory Pap tests varied across the participating sites and depended on the type of LBP technology, the age of women, and the rates before the implementation of this technology. Cancer (Cancer Cytopathol) 2013;121:568\u2013575. \u00a9 2013 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.21309","type":"journal-article","created":{"date-parts":[[2013,5,8]],"date-time":"2013-05-08T11:23:33Z","timestamp":1368012213000},"page":"568-575","source":"Crossref","is-referenced-by-count":7,"title":["Effects of transitioning from conventional methods to liquid\u2010based methods on unsatisfactory Papanicolaou tests"],"prefix":"10.1002","volume":"121","author":[{"given":"Christopher L.","family":"Owens","sequence":"first","affiliation":[{"name":"Meyers Primary Care Institute a joint endeavor of the University of Massachusetts Medical School Fallon Community Health Plan, and Reliant Medical Group Worcester Massachusetts"},{"name":"Department of Pathology University of Massachusetts Medical School Worcester Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Peterson","sequence":"additional","affiliation":[{"name":"Meyers Primary Care Institute a joint endeavor of the University of Massachusetts Medical School Fallon Community Health Plan, and Reliant Medical Group Worcester Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aruna","family":"Kamineni","sequence":"additional","affiliation":[{"name":"Group Health Research Institute Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana S. 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