{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T04:07:40Z","timestamp":1785557260603,"version":"3.56.0"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,3,31]],"date-time":"2018-03-31T00:00:00Z","timestamp":1522454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008746","name":"National Cancer Center","doi-asserted-by":"publisher","award":["26\u2010A\u201030"],"award-info":[{"award-number":["26\u2010A\u201030"]}],"id":[{"id":"10.13039\/100008746","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008746","name":"National Cancer Center","doi-asserted-by":"publisher","award":["29\u2010A\u201016"],"award-info":[{"award-number":["29\u2010A\u201016"]}],"id":[{"id":"10.13039\/100008746","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Science"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:p>The Bethesda system (<jats:styled-content style=\"fixed-case\">TBS<\/jats:styled-content>) has been used for cervical cytological diagnosis in Japan since 2008. Evaluation of specimen adequacy is the most important aspect of quality assurance and for precise diagnosis in <jats:styled-content style=\"fixed-case\">TBS<\/jats:styled-content>. A systematic review and meta\u2010analysis were carried out to assess the unsatisfactory specimen rate in the primary cervical cancer screening setting in Japan. Ovid Medline and Ichushi\u2010Web databases were searched from inception through to May 2017. Prospective and retrospective studies that reported the proportion of unsatisfactory specimens in healthy asymptomatic Japanese women in a cervical cancer screening program were eligible for inclusion; 17 studies were included in the meta\u2010analysis. The random\u2010effects model meta\u2010analysis calculated summary estimates of the unsatisfactory rate of 0.60% (95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>], 0.18\u20101.96%; <jats:italic>I<\/jats:italic><jats:sup><jats:italic>2<\/jats:italic><\/jats:sup><jats:italic> =<\/jats:italic> 99%) for conventional cytology and 0.04% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.00\u20100.35%; <jats:italic>I<\/jats:italic><jats:sup><jats:italic>2<\/jats:italic><\/jats:sup><jats:italic> =<\/jats:italic> 99%) for liquid\u2010based cytology (<jats:styled-content style=\"fixed-case\">LBC<\/jats:styled-content>). However, comparative results between conventional and liquid\u2010based cytology, based on four direct and nine comparative studies, showed no significant difference (summary odds ratio = 3.5 \u00d7 10<jats:sup>\u22122<\/jats:sup> favoring <jats:styled-content style=\"fixed-case\">LBC<\/jats:styled-content> [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 6.9 \u00d7 10<jats:sup>\u22124<\/jats:sup>\u20101.7]; <jats:italic>I<\/jats:italic><jats:sup><jats:italic>2<\/jats:italic><\/jats:sup><jats:italic> =<\/jats:italic> 98%). In the subgroup analyses and meta\u2010regressions, use of non\u2010cotton devices for conventional cytology and use of a particular platform for <jats:styled-content style=\"fixed-case\">LBC<\/jats:styled-content> were associated with lower unsatisfactory rates. Meta\u2010regression also suggested chronological improvement in unsatisfactory rates for both tests. In Japanese cervical cancer screening programs, conventional cytology remains prevalent. Future research needs to focus on evaluating the impact of screening programs using <jats:styled-content style=\"fixed-case\">LBC<\/jats:styled-content> by comparing the accuracy, performance, and cost\u2010effectiveness with conventional cytology in the Japanese population.<\/jats:p>","DOI":"10.1111\/cas.13549","type":"journal-article","created":{"date-parts":[[2018,2,25]],"date-time":"2018-02-25T09:42:35Z","timestamp":1519551755000},"page":"934-943","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Frequency of unsatisfactory cervical cytology smears in cancer screening of Japanese women: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2569-0127","authenticated-orcid":false,"given":"Satoyo","family":"Hosono","sequence":"first","affiliation":[{"name":"Department of Public Health Nagoya City University Graduate School of Medical Sciences Nagoya Japan"},{"name":"All Japan Labour Welfare Foundation Tokai Clinic Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teruhiko","family":"Terasawa","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine Department of Emergency and General Internal Medicine Fujita Health University School of Medicine Toyoake Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takafumi","family":"Katayama","sequence":"additional","affiliation":[{"name":"Department of Statistics and Computer Science College of Nursing Art and Science University of Hyogo Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiju","family":"Sasaki","sequence":"additional","affiliation":[{"name":"St. Luke's International Hospital Affiliated Clinic Center for Preventive Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keika","family":"Hoshi","sequence":"additional","affiliation":[{"name":"Department of Hygiene Kitasato University School of Medicine Sagamihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2585-8479","authenticated-orcid":false,"given":"Chisato","family":"Hamashima","sequence":"additional","affiliation":[{"name":"Division of Cancer Screening Assessment and Management Center for Public Health Sciences National Cancer Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,31]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Guideline for Utreine Cervix Cancer Screening","author":"Japan Asssociation of Obstetricians and Gynecologists","year":"1989"},{"key":"e_1_2_7_3_1","volume-title":"For an Understanding of a Bethesda System 2001 Conformity Uterine Cervix Cytology 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introducin The 2001 Bethesda System","volume":"465","author":"Fujii K","year":"2012","journal-title":"J Prevent Med."},{"key":"e_1_2_7_20_1","first-page":"17","article-title":"Comparison of liquid based cytology and conventional smears in cervical cancer screening in our health check\u2010up clinic","volume":"27","author":"Kamei K","year":"2012","journal-title":"Official J Japan Soc Ningen Dock"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.5795\/jjscc.52.545"},{"key":"e_1_2_7_22_1","first-page":"24","article-title":"Efficiency of the incorporated liquid\u2010based cytology method in cervical cancer screening","volume":"489","author":"Kato N","year":"2016","journal-title":"J Prevent Med."},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.5795\/jjscc.55.137"},{"key":"e_1_2_7_24_1","first-page":"20","article-title":"Effectiveness of liquid based cytology and human papillomavirus testing for cervical cancer screening","volume":"489","author":"Kuwakubo 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HenstockE.Evaluation of HPV\/LBC cervical screening pilot studies. First report to the Department of Health on evaluation of LBC (December 2002) 2002."},{"key":"e_1_2_7_33_1","unstructured":"The National Institute for Health and Care Excellence.Guidance on the use of liquid\u2010based cytology for cervical screening. Available from URL:https:\/\/www.nice.org.uk\/guidance\/ta69\/resources\/guidance-on-the-use-of-liquidbased-cytology-for-cervical-screening-pdf-2294706450373. 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