Introduction: Liquid-based cytology is a technique that enables cells to be suspended in a liquid medium and spread in a monolayer, thereby enabling a better morphological assessment. Automated techniques have been widely used especially in the developed countries but limited in the developing countries due to cost and availability.

Conventional Pap smear (CPS) examination has been the commonly used method for detection of cervical cancer. However, there have been challenges in its use due to the inherent limitations, like presence of obscuring blood and inflammation which has reduced its sensitivity considerably. On the other hand, manual liquid based cytology (MLBC) is a technique that is cost effective and improves detection of precursor lesions and specimen adequacy.

Methodology: A total of 295 women were assessed for pre-cancerous lesions and cervical cancer using Manual Liquid Based Cytology and Conventional Pap Smear method.Cohen Kappa test was run to determine the level of agreement the two methods.

Results: There was moderate agreement between the two methods (k=0.673, 95% CI, p=0.065). Specimen adequacy was found to be better with MLBC than CPS with 12 unsatisfactory smears in MLBC and 22 in CPS. There was increased detection rate of abnormal cervical cytology smears with MLBC of 85.7%.

Conclusion: Manual liquid based cytology was found to give better results than conventional Pap smear and therefore it can be used as an alternative liquid based cytology technique for cervical cancer screening in limited resource settings.

Keywords: Manual Liquid Based Cytology, Conventional Pap Smear.

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Onesmus Mutuku

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