Role of automation in cervical cytology

The introduction of liquid-based cytology (LBC) in UK laboratories has set a platform for automation in the cervical screening process. Currently, machines are used in sample preparation, recording of results and electronic transfer of data to various agencies. The UK government has recently set a turnaround time target by 2010 of 14 days from the sample being taken to the result being received by the woman. This target gives laboratories only 7 days to process and report cervical samples. Currently, two FDA-approved semi-automated machines are available which can expedite the microscopic analysis of the process; however, the available data on effectiveness and cost-effectiveness are not sufficient for the UK screening programme to make a decision regarding their introduction in cytology laboratories. The Health Technology Assessment-funded MAVARIC trial is assessing each system. It is also designed to provide a head-to-head comparison of both systems. The trial is due to report in 2009. If favourable, the UK screening programme will have to look into the detail of the practicality of introducing these technologies in cytology laboratories. This review focuses on the brief history of automation and gives details of the working of the two FDA-approved systems. The points needing to be considered when deciding whether or not to implement these technologies in the National Health Service Cervical Screening Programme (NHSCSP) in the UK will be enumerated.