Opinions...Cytyc or Tripath(thinprep or surepath)

[Anonymous]

Lets see some cytotechnologists say that these are both great tests.............of course, they know better than to say something so patently ignorant. After all, they use them each day.

 

[Anonymous]

Lets see some cytotechnologists say that these are both great tests.............of course, they know better than to say something so patently ignorant. After all, they use them each day.

Personally, I think SurePath is the more accurate test. However, most cytotechs prefer to screen ThinPrep slides because the smears are cleaner and the cells are more similar to the cells found on conventional Pap smears. Thin Prep does have more unsats, mainly because of scant smears or patchy smears where the cell layers become thick clusters of cells piled on top of each other in patches, leaving large empty spaces around the patches. There is also a problem with physicians using either cheap or the wrong type of lubricant. The lubricant stains either red or deep purple, cover and obscure the cells and making the slides unreadable. Or the lubricant blocks the filter, causing an unsat due to scant cellularity.

Because Surepath uses a stratification process, it has a much lower unsat ratio than ThinPrep. Surepath seems to pick up more abnormal cases. I read an independent research paper that compared the accuracy for test results between the three methods :the conventional smear, ThinPrep and Surepath. SurePath won. That Independent lab converted completely over to Surepath, and not only did they save money in expenses, but the lab grew phenomenally.

The imager would be helpful if Cytic, in a desperate attempt to compete with the lower cost of Surepath had not authored legislation to arbitrarily change the maximum number that cytotechnologists may read in a 24 hour period from 80 slides per day to 200 slides per day.That was the only way that they could convince labs to use their imager. The only way that labs can justify the expense, doing a cost/benefit analysis, is to increase the number of slides that the cytotechnologist may screen, providing a way to evade CLIA 88. It is not possible to reliably read that many slides. To be sure, the added expense of the imager outweighs the benefits. Especially in these harsh economic times. The imager doubles the expense of the thin layer test yet it does not exceed the accuracy of manually screened thin layer tests. It only equals the accuracy. In effect, labs are forcing cytotechs to read twice as many slides for no increase in pay. Because of this, many cytotechs who are now out of work because of layoffs. Most other Cytotechs are suffering through this out of fear that speaking up will get them fired. Get my point? Talk about burnout!

And yes, most labs have done their own validations and use SurePath for HPV testing with no problem. If Cytic comes up with a new test like typing the virus, labs will probably validate and use SurePath for that procedure too.

A Cytotechnologist's thoughts

 

[MONOGEN SALES REP]

Cytology is a dying field anyways so cytotechs wont have to put up with it forever. The 200 slide limit also pertains to Surepath's imager too. The number is completely arbitrary. Probably made up by accountants.

 

[Anonymous]

Cytology is a dying field anyways so cytotechs wont have to put up with it forever. The 200 slide limit also pertains to Surepath's imager too. The number is completely arbitrary. Probably made up by accountants.

Well, lets put it this way. They have been trying to come up with a way to replace us cytotechnologist for a long time. The reason that it has not happened is equipment, like both the Focal Point and the Hologic Imager use algorithms that give the probability that a cell is normal or abnormal. A human eye has to make the determination. Even with the HPV testing. The test only shows that you at the time of the testing carry the virus. It does not mean that you are symptomatic or have a neoplasm. HPV testing is helpful because it screens out patients who are high risk of developing a neoplasm and should be followed. In most cases, the virus is eliminated by the patient's immune system.

Who is going to give a patient a biopsy just because an HPV test is positive? A colleague told me that they tried that at Kaiser. Big mistake. Don't think they will do that again.

If logic will ever prevail again, we will survive the corporate greed and get back to real health care.

 

[MONOGEN SALES REP]

Where you been the last 7 years. Techs getting laid off in large numbers and pap test volumes are dropping fast. You are being replaced.

 

[Anonymous]

Where you been the last 7 years. Techs getting laid off in large numbers and pap test volumes are dropping fast. You are being replaced.

Reading paps long before this form of the imager. Remember Pathnet? Accucell?Like I said. Logic will prevail. If your mother, wife, or daughter had a positive hpv test, would you send her directly to the knife, or follow her with a what used to be inexpensive pap test?
The imager only increases the cost of the test. It is no more accurate than manual screening and may be less accurate. The Focal Point is way less accurate. A lab I worked for found so many missed cases in the quintile that was supposed to be negative. making screening unnecessary during validation, that they refused to use it.

Lets see what the future really has in store.

 

[Anonymous]

Where you been the last 7 years. Techs getting laid off in large numbers and pap test volumes are dropping fast. You are being replaced.

Spoken like a true money freak. excuse me, sales rep.

Techs are being laid off because the FTC is not doing its job. Large corporate labs are gobbling up all of the smaller labs. This is pure unregulated monopoly. They increased productivity by working cytotechs to death and not paying them for the increase in productivity. They use the revenues derived from this to buy up other labs.They use the imager to get around CLIA regulations on slide limits.
Sure, efficiency is improved by multi-testing from one vial, however, many of the split specimens used for ancillary testing yield inadequate samples for pap testing and have to be rerun. Not exactly sure why.

Yes, Cytology is a dying field. Check out who is reading your paps. Chances are that they can barely speak English. The techs are being imported from Asia and India ( who may grumble in the back rooms but will not speak up to management) using the excuse that there is a shortage in the field while home grown Americans are losing their jobs and cannot get hired.

So life is not fair, right? Only the all mighty dollar rules, right? We'll see.

 

[MONOGEN SALES REP]

I am actually a cytotech myself and not a sales rep. I took the name Monogen sales rep as a joke. I agree the field is dead due to uncontrolled consolidation and the loss of the hospital based lab. Cytyc keeps saying the imager "frees" techs up to do other responsibilities. At the corporate labs, your only responsibility is screening paps. No FNAs are being done there. I guess it "frees" techs up to look for employment. No way in hell am I am EVER going to bring the imager to my lab. Stupid technology and probably will be shortlived anyways.

 

[Anonymous]

Personally, I think SurePath is the more accurate test. However, most cytotechs prefer to screen ThinPrep slides because the smears are cleaner and the cells are more similar to the cells found on conventional Pap smears. Thin Prep does have more unsats, mainly because of scant smears or patchy smears where the cell layers become thick clusters of cells piled on top of each other in patches, leaving large empty spaces around the patches. There is also a problem with physicians using either cheap or the wrong type of lubricant. The lubricant stains either red or deep purple, cover and obscure the cells and making the slides unreadable. Or the lubricant blocks the filter, causing an unsat due to scant cellularity.

Because Surepath uses a stratification process, it has a much lower unsat ratio than ThinPrep. Surepath seems to pick up more abnormal cases. I read an independent research paper that compared the accuracy for test results between the three methods :the conventional smear, ThinPrep and Surepath. SurePath won. That Independent lab converted completely over to Surepath, and not only did they save money in expenses, but the lab grew phenomenally.

The imager would be helpful if Cytic, in a desperate attempt to compete with the lower cost of Surepath had not authored legislation to arbitrarily change the maximum number that cytotechnologists may read in a 24 hour period from 80 slides per day to 200 slides per day.That was the only way that they could convince labs to use their imager. The only way that labs can justify the expense, doing a cost/benefit analysis, is to increase the number of slides that the cytotechnologist may screen, providing a way to evade CLIA 88. It is not possible to reliably read that many slides. To be sure, the added expense of the imager outweighs the benefits. Especially in these harsh economic times. The imager doubles the expense of the thin layer test yet it does not exceed the accuracy of manually screened thin layer tests. It only equals the accuracy. In effect, labs are forcing cytotechs to read twice as many slides for no increase in pay. Because of this, many cytotechs who are now out of work because of layoffs. Most other Cytotechs are suffering through this out of fear that speaking up will get them fired. Get my point? Talk about burnout!

And yes, most labs have done their own validations and use SurePath for HPV testing with no problem. If Cytic comes up with a new test like typing the virus, labs will probably validate and use SurePath for that procedure too.

A Cytotechnologist's thoughts

But as a fellow CT (and agreeing with the above statements re: the Imager) - Hasn't the workload limits changed since the FDA regulations came out?? This is perplexing if it hasn't in all the labs? I know that Cytyc probably sh** a brick when that came out, but aren't all labs nationwide following those regulations??

 

[Anonymous]

What is Labcorp doing now? Are they still screening 130 almost everywhere?

 

[Anonymous]

i gotta love the monogen rep always going on every labs board to talk about this and pretend to be a cytotech. Heres the bottom line. LCA will offer both until genprobe replaces pap testing as the primary screening test with a potential reflex to pap(most likely reflex to e6 e7 rna) for a huge improvement in specificity for hpv testing.

i have some accounts i will never convert because the doctors flat out dont care until they miss a case of cancer. I believe that in a well screened population either test will detect the majority of disease with HPV ascus testing and more importantly, hpv co testing with reflex to 16/18 typing. If they are not cotesting with surepath they are putting themselves at serious risk. What woman pick the non fda approved test for HPV if they had the choice? 2 failures and a third withdrawl at the fda.

With doctors extending screening intervals there will be an increase in cervical cancer incedence for patients who were papd with surepath due to its low hsil detection(reference 2006 cap data) Any physician that is offering this test is putting themselves at risk with healthcare reform. If i went into law after this i would start a gyn law firm targeting offices using surepath and not using hpv for women over 30.

 

[Anonymous]

i gotta love the monogen rep always going on every labs board to talk about this and pretend to be a cytotech. Heres the bottom line. LCA will offer both until genprobe replaces pap testing as the primary screening test with a potential reflex to pap(most likely reflex to e6 e7 rna) for a huge improvement in specificity for hpv testing.

i have some accounts i will never convert because the doctors flat out dont care until they miss a case of cancer. I believe that in a well screened population either test will detect the majority of disease with HPV ascus testing and more importantly, hpv co testing with reflex to 16/18 typing. If they are not cotesting with surepath they are putting themselves at serious risk. What woman pick the non fda approved test for HPV if they had the choice? 2 failures and a third withdrawl at the fda.

With doctors extending screening intervals there will be an increase in cervical cancer incedence for patients who were papd with surepath due to its low hsil detection(reference 2006 cap data) Any physician that is offering this test is putting themselves at risk with healthcare reform. If i went into law after this i would start a gyn law firm targeting offices using surepath and not using hpv for women over 30.

Oh, Please. Go to this link and weep:

http://www.hivandhepatitis.com/recent/2011/0429_2011_c.html

You have just been scooped and don't even know it. You have been looking in the wrong direction, Hologic and BD. Roche is about to eat your lunch.

 

[Anonymous]

But as a fellow CT (and agreeing with the above statements re: the Imager) - Hasn't the workload limits changed since the FDA regulations came out?? This is perplexing if it hasn't in all the labs? I know that Cytyc probably sh** a brick when that came out, but aren't all labs nationwide following those regulations??

Which regulations are you talking about? Has anything changed since the slide limits for each tech was left up to the cytopathologist? meaning do the max or else regulations???

 

[Anonymous]

It will be a pleasure to see greedy Cytic loose market share to Roche....

http://www.hivandhepatitis.com/recent/2011/0429_2011_c.html

 

[Anonymous]

i gotta love the monogen rep always going on every labs board to talk about this and pretend to be a cytotech. Heres the bottom line. LCA will offer both until genprobe replaces pap testing as the primary screening test with a potential reflex to pap(most likely reflex to e6 e7 rna) for a huge improvement in specificity for hpv testing.

i have some accounts i will never convert because the doctors flat out dont care until they miss a case of cancer. I believe that in a well screened population either test will detect the majority of disease with HPV ascus testing and more importantly, hpv co testing with reflex to 16/18 typing. If they are not cotesting with surepath they are putting themselves at serious risk. What woman pick the non fda approved test for HPV if they had the choice? 2 failures and a third withdrawl at the fda.

With doctors extending screening intervals there will be an increase in cervical cancer incedence for patients who were papd with surepath due to its low hsil detection(reference 2006 cap data) Any physician that is offering this test is putting themselves at risk with healthcare reform. If i went into law after this i would start a gyn law firm targeting offices using surepath and not using hpv for women over 30.

Check this out and think again:
http://www.hivandhepatitis.com/recent/2011/0429_2011_c.html

 

[Anonymous]

Which regulations are you talking about? Has anything changed since the slide limits for each tech was left up to the cytopathologist? meaning do the max or else regulations???

The FDA came out with slide regulations last August. Didnt all the Labcorps change how they count slides? I know Q did.
Do LC still have quotas?

 

[Anonymous]

wow thanks for the press release i forgot about that one. You are an idiot to think roche will eat my lunch. They will get a piece but i suggest you do your homework before speaking. Genprobe aptima hpv is the gamechanger and they will eat your butt

nothing else you can say

 

[MONOGEN SALES REP]

Cervical cancer screening is overkill. Vaccines, hpv tests, imaged guided paps. Its no wonder our health insurance is so damn expensive. A conventional pap once a year was probably the best method when you take all factors into consideration. There is no evidence that liquid based is any better. With thinprep having more unsatisfactory specimens, conventional may even be superior.

The corpse, bioreference and the Q are still making techs screen WAY too many slides. The door is open for cytology to be replaced since doctors wont be able to trust results anymore.

What doctor is actually following the new guidelines for less screening. They like the revenue from low client pricing. They will collect paps till the end of time unless insurance companies quit allowing it.

 

[Anonymous]

Which regulations are you talking about? Has anything changed since the slide limits for each tech was left up to the cytopathologist? meaning do the max or else regulations???

Probably one of the most significant regulation changes in the history of cytology, but are you telling me that you think big labs are still making cytotechs screen over those limits?
If there are cytos out there are you work at corpse or Q, how many are you still screening? Over 100? Over 130? More?
Requesting serious posts please, this is important!

 

[MONOGEN SALES REP]

The labs can make techs do way more than 100 cases nowadays since the slides only count 0.5. Most techs are doing way over 100 now. I've heard some doing 20 slides an hour.