The merits of rapid, economic acetic acid, papanicolaou stain (REAP) over papanicolaou stain (PAP) technique in cervical cytology

Background: Carcinoma cervix is the most common preventable cancer in women. The universal stain used in screening of pre-cancer and cancer cervix is papanicolaou stain. The objective of this study was to carry out to assess the quality of staining, cost effectiveness, duration of staining and preservation of staining of PAP stain in comparison with REAP stain.Methods: 200 smears were collected from 100 patients; one set of smears were stained with conventional PAP technique and other set with REAP technique. The ethanol bath in PAP technique is replaced with 1% acetic acid, tap water is used instead of scotts tap water in REAP technique. Methanol is used only for final dehydration. The two sets were assessed for optimal and suboptimal nuclear and cytoplasmic staining and the results were analysed.Results: Good cytoplasmic transparency and optimal nuclear details were seen in REAP stained smears when compared to the conventional PAP stain. The cost involved in REAP method was lesser when compared to PAP technique. REAP method took 7 minutes whereas PAP method involved 30 minutes.Conclusions: REAP technique produces better staining, cost effective and simple, with minimum use of alcohol. Involves minimal time for mass cervical cancer screening as compared to conventional PAP smears.