Rapid Acetic Acid Papanicolaou Stain: An Economical and Rapid Substitute to conventional PAP Stain

Abstract

Background: Cervical cancer screening relies heavily on the Papanicolaou (PAP) stain, which, although effective, is time-consuming and relatively costly. In resource-limited and high-volume settings, there is a need for faster, economical, and efficient staining techniques such as the REAP method.
Aim: To evaluate and compare the staining quality of the Rapid Economical Acetic acid Papanicolaou (REAP) staining technique with Conventional PAP stain
Material & Method: We collected 372 cervical smears from 186 patients over the course of six month. Each patient provides two samples- one for routine examination for conventional PAP stain and the other for the REAP stain. One batch of smears was stained using the traditional PAP stain method, while the other was stained using the REAP technique which utilized 1% acetic acid instead of absolute alcohol in almost every step except during the fixation and just before mounting.
Result: The comparative analysis of the REAP stain versus the PAP stain highlights the REAP method as a feasible and effective alternative for cytological diagnosis, particularly in environments with limited resources and high sample volumes. REAP staining significantly reduces turnaround time, completing the process in approximately 3 to 6 minutes, as opposed to the 20 to 30 minutes required for the conventional PAP method.
Conclusion: REAP staining is faster, cheaper, and simpler than PAP, making it suitable for high-throughput and low-resource settings while maintaining strong diagnostic accuracy. Despite slightly less cytoplasmic detail, it shows excellent nuclear clarity, higher abnormal detection, and fewer unsatisfactory slides, making it ideal for large-scale screening.