Cervical cancer remains one of the leading causes of cancer-related morbidity and mortality among women worldwide despite being largely preventable through organized screening programs. Persistent infection with high-risk human papillomavirus (HPV) plays a central role in the development of cervical intraepithelial neoplasia (CIN) and invasive cervical carcinoma. Early identification of precancerous lesions significantly reduces disease burden through timely intervention. Liquid-Based Cytology (LBC) has emerged as an important advancement over the conventional Papanicolaou smear by providing cleaner background preparations, improved specimen adequacy, reduced obscuring material, and compatibility with ancillary molecular testing. Numerous studies have demonstrated that LBC offers higher sensitivity while maintaining comparable specificity for detecting cervical epithelial abnormalities.

This review summarizes the current evidence regarding the diagnostic performance of LBC in identifying cervical precancerous lesions. The article discusses specimen collection techniques, laboratory processing, interpretation using the Bethesda System, comparison with conventional cytology, integration with HPV testing, clinical applications, limitations, future developments involving artificial intelligence, and the role of LBC in modern cervical cancer screening.