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The liquid-based cytological test (LCT) is successfully and widely used to assess cervical cytology. This study aimed to compare the cytological findings and diagnostic sensitivity of LCT with those of the pick-and-smear (PS) method for diagnosing lung cancer.Sputum specimens from 101 patients diagnosed with lung cancer were studied.LCT slides showed decreased areas of cell monolayers, a clearer background and distinct, stereoscopic cytological features. The LCT had a significantly higher diagnostic sensitivity for lung cancer (80.2%) than the PS method (63.4%, P < 0.05), particularly for small cell lung carcinoma (P < 0.05). Combination of the LCT with the conventional PS method showed significantly higher diagnostic sensitivity for the detection of adenocarcinoma (80.6%) compared with the PS method alone (55.6%, P < 0.05).LCT is a useful and easily performed technique that can be widely applied, and is suitable for mass screening for the early diagnosis of lung cancer.