Correlation of cytotechnologists' parameters with their performance in rapid prescreening of papanicolaou smears (original) (raw)

A practical guide to papanicolaou smear rescreens

Cancer, 1998

BACKGROUND. The question of the minimum number of Papanicolaou (Pap) smear slides that must be rescreened to draw statistically valid conclusions regarding the accuracy of screening often is raised. No method for generating answers in varying laboratory circumstances has achieved widespread application; standard statistical sample size calculations may represent such a resource.

Detection of False Negative Pap Smears by Rapid Reviewing

Acta Cytologica, 2000

OBJECTIVE: To explore the diagnostic validity of rapid reviewing (RR) as a quality control method in cytologic laboratories. STUDY DESIGN: Fourteen studies dealing with the detection of false negative Pap smears by RR were included in a metaanalysis. RESULTS: The overall additional yield of positive slides, expressed as the percentage of all reviewed slides, is: 0.18% (95% confidence interval [CI]: .14-.21) for all cytologic abnormalities; 0.07% (CI: .05-.09) for squamous intraepithelial lesions (SIL) and 0.02% (CI: .01-.03) for high grade SIL. The false negative rate of primary screening, evaluated by RR, was 2.0% (CI: 1.5-2.6) for all cytologic abnormalities and 1.4% (CI: .8-2.1) for high grade SIL. The specificity of rapid rescreening was estimated as 97.2% (CI: 96.4-98.1). The positive predictive value of suspicion at RR is about 8.8%. Seven references contained historical data on full rescreening of a random sample of slides reported originally as negative. The results were also pooled and compared with RR. Complete rescreening is more sensitive, but if applied on only 10% of the negative workload, it would yield, on average, 4.7 times fewer extra positives, 5.6 times fewer SIL and 7.9 times fewer high grade SIL in comparison with RR of all sides. CONCLUSION: RR of all smears initially reported as nonpositive is a more effective and a fortiori a more cost effective quality control method in comparison with full rescreening of a 10% random sample. (Acta Cytol 2000; 44:949-957)

Cytohistopathological correlation of Papanicolaou smears: a hospital based study

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016

Background: Carcinoma of cervix is the second most common cancer in women worldwide and the leading cause of death from cancer in several developing countries including India. The use of the cervical smear (Papanicolaou/Pap) as a screening tool has significantly reduced the incidence of cervical cancer. Cytohistopathological correlation of Pap smear is a widely accepted method of internal quality assurance and helps in the analysis of various factors leading to discrepant diagnosis. With the above view, the present study has been carried out to evaluate the cytohistopathological correlation of the various cervical lesions. Methods: The study was prospective cross-sectional hospital based study carried out over a period of eight months in which out of 500 pap smears screened, cytohistopathological correlation of 70 cases were obtained. Results: Specificity in the present study was 84.2% and the sensitivity was 77.7%. The accuracy of Pap smears was 82.1%. The overall correlation between cytology and histopathology was found to be 57% with the highest correlation in the high grade squamous intraepithelial lesion (HSIL) category (87.5%). Conclusions: The study provides good cytohistopathological correlation especially for high grade lesions. So we believe that the success of screening for cervical cancer is based on collection of adequate materials and correct interpretation of abnormal cells.

Metaanalysis of the accuracy of rapid prescreening relative to full screening of pap smears

Cancer, 2002

BACKGROUND. Efficient quality assurance and improvement measures are essential ingredients in a well organized cytology-based program for cervical carcinoma screening. Various pap smear review procedures, aiming for optimization of accuracy, are described throughout the literature. Evaluation and synthesis of those methods are needed. In a previous study, we pooled data on the diagnostic quality of rapid reviewing (RR) of cervical smears initially reported as normal or unsatisfactory. We now focus on rapid prescreening (RPS) of unreported smears.

Papanicolaou smear history in women with low-grade cytology before cervical cancer diagnosis

Cancer, 2007

BACKGROUND. The purpose of the current study was to examine the screening histories of women diagnosed with invasive cervical cancer (ICC) in 2000 who had previous Papanicolaou (Pap) smears deemed to be unsatisfactory or with low-grade findings that did not lead to biopsy. METHODS. A total of 252 Pap smears from 47 women taken between 1992 and 2000 were included in the study; 247 smears were reexamined at the laboratory of origin before the study and all 252 were then reexamined independently by 2 experienced cytotechnicians and 2 cytopathologists. RESULTS. Of the 47 cases of ICC, 35 were squamous cell carcinoma, 10 were adenocarcinoma, and 2 were other types. On reexamination at the laboratory of origin, 24 cases were upgraded and in the study group 27 cases were upgraded to diagnoses requiring biopsy. On reexamination at the laboratory of origin, it was found that the first high-grade squamous intraepithelial lesion (HSIL) could have been diagnosed on average 4.2 years earlier than it was originally (95% confidence interval [95% CI], 3.3-5.1 years). On reexamination by the study group the first diagnosis of HSIL was made in smears dating from 5.4 years before the diagnosis of ICC (95% CI, 4.5-6.2 years). CONCLUSIONS. The study confirms that unsatisfactory and low-grade Pap smears imply a risk of developing high-grade lesions at a later date and shows that in a screening program a subgroup of smears may be diagnosed as unsatisfactory or low grade despite the presence of high-grade findings that are detectable on reexamination. Cancer (Cancer Cytopathol) 2007;111:210-6. 2007 American Cancer Society.