Assessment of the Validity and Reproducibility of the Pap Smear in Mexico: Necessity of a Paradigm Shift

Yunes-Díaz, Elsa; Ruiz, Patricia Alonso-de; Lazcano‐Ponce, Eduardo

doi:10.1016/j.arcmed.2015.05.013

Cited by 11 publications

(10 citation statements)

References 32 publications

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“…The changes not detected by rapid prescreening and 100% rapid review corresponded to ASC‐US and LSIL. These changes may be less evident during routine scrutiny, thereby accounting for most cases of interobserver variability . The cellular morphological criteria are the basis for the cytological diagnosis; however, morphological abnormalities are not always sufficiently different that rapid identification can detect rare smear cells and confuse them with benign cellular alterations .…”

Section: Discussionmentioning

confidence: 99%

Performance of rapid prescreening and 100% rapid review as internal quality control methods for cervical cytopathology

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Performance of rapid prescreening and 100% rapid review as internal quality control methods for cervical cytopathology

et al. 2018

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“…Both errors contribute to a relatively low sensitivity of the Pap test 12 . In Mexico, the sensitivity of the Pap test to detect high‐grade squamous intraepithelial lesions (HSIL) or CC ranges from 40% to 59%, with a corresponding specificity of 87% to 98% 13‐15 …”

Section: Introductionmentioning

confidence: 99%

Benefit of double‐reading cytology smears as a triage strategy among high‐risk human papillomavirus–positive women in Mexico

Ramírez-Palacios

Chen

Flores

et al. 2020

Cancer Cytopathology

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BACKGROUND: The goal of this study was to determine whether the detection of histologically confirmed cases of cervical high-grade squamous intraepithelial lesions or worse (HSIL+) can be increased by having each liquid-based cytology (LBC) slide read by 2 cytotechnologists as part of routine screening. METHODS: Over 36,212 women aged 30 to 64 years participated in the Forwarding Research for Improved Detection and Access for Cervical Cancer Screening and Triage (FRIDA) Study in Mexico between 2013 and 2016. For each participant, 2 cervical samples were collected at the same clinic visit, one to test for high-risk human papillomavirus (hrHPV) and the other for LBC, which was used to triage those with a hrHPV positive result. LBC slides were evaluated by 7 cytotechnologists, with each slide read independently by 2 blinded cytotechnologists. All women with atypical cells of undetermined significance or a worse result were referred to colposcopy for further evaluation and diagnosis. Three pathologists evaluated the biopsy specimens to confirm the final HSIL+ diagnosis. The HSIL+ detection rates for the single versus double reading were estimated and compared.

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“…Papanicolaou (Pap) test is an essential screening test for the early detection of cervical cancer. [ 7 8 ] Nevertheless, the literature generally maintains that Pap smear is not a very precise, sensitive test for the detection of endometrial pathology. [ 9 ] To date, there is no standard screening test for the early detection of EC.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic role of papanicolaou smear, hemoglobin, blood group, and other clinical symptoms in detecting endometrial carcinoma: A clinicopathological study of 175 Iranian women with endometrial carcinoma

Hosseini

Mohammadian

Farzaneh

et al. 2020

Gynecol Minim Invasive Ther

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Objectives: Endometrial carcinoma (EC) is a common gynecologic malignancy in the female genital tract, especially in postmenopausal women. The current study aimed to analyze Papanicolaou (Pap) smear in patients with EC to assess the relationship between EC and abnormal cells in Pap smear, ABO blood group, and hemoglobin anemia. Materials and Methods: A retrospective study was conducted on 175 patients with EC in Imam Hossein Hospital, Tehran, Iran, during the period from 2013 to 2019. The histology information of cases was extracted from the hospital database, and Pap smear slides were taken from pathological archives. The acquired information and slides were then reviewed by an expert pathologist in the hospital. The data were analyzed in SPSS (version 18) by the Chi-square test, Fisher's exact test, and independent-samples t -test. P < 0.05 was assigned as significant. Results: The mean age of patients was 54.47 ± 11.34, ranging from 32 to 85 years, and 31.4% of the patients were premenopausal women. Grade III, invasion ≥ 50% of myometrial, and advanced stage (III and IV) were diagnosed in 30%, 7.4%, and 22.86% of the patients, respectively. The most common histological types of EC were endometrioid (66.9%), papillary (10.3%), and malignant mixed Mullerian tumor (5.7%). The abnormal Pap smear was achieved only in 37 EC patients (21.1%). Endometrial cells, atypical squamous cells of undetermined significance, and atypical glandular cells were observed in 56.8%, 29.7%, and 13.5% of the patients > 40 years of age with abnormal Pap smears, respectively. In patients with normal Pap smears, the most common results were inflammation in 75.1% and atrophy in 14.6% of the patients. Abnormal uterine bleeding was the most important problem observed in patients with EC. Conclusion: The efficacy of Pap smear in detecting EC is limited. Therefore, women with EC, >40 years of age, with heavy bleeding, anemia, O blood group, inflammation, and atrophy in Pap smear in the past 3 years need to be precisely checked up for EC. These items can be added as new criteria for EC screening procedures.

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Assessment of the Validity and Reproducibility of the Pap Smear in Mexico: Necessity of a Paradigm Shift

Cited by 11 publications

References 32 publications

Performance of rapid prescreening and 100% rapid review as internal quality control methods for cervical cytopathology

Performance of rapid prescreening and 100% rapid review as internal quality control methods for cervical cytopathology

Benefit of double‐reading cytology smears as a triage strategy among high‐risk human papillomavirus–positive women in Mexico

Diagnostic role of papanicolaou smear, hemoglobin, blood group, and other clinical symptoms in detecting endometrial carcinoma: A clinicopathological study of 175 Iranian women with endometrial carcinoma

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