Cytopathology in Austria

Breitenecker, G.; Dinges, H. P.; Regitnig, Peter; Wiener, H.; Vutuc, Ch.

doi:10.1111/j.1365-2303.2004.00125.x

Cited by 14 publications

(7 citation statements)

References 5 publications

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“…External quality assurance (EQA) may also take the form of monitoring staining procedures, laboratory and personal reporting rates for high-grade and low-grade cytological abnormalities and comparing results with national standards. 10 In the UK, a technical EQA scheme for staining techniques was established and reporting rates of all cytology laboratories are published annually and are used to provide achievable ranges for reporting cytological abnormalities. 15,32 Accreditation of the laboratory unit Based on predefined standards, an external organisation checks 33 and finally certifies the quality of the institution under investigation.…”

Section: External Quality Control Of Screening Skillsmentioning

confidence: 99%

“…Communication with gynaecologists and other sample takers with respect to specific cases. Communication includes a periodical report to smear takers with respect to the quality aspects of the samples. Communication and education of cytotechnologists with respect to difficult cases and cases with discrepant cyto‐histological results. Guidance and support for adequate (continuing) education of cytotechnologists and junior medical staff. Participation in quality assurance programmes including preparation of an annual report concerning the outcomes of the cytological and histological follow‐up examinations 10 …”

mentioning

confidence: 99%

“…Participation in quality assurance programmes including preparation of an annual report concerning the outcomes of the cytological and histological follow‐up examinations 10 …”

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confidence: 99%

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European guidelines for quality assurance in cervical cancer screening: recommendations for cytology laboratories*

Wiener¹,

Klinkhamer

Schenck

et al. 2007

Cytopathology

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European guidelines for quality assurance in cervical cancer screening: recommendations for cytology laboratoriesThe quality of a cervical cytology laboratory depends on adequate handling and staining of the samples, screening and interpretation of the slides and reporting of the results. These guidelines give an overview of procedures recommended in Europe to manage the balance between best patient care possible, laboratory quality assurance and cost effectiveness and will be published as a chapter 4 in the European Guidelines for Quality Assurance in Cervical Cancer Screening. The laboratory guidelines include protocols for personnel and organisation, material requirements, handling and analysing cervical samples, recording of results, quality management and communication. The section on quality management is comprehensive and includes protocols for all aspects of internal and external quality assurance. The guidelines are extensively referenced and as far as possible the recommendations are evidence-based.

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Section: External Quality Control Of Screening Skillsmentioning

confidence: 99%

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confidence: 99%

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European guidelines for quality assurance in cervical cancer screening: recommendations for cytology laboratories*

Wiener¹,

Klinkhamer

Schenck

et al. 2007

Cytopathology

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“…Austrian medical societies recommend an annual smear test for all women from the age of 19, as part of their gynecological examination [8]. The costs for these examinations are borne by the statutory health insurance as part of the “new prevention program” regardless of individual insurance coverage.…”

Section: Introductionmentioning

confidence: 99%

Quality of screening with conventional Pap smear in Austria – a longitudinal evaluation

et al. 2013

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BackgroundIn recent decades, the incidence of cervical cancer and cervical cancer mortality in Austria has declined by varying degrees. The Pap smear is to be considered a causal factor for this decline.MethodsThis longitudinal analysis is based on a data set of Pap smear assessments collected by the Committee for Quality Assurance of the Austrian Society of Cytology. Data from 15 laboratories participating in a voluntary self-monitoring program was analyzed for the time span 2004–2008. The data was analyzed in terms of smear quality and assessment quality.A rank-correlation-test for a monotonic trend analysis in the proportion of the three parameters Pap 0, “satisfactory, but limited/SBL”, and Pap IIID/IV for the timespan 2004 to 2008 was carried out.ResultsFor this study, we analyzed an average number of 730,000 smears per year over a five-year period. Specimens from all but two laboratories, i.e. < 2% of all smears, met the quality criterion for Pap 0 (Bethesda 2001 equivalent: Specimen processed and examined, but unsatisfactory for evaluation of epithelial abnormality), whilst only four laboratories, i.e. < 10% of all smears, reached the national requirement for smears classified as “satisfactory, but limited/SBL”.When using the Pap IIID/IV ratio (LSIL: HSIL/AIS ratio) of 3:1 to 8:1 as a surrogate quality marker for the interpretation of smears, only five laboratories met this criterion during the survey period.The trend analysis indicated only that an increasing number of samples per year is correlated with an increased proportion of Pap 0 and “satisfactory, but limited/SBL” smears.ConclusionsAlthough participants get regular feedback about their results, no general improvements in smear taking or assessment were observed over the years, so mandatory quality management, including the possibility of sanctions, is suggested in order to reduce adverse health effects for women.

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“…Infrastructure and resources in healthcare are not adequate in many areas to build‐up an effective programme based on conventional Pap‐smear cytology. In several rich countries, even with an annual screening policy recommended, when theoretically cervical cancer‐induced mortality should have been prevented by up to 99.6% (6), a large proportion of the target women remain totally unscreened (7), and form the biggest risk population for cervical cancer. Moreover, very frequent screening intervals of young women may be associated with growing anxiety, over‐treatment and unfounded costs.…”

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confidence: 99%

Introducing HPV screening: challenges and fallacies

Nieminen

Anttila

2007

Acta Obstet Gynecol Scand

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For 40 years it has been known that 80% of cervical cancer can be prevented by well-organised, high quality screening programmes, using Papsmears with 3-to 5-year screening intervals (1). With the best programmes, mortality from the disease can be reduced by approximately 90% (2). Some of the Nordic countries are good examples in this respect (3). On the other hand, in several countries a decrease of only 40Á65% in cervical cancer incidence has been documented (1Á4). There are still countries with very high death and morbidity rates from this disease, even with no historical decrease in the rates (1).There is considerable variation in the organisation and implementation of cervical cancer screening programmes within European countries (5). Infrastructure and resources in healthcare are not adequate in many areas to build-up an effective programme based on conventional Pap-smear cytology. In several rich countries, even with an annual screening policy recommended, when theoretically cervical cancer-induced mortality should have been prevented by up to 99.6% (6), a large proportion of the target women remain totally unscreened (7), and form the biggest risk population for cervical cancer. Moreover, very frequent screening intervals of young women may be associated with growing anxiety, over-treatment and unfounded costs.Nearly all cervical cancers are caused by the human papilloma virus (HPV), and new screening techniques based on HPV-DNA testing have raised hope and expectations for eradication of the disease. Testing for HPV-DNA is one of the most intensively studied alternatives to cervical cytology screening. HPV-tests verify the presence of practically any oncogenic HPV type, i.e. those HPV types associated with high risk ratios for cervical cancer. Several studies on HPV-DNA test screening indicate that these tests, used alone or in conjunction with cytology, have a high sensitivity (90%) for the detection of cervical intraepithelial neoplasia (CIN) lesions (8Á10). It has also been suggested that HPV-DNA tests are more reproducible than cytology. In a recent overview of 8 European and North American studies, variation of the cross-sectional sensitivity of Pap smears to detect CIN 2 and more serious lesions varied between 19 and 76%, with an average of 53%, whereas for HPV screening the corresponding range was smaller at 55Á100%, with an average of 96% (9). These lesions were both regressive and progressive, and so far it has not been possible to estimate outcomes based on cervical cancer incidence, which is the gold standard for evaluating progressive lesions. Follow-up studies thus far suggest that cervical cancer rates are 80Á95% lower in populations screened adequately with cytology than in unscreened populations (1,11). Thus, there is only a No potential conflict of interest disclosed. b Consultant (Merck and Co; GlaxoSmithKline, paid).

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Cytopathology in Austria

Cited by 14 publications

References 5 publications

European guidelines for quality assurance in cervical cancer screening: recommendations for cytology laboratories*

European guidelines for quality assurance in cervical cancer screening: recommendations for cytology laboratories*

Quality of screening with conventional Pap smear in Austria – a longitudinal evaluation

Introducing HPV screening: challenges and fallacies

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