Prospective study of PAPNET: review of 25656 Pap smears negative on manual screening and rapid rescreening

Abstract

In this prospective study, 27,014 Pap smears were selected for PAPNET review on the request of the referring practitioner or patient. Smears that were negative on routine manual screening were submitted for rapid rescreening. Smears considered normal after these two manual screens (n = 25,656) were reviewed using the PAPNET testing system. Routine manual screening identified 1340 (4.96%) of the smears as abnormal, and a further 18 (0.07%) abnormalities were detected by rapid rescreening. PAPNET review identified an additional 102 (0.4%) abnormal smears, including 10 histologically confirmed high grade lesions. The use of PAPNET testing following routine manual screening and rapid rescreening in tandem, enables cytologists to detect additional diagnostically significant abnormalities and reduce the rate of false-negative smears.

Detection of False Negative Pap Smears by Rapid Reviewing

“…14,15 This number was too small for metaanalytic exploration. AutoPap (NeoPath Incorporated, Redmond, Washington, U.S.A.) was applied in only one, small trial, not allowing statistically significant conclusions.…”

Cervical False Negative Cases Detected by Neural Network–Based Technology

“…When nnb rescreening (nnbr) is performed by an experienced CP, it is more efficient than random 10% manual rescreening. [4][5][6][7][12][13][14] Nnbt detects even rare and scattered atypical cells that are hard to identify by OM because of their scanty cellularity and because they can be masked by inflammatory cells. We did not evaluate the cost/benefit ratio in our study.…”

Improvement in the routine screening performance of cytotechnologists over time

“…[9][10][11][12][13][14][15][16] Rapid prescreening (RPS) of all gynecologic specimens is an inexpensive technique that was introduced in the United Kingdom (UK) as an alternative and useful QC standard; however, it is far from becoming routine practice in North America.…”

“…[5][6][7][8] Alternative strategies include either manual rescreening of all negative Pap smears, which is time-consuming and not practical in a high-volume laboratory, or automated rescreening of all negative Pap smears, which has generated promising results but is still expensive and not widely used. [9][10][11][12][13][14][15][16] Rapid prescreening (RPS) of all gynecologic specimens is an inexpensive technique that was introduced in the United Kingdom (UK) as an alternative and useful QC standard; however, it is far from becoming routine practice in North America. [17][18][19] As a matter of fact, even in the UK, the most widely used QC method is rapid rescreening (RR) rather than RPS.…”