Rapid rescreening of cervical smears as a quality control method in a high‐risk population

Michelow, Pam; McKee, Grace; Hlongwane, F.

doi:10.1111/j.1365-2303.2006.00366.x

Cited by 12 publications

(16 citation statements)

References 29 publications

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“…Also, 100% RR is supposed to have relatively low cost compared with other rescreening modalities, making it an attractive option for internal control in low-resource settings. 20 Our results confirm the qualities of 100% RR as a useful option for internal QC of cervical cytology diagnoses and to avoid false negative results. Further studies addressing costs should be performed to determine the cost-effectiveness of this quality control procedure in a public health cytology laboratory.…”

Section: Discussionsupporting

confidence: 75%

Performance of 3 Methods for Quality Control for Gynecologic Cytology Diagnoses

Utagawa

Shirata²,

Ferraz³

et al. 2008

Acta Cytologica

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Section: Discussionsupporting

confidence: 75%

Performance of 3 Methods for Quality Control for Gynecologic Cytology Diagnoses

Utagawa

Shirata²,

Ferraz³

et al. 2008

Acta Cytologica

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“…Michelow et al [30] reported that 16/19 (84.0%) cases identified at RR-100% were confirmed at repeat cytopathology and, even though our rates of agreement are lower, the result of repeat cytopathology confirmed 44.5% of cases identified at RPS and only 22.2% of cases identified at RR-100%. The studies by Lapin et al [24] and Alves et al [31] reported that 62.4 and 80.9% of cytopathology examinations, respectively, were abnormal on repeat cytopathology.…”

Section: Discussionmentioning

confidence: 66%

“…In the second, histopathology results were abnormal in 21% of cases of CIN1/+ and in 12% of cases of CIN2/+ [26,27]. The performance of RR-100% in the studies that took histopathology results into consideration ranged from 25 to 76.9% for CIN1/+ and 13.1 to 31.6% for CIN2/+ [14,28,29,30]. In this same study, an improvement was found in the performance of RS and consequently in the quality of the cytopathological diagnosis when the IQC methods were used.…”

Section: Discussionmentioning

confidence: 99%

Internal Quality Control for Cervical Cytopathology: Comparison of Potential False-Negatives Detected at Rapid Prescreening and at 100% Rapid Review

Tavares¹,

Souza²,

Manrique³

et al. 2014

Acta Cytologica

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Objective: To evaluate the performance of rapid prescreening (RPS) and 100% rapid review (RR-100%) as internal quality control (IQC) methods assessed by outcome at colposcopy, histopathology and repeat cytopathology for cases with false-negative results on cervical cytopathology at routine screening (RS). Study Design: Out of 12,208 cytology smears analyzed, 900 were abnormal. Of these, 656 were identified at RS, and 244 were false-negative, with 90.2% identified at RPS and 57.4% at RR-100%. Of the 900 abnormal cases, 436 were submitted for additional testing. Results: Of the 244 women with cytopathological abnormalities identified only by the IQC methods, 114 had supplementary examinations: 35 were submitted for colposcopy, 22 for biopsy and 99 for repeat cytopathology. The sensitivity of RPS for the detection of abnormalities identified on colposcopy, histopathology and repeat cytopathology was 87.5% (95% CI 67.6-97.3), 82.4% (95% CI 56.6-96.2) and 95.7% (95% CI 85.2-99.5), respectively. The sensitivity of RR-100% was 54.2% (95% CI 32.8-74.4), 52.9% (95% CI 27.8-77.0) and 47.8% (95% CI 32.9-63.1), respectively. RPS was more sensitive than RR-100% when compared to the findings on colposcopy (p = 0.011) and repeat cytopathology (p = 0.000). When compared to colposcopy, histopathology and repeat cytopathology, the sensitivity of RS was 83.2% (95% CI 76.1-88.9), 85.7% (95% CI 78.1-91.5) and 73.3% (95% CI 66.0-79.7), respectively. Conclusion: RPS performed better than RR-100% when compared to the results of colposcopy and repeat cytopathology.

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“…Since the publication of the 1991 article by Baker and Melcher, at least an additional 37 articles have been published on some aspect of rapid rescreening of negative smears, reporting large or small studies, testing the best methods and times for rapid rescreening or editorializing 1, 3–41. Although the data have been variable, nearly all reports have concluded that additional abnormal cases have been detected at all levels beyond those found by 10% full rescreening of negatives, including high‐risk cases determined by a variety of clinical factors, most specifically a history of abnormal cervical cytology.…”

Section: Discussionmentioning

confidence: 99%

Rapid prescreen of cervical liquid‐based cytology preparations: Results of a study in an academic medical center

Frable¹,

Pedigo²,

Powers³

et al. 2010

Diagnostic Cytopathology

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A rapid prescreening or rapid rescreening method for quality assurance in cervical cytology has been used in Europe and in Canada but has not been accepted in the United States. The rapid prescreen method was tested in a cytology laboratory that serves an academic medical center with a high-risk population for cervical cancer. For a period of 3 months, a tray of 20 sequentially numbered Surepath™ liquid-based preparations, randomly selected from the cervical cytology daily workload, were each prescreened in a random fashion for 1 minute. Experienced cytotechnologists performed the rapid prescreen. Results were recorded as negative, further review needed, or epithelial cell abnormality, category specified. The 20 cervical cytology preparations were then replaced in their same position in the daily workload for routine screening performed by another cytotechnologist. Final interpretation was by a cytopathologist as requested or required by Clinical Laboratory Improvement Amendments of 1988. The rapid prescreen data was tabulated and compared with data for a similar time period using the laboratory's normal quality assurance program. Seven hundred and twelve cases underwent rapid prescreen. Six hundred and forty-two were interpreted as negative. Twenty-six cases were interpreted as low-grade squamous intraepithelial lesion (LGSIL) or higher. Forty-four cases were classified as needing further review. For the 642 negative cases by rapid prescreening, routine screening reported 537 as negative and 105 as either abnormal or needed cytopathologist review. The error rate for the rapid prescreen is 50 of 712 (7.0%); for LGSIL and above 19 of 712 (2.6%). Of the 105 abnormal cases or those submitted for cytopathologist review, 31 were interpreted as atypical squamous cells of undermined significance (ASCUS), 41 cases as reactive/repair, 17 as LGSIL, 4 as unsatisfactory, 1 as atypical squamous cells, cannot rule out high-grade squamous intraepithelial lesion (ASC-H), 8 as the presence of endometrial cells in a women aged >40, 1 as malignant melanoma, and 2 as within normal limits with the presence of Actinomyces. The laboratory's routine quality assurance program selects cases, 10% of initially interpreted negative cases plus any gynecologic cytology on patients with a prior abnormal cervical cytology, or history of cervical epithelial cell abnormality. This quality assurance program averages 29% of cases, 4,045 of a total of 13,767, in 2008. Thirty-seven (0.9%) cases were detected in this rescreen (ASCUS, 16 cases; LGSIL, 13 cases; 1 high-grade squamous intraepithelial lesion; 4 ASC-H; and 3 atypical glandular cells of undetermined significance). Eliminating ASCUS cases, eight significant cases were detected, with an error rate of 0.2%. In this cytology laboratory, the rapid prescreen did not prove as reliable as routine quality assurance program for cervical cytology cases.

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Rapid rescreening of cervical smears as a quality control method in a high‐risk population

Cited by 12 publications

References 29 publications

Performance of 3 Methods for Quality Control for Gynecologic Cytology Diagnoses

Performance of 3 Methods for Quality Control for Gynecologic Cytology Diagnoses

Internal Quality Control for Cervical Cytopathology: Comparison of Potential False-Negatives Detected at Rapid Prescreening and at 100% Rapid Review

Rapid prescreen of cervical liquid‐based cytology preparations: Results of a study in an academic medical center

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