The College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology

Benign Cellular Changes in Pap Smears

“…As reported in the College of American Pathologists interlaboratory comparison program in cervicovaginal cytology, the leading cause of overclassification of Pap smears is reactive/ reparative changes. 4 Of the patients who underwent biopsies, 14% had HPV/CIN 1-related changes. All these patients had at least two previous Pap smears classified either as ASCUS or LSIL.…”

Do Proficiency Test Results Correlate With the Work Performance of Screeners Who Screen Papanicolaou Smears?

“…3 It has not been possible to implement such a program nationwide because of the resources needed to assemble and maintain the necessary number of high-quality glass slides in the required diagnostic caté-gories for the test. [4][5][6] This has renewed a longstanding discussion about the validity of glass-slide proficiency testing in Pap smear quality assurance and stimulated a search for alternative testing stratégies. 7 -8 State operated and approved proficiency testing programs hâve been available in the United States for more than 20 years, and thèse hâve been studied in détail, 5 -9-19 but the validity of the glass-slide proficiency test for measuring screening skills has not been established firmly.…”

Cervical Cytologic Smear False Negative Fraction

“…31 Another recent CAP Q-probe study analyzed the performance of a varied group of laboratories, pathologists and cytotechnologists interpreting the cervical smears sent out in the CAP's Interlaboratory Comparison Program in Cervicovaginal Cytology. 8 Of interest was the better performance of large laboratories, reviewing more than 100,000 smears a year, which had error rates of 1.9% as compared to those of smaller laboratories, such as ours, which reviewed between 5,000 and 14,999 smears a year and had error rates of 3.3%.…”

“…This parallels the experience reported by Krieger and Naryshkin and others who claim that although FNFs may fall below 5%, they are unlikely to remain below this level: a 5-10% FNF may represent a "floor." [1][2][3][4][7][8][9]15,[18][19][20][21]24,32 A main cause of false negative smears not addressed in this or many other studies is the absence of abnormal cells on the smears themselves due to sampling problems. In this study we dealt only with false negatives due to either the misinterpretation of or failure to detect abnormal cells on the smears.…”