The Value of Repeat Pap Smear at the Time of Initial Colposcopy

Spitzer, Mark; Ryskin, Michael; Chernys, Ann E.; Shifrin, Alexander L.

doi:10.1006/gyno.1997.4829

Cited by 27 publications

(12 citation statements)

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“…The sensitivity of conventional cytology for epithelial abnormalities has been found to be lower when used at the time of colposcopically directed biopsy 3,18,21,22 than when used for screening purposes. This historical tendency, and the fact that the current study was exclusively one of cytology at the time of cone biopsy in a population with previous abnormal cytology, are facts to be kept in mind when considering these results as measures of general test performance.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Thin-Layer Cytology in Patients Undergoing Cervical Cone Biopsy

Bergeron¹,

Bishop²,

Lemarie³

et al. 2001

Acta Cytologica

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Section: Discussionmentioning

confidence: 99%

Accuracy of Thin-Layer Cytology in Patients Undergoing Cervical Cone Biopsy

Bergeron¹,

Bishop²,

Lemarie³

et al. 2001

Acta Cytologica

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“…[2][3][4]6 The changes in the second smear have been shown to be either more or less advanced and the usefulness of this practice has been questioned. [2][3][4]7 When we compared the first Pap smear with the second Pap smear and the cervical punch biopsies, the following findings emerged. In the original high grade group, the second Pap smear often underestimated the abnormality, and in only 51% of cases were high grade lesions detected.…”

Section: Discussionmentioning

confidence: 99%

“…The potential contribution of this practice to patient management is unclear. [2][3][4] The new paradigm of evidence-based medicine requires critical evaluation of this practice. 5 This study assessed the clinical value of a Pap smear taken at the time of colposcopy and addressed issues related to concordance between the first and second smears.…”

mentioning

confidence: 99%

Clinical Value of Repeat Pap Smear at the Time of Colposcopy

Zardawi

Rode

2002

Acta Cytologica

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“…7,10 On the other hand, recent studies suggest that the value of repeating a cervical smear at the time of colposcopy may be low, with sensitivity ranging from 25 to 57%. [11][12][13][14][15] Possible mechanisms that justify this low sensitivity include recent removal of the neoplastic cells and the fact that, after the initial scraping, the abnormal cells are not so easily exfoliated. 4,11 However, other studies have reported sensitivity above 70%.…”

mentioning

confidence: 99%

“…[11][12][13][14][15] Possible mechanisms that justify this low sensitivity include recent removal of the neoplastic cells and the fact that, after the initial scraping, the abnormal cells are not so easily exfoliated. 4,11 However, other studies have reported sensitivity above 70%. 15 Hypothetically, repeat cytology performed at the time of colposcopy may be clinically significant when results indicate a grade higher than that found by colposcopyguided biopsy, hence raising the suspicion that the lesion may be inside the cervical canal.…”

mentioning

confidence: 99%

Usefulness of repeat cytology at the time of first colposcopy

Alves

Rabelo-Santos

Ribeiro

et al. 2008

Diagnostic Cytopathology

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The value of repeat cytology in the detection of high-grade preinvasive or invasive disease was analyzed at the time of colposcopy in cases of patients with abnormal referral cytology. A series of 136 patients with squamous abnormalities in their referral cytology, who had undergone repeat cytology and for whom outcome had been established, were included in the study. Final diagnosis consisted of 27 negative results (20%), 37 cases of CIN1 (27%), 31 CIN2 (23%), 39 CIN3 (29%), and 2 (1%) cases of squamous cell carcinoma (SCC). Referral and repeat cytology suggestive of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H), high-grade squamous intraepithelial lesion (HSIL) were findings significantly associated with a final diagnosis of CIN2 or worse. Sensitivity and positive predictive value of repeat cytology for the histological diagnosis of significant histological neoplasia (CIN2 or worse) were 81.9% and 77.6%, respectively. In women with referral cytology findings of atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion (ASC-US/ LSIL), repeat cytology was suggestive of HSIL in 20% of cases (11/ 54), and in 4% (2/54) biopsy was negative or CIN1, and the final diagnosis established by LLETZ was CIN3. Eight cases (10%) of HSIL in referral and repeat cytology in which biopsies were negative or insufficient were diagnosed as CIN3 or worse in the final diagnosis. Repeat cytology would have changed therapeutic management in 4 and 10%, respectively, of patients included as ASC-US/ LSIL and ASC-H/HSIL in referral cytology. Diagn. Cytopathol. 2009;37:68-73. ' 2008 Wiley-Liss, Inc.Key Words: cytology; colposcopy; CIN; outcome Conventional cervical cytology is the worldwide screening test for cervical cancer and its accuracy has been discussed recently. The levels of sensitivity and specificity of cervical cytology vary greatly. A meta-analysis on the accuracy of cervical cytology estimates sensitivity and specificity ranging from 11 to 99% and 14 to 97%, respectively. 1,2 New technologies such as liquid-based cytology (LBC) and human papilloma virus (HPV) testing have been introduced into cervical cancer screening. However, there is continuous debate about whether society's limited resources are better spent on reaching the underserved rather than on these technologies. 3 Davey et al. 4 in a meta-analysis did not show evidence that LBC reduced the proportion of unsatisfactory slides or detected more high-grade lesions in high-quality studies than in conventional cytology. This review does not lend support to claims of better performance by liquidbased cytology. In addition, although HPV-DNA testing had higher sensitivity for detecting high-grade squamous intraepithelial lesions, its specificity is lower than that of cytology, particularly in younger women, and this represents an important restriction to the adoption of this technique as a single screening tool. 2,5 Performing a repeat cervical smear just prior to colposcopy is a common pr...

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The Value of Repeat Pap Smear at the Time of Initial Colposcopy

Cited by 27 publications

References 0 publications

Accuracy of Thin-Layer Cytology in Patients Undergoing Cervical Cone Biopsy

Accuracy of Thin-Layer Cytology in Patients Undergoing Cervical Cone Biopsy

Clinical Value of Repeat Pap Smear at the Time of Colposcopy

Usefulness of repeat cytology at the time of first colposcopy

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