Trends in Cervical Cytology Screening and Reporting Practices: Results From the College of American Pathologists 2011 PAP Education Supplemental Questionnaire

Abstract

Context.-The College of American Pathologists periodically surveys laboratories to determine changes in cytopathology practices. We report the results of a 2011 gynecologic cytology survey.Objective.-To provide a cross-sectional survey of gynecologic cytology practices in 2010.Design.-In 2011, a survey was sent to 1604 laboratories participating in the College of American Pathologists gynecologic cytology interlaboratory comparison education program and proficiency testing programs requesting data from 2010 on the following topics: terminology/ reporting, cytotechnologist workload, quality assurance, reagents, and ancillary testing.Results.-Six hundred and twenty-five laboratories (39%) replied to the survey. The nonstandard use of ''low-grade squamous intraepithelial lesion cannot exclude high-grade squamous intraepithelial lesion'' is used by most laboratories to report the presence of low-grade squamous intraepithelial lesion with possibility of high-grade squamous intraepithelial lesion. Most laboratories also report the presence or absence of cells from the transformation zone. Most respondents do not limit cytotechnologist screening workload during the work shift. Only about one-third of laboratories (188 of 582; 32%) use image-assisted screening devices. Rapid prescreening as a quality assurance measure is used by only 3.5% (21 of 594) of the laboratories. When used for screening, most laboratories use the imager for retrospective review of slides to detect human locator and interpretive errors. Most laboratories receive both liquid-based cytology samples (mainly ThinPrep, Hologic, Marlborough, Massachusetts) and conventional Papanicolaou tests. Expiration dates of liquid-based cytology test vials are not usually recorded.Conclusions.-The field of gynecologic cytology is evolving rapidly. These survey results offer a snapshot of national gynecologic cytology practices in 2010. (Arch Pathol Lab Med. 2016;140:13-21; doi: 10.5858/ arpa.2015-0004-CP) C ervical cytology has been the focal point for cytology innovation for the past 20 years, beginning with the adoption of the 1991 Bethesda System (TBS) for reporting cervicovaginal cytology. Since then, the practice of processing, screening, interpreting, and reporting Papanicolaou (Pap) tests has evolved to include adoption of liquid-based cervical sample collection with automated processing systems, implementation of automated screening devices, reflex testing of residual samples for human papillomavirus (HPV), and updated TBS reporting terminology to augment our improved understanding of HPV pathogenesis in cervical cancer and to complement clinical practice guidelines. There are few opportunities to assess and monitor national laboratory practices in cytology as they change over time, but the College of American Pathologists (CAP) interlaboratory comparison programs provide a unique opportunity to investigate changes in practices among participating laboratories by creating

Implementation of a real‐time reference and calibration grid platform for improved screening – mapping in Pap test slides

“…Recently, another study group presented the results of a consortium of many cytopathology labs regarding the implementation of these systems in the routine practice. When used for screening, most laboratories applied them only for retrospective review of slides instead of the daily conventional microscopy process …”

“…When used for screening, most laboratories applied them only for retrospective review of slides instead of the daily conventional microscopy process. 28 Although this specific study of RCG platform was implemented on thin solid glass cover slips, other approaches and fabrication techniques 11 could also be available for even more efficient handling and with a lower implementation cost, such as on suitable flexible polymer stripes or self-adhesive transparent tapes that could be easily attached to conventional cover slips. Modern available industrial capabilities could allow the upgrade of the prototype Laser writing system in large scale industrial inscription systems leading to the drastic improvement of production's efficiency, minimizing or even eliminating the cost of grids' production as this could be integrated with minimal modifications at the manufacturing process of the traditional cover slips.…”

Technical proficiency in cytopathology: assessment through external quality assurance

“…Those administered by the RCPAQAP Anatomical Pathology programme, including haematoxylin and eosin staining, frozen sections, immunohistochemistry and a variety of special stains, have helped establish benchmarks for technical expertise. Quality studies concerning laboratory aspects of cytopathology are more limited . The RCPAQAP has an educational as well as a proficiency testing role.…”

“…Quality studies concerning laboratory aspects of cytopathology are more limited. [1][2][3][4][5][6] The RCPAQAP has an educational as well as a proficiency testing role. This pilot study was undertaken to assess the feasibility of providing a technical module in cytopathology and its acceptance by laboratories.…”

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“…Возможности иммуногистохимических и иммуноцитохимических исследований, молекулярно-биологических методов морфологической диагностики опухолей в определе-нии гистогенеза новообразований могут послужить ос-новой для модификации ряда существующих класси-фикаций, определения маркеров, важных для прогноза и чувствительности к таргетной терапии при лечении ЗНО. Вопрос выносится на всеобщее обсуждение, по-скольку требует принятия мер как на федеральном, так и на региональном уровне [8].…”