title: A model for quality assessment in cervical cytology used as a screening test.
abstract: Although many reliability studies on cervical cytology have been carried out, measurements of sensitivity and specificity have rarely been made since biopsies are not often performed on patients with a negative smear result. This screening assessment was performed over 3 years, using a database of 230,167 smears from 177,051 women. It would seem that cervical cytology has a high specificity (over 99%) but a relatively low sensitivity (61%). Values for sensitivity (exceeding 95%) and specificity (exceeding 99%) for invasive carcinoma should be regarded as reasonably accurate as all incident cases of symptomatic cervical carcinoma are recorded in the Burgundy register. The sensitivity (57%) for pre-invasive lesions is underestimated while their prevalence is overestimated: the lack of organized screening leads to the loss of prevalent cases. The predictive value of a positive smear is 76% for moderate-severe dysplasia, 85% for in situ carcinoma and over 95% for invasive carcinoma.
authors.affiliation: Medical Data Processing Department, Centre Hospitalier Régional et Universitaire de Dijon, France.
authors.forename: C
authors.initials: C
authors.lastname: Quantin
authors.forename: L
authors.initials: L
authors.lastname: Dusserre
authors.forename: A M
authors.initials: AM
authors.lastname: Montaud
authors.forename: C
authors.initials: C
authors.lastname: Mottot
authors.forename: J P
authors.initials: JP
authors.lastname: Feldman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000473:pathology; D002648:Child; D003218:Condylomata Acuminata / Q000175:diagnosis* / Q000473:pathology; D003955:Diagnostic Tests, Routine / Q000592:standards; D005260:Female; D006801:Humans; D008875:Middle Aged; D008962:Models, Theoretical; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D014626:Vaginal Smears / Q000592:standards*