title: Etiologies for non-correlating cervical cytologies and biopsies.
abstract: To investigate the etiologies for discrepancies between cervicovaginal smear and corresponding cervical biopsy results, 615 patients with cytologic diagnoses of dysplasia or malignancy during 1 year were reviewed. Sixty-nine patients (11%) were identified in which the cytologic and histologic diagnoses differed. Utilizing an algorithm developed for the study, these cases were assigned an etiologic category for discrepancy: colposcopic biopsy or cytologic sampling, cytologic screening, histotechnical processing, histologic or cytologic interpretation. The most common cause for a discrepancy was colposcopic biopsy sampling (36 cases, 51%). There were nine errors (13%) in biopsy interpretation, with seven underdiagnoses and two overdiagnoses. Eight errors (11%) in cytologic interpretation occurred with half of these representing underdiagnoses. The other causes for discrepancy were less common--cytologic sampling (6 cases), histotechnical processing (3 cases), cytologic screening (2 cases), and a combination of factors (5 cases). Use of this algorithm allows laboratories to identify problem areas and design specific corrective protocols to improve diagnostic accuracy and patient care.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington 40536, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Tritz
authors.forename: J A
authors.initials: JA
authors.lastname: Weeks
authors.forename: S E
authors.initials: SE
authors.lastname: Spires
authors.forename: M
authors.initials: M
authors.lastname: Sattich
authors.forename: H
authors.initials: H
authors.lastname: Banks
authors.forename: M L
authors.initials: ML
authors.lastname: Cibull
authors.forename: D D
authors.initials: DD
authors.lastname: Davey
mesh_terms: D000465:Algorithms; D001706:Biopsy / Q000592:standards*; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D011786:Quality Control; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000592:standards*