False positive cervicovaginal cytology. A follow-up study.
OBJECTIVE
To determine what percentage of cervical cytologic diagnoses initially classified as false positives (based on a negative cervical biopsy within three months of the cervical cytologic smear) are recategorized as histologic false negatives when subsequent studies reveal abnormalities.


METHODS
A three-year review of 1,242 cervicovaginal biopsies with corresponding cytology in the preceding three months revealed 68 cases (5.5%) where the cytology was positive for a squamous intraepithelial lesion but the biopsy was within normal limits or showed benign cellular changes. Follow-up cytologic and/or histologic diagnoses were obtained for 53 of the 68 cases from the patients' hospital and physician office records.


RESULTS
Of the 53 cases with follow-up, 24 (45%) were found to have a subsequent squamous intraepithelial lesion (indicating a sampling error at the time of the initial biopsy), and 9 showed atypical squamous cells of undetermined significance. In addition, 9 of the 20 patients (45%) who had negative follow-up studies had benign abnormalities on the initial, noncorrelating biopsy that may have contributed to the discrepancy.


CONCLUSIONS
This study emphasized the importance of diligent follow-up of patients with noncorrelating studies since they represent a population at high risk for the subsequent detection of premalignant conditions.
Anderson
M B
MB
Department of Pathology, St. John Hospital and Medical Center, Detroit, Michigan 48236, USA.
Jones
B A
BA
D001706:Biopsy / Q000592:standards*; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D002584:Cervix Uteri / Q000166:cytology* / Q000473:pathology*; D003581:Cytodiagnosis / Q000592:standards; D003656:Decidua / Q000473:pathology; D003951:Diagnostic Errors; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia; D015203:Reproducibility of Results; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014621:Vagina / Q000166:cytology* / Q000473:pathology*; D014625:Vaginal Neoplasms / Q000473:pathology; D014626:Vaginal Smears