Papnet-assisted, primary screening of cervico-vaginal smears.
OBJECTIVE
The Papnet system was initially designed for rescreening negative Pap tests but may also be an effective primary screener.


METHODS
A set of 2,200 archival slides diagnosed by conventional, manual screening as 2,000 (90%) WNL, 47 (2.1%) carcinomas, 50 (2.3%), HSIL, 50 (2.3%) LSIL, and 53 (2.4%) ASCUS/AGUS were compared to the results of Papnet-assisted, primary screening. Following Papnet scanning, the digitized images were triaged and classified as abnormal or negative. All abnormals had a full manual screening, whereas negatives had a limited screening. Results by each screening method were compared and discordant cases were peer reviewed for a consensus result. Screening efficacy by each method was measured against a standard result composed of the concordant and consensus results.


RESULTS
There were 101 concordant and 181 discordant abnormal results. The standard result for the slide set was 1,953 (88.9%) WNL, 87 (3.9%) ASCUS/AGUS, 52 (2.4%) LSIL, 62 (2.8%) HSIL, 39 (1.8%) carcinomas, and 5 (0.2%) unsatisfactory. Papnet versus manual sensitivity rates were 87.6% vs 72.3% at the ASCUS/AGUS threshold, 85.6% vs 82.4% at the LSIL threshold, and 89.1% vs 90.1% at the HSIL threshold.


CONCLUSIONS
Papnet-assisted, primary screening equals conventional, manual screening in the detection of a wide range of cell abnormalities and is more effective in the detection of abnormalities at the lower end of the abnormal spectrum.
Duggan
M A
MA
Dept. of Pathology and Laboratory Medicine, University of Calgary, Alberta, Canada.
D000328:Adult; D003936:Diagnosis, Computer-Assisted; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008403:Mass Screening; D015588:Observer Variation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012984:Software; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000592:standards*