Detection of false-negative Pap smears using the PAPNET system.
OBJECTIVE
False-negative cytological diagnoses represent the critical point of a screening program for early detection of cervical cancer. Computer-assisted reading using neural network technology has been suggested as a possible approach to manage the problem. The study assessed the performance and the cost-outcome ratio of computer-assisted versus conventional manual Pap smear reading.


METHODS
One thousand routine smears, seeded with 81 false-negative smears, were independently interpreted by two readers by conventional and PAPNET-assisted reading. Results of both readings were compared in terms of: a)sensitivity for false-negative smears, b)specificity, and c) cost-outcome (cost per CIN2+ lesion detected).


RESULTS
PAPNET-assisted reading showed a small increase in sensitivity only for one reader. Including the cost of PAPNET, the cost per detected lesion would be $7,543 and the cost per additional detected lesion would be $25,748.


CONCLUSIONS
The present study provides further evidence that PAPNET-assisted screening may allow the detection of a few extra cases of CIN2+ lesions with respect to conventional reading, though at a very high cost.
Troni
G M
GM
Department of Cytopathology, Center for Cancer Study and Prevention, Florence, Italy.
Cipparrone
I
I
Cariaggi
M P
MP
Ciatto
S
S
Miccinesi
G
G
Zappa
M
M
Confortini
M
M
D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007558:Italy; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data; D065006:Papanicolaou Test; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000517:prevention & control*; D014626:Vaginal Smears / Q000191:economics / Q000706:statistics & numerical data