title: Repeat cervical cytology at the time of colposcopy. Is there an added benefit?
abstract: OBJECTIVE
  To determine if repeating the Pap smear (PS) at colposcopy offers added benefit in the detection of cervical squamous intraepithelial lesions (SILs).
  
  
  METHODS
  Eight hundred fifty-two women were subjects of this study. Patients with cervical SIL were defined as women with SIL on the repeat PS, or SIL on the colposcopic cervical biopsy (bx) or a negative repeat PS and bx but confirmed SIL on both the previous and follow-up PS or bx. The sensitivities of repeat PS and bx in detecting SIL were calculated. The chi 2 test was used to assess statistical significance. The total cost of repeating the PS was calculated by multiplying the total number of patients (852) by the estimated cost of a single PS ($25).
  
  
  RESULTS
  The sensitivities of repeat PS, bx and PS/bx combined were .89, .69 and .92 for low grade SIL (LSIL) and .74, .77 and .98 for high grade SIL (HSIL), respectively (P < .0001). Sixteen percent of the HSIL and 28% of the LSIL cases were diagnosed on repeat PS only (negative bx). If repeat PS was omitted, $21,300 would have been saved.
authors.affiliation: Departments of Pathology and of Obstetrics and Gynecology, University of Maryland Medical System, and Department of Pathology, National Naval Medical Center, Bethesda, Maryland, USA.
authors.forename: A
authors.initials: A
authors.lastname: Simsir
authors.forename: O B
authors.initials: OB
authors.lastname: Ioffe
authors.forename: P
authors.initials: P
authors.lastname: Bourquin
authors.forename: S E
authors.initials: SE
authors.lastname: Brooks
authors.forename: M
authors.initials: M
authors.lastname: Henry
mesh_terms: D001706:Biopsy; D003127:Colposcopy; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000191:economics / Q000473:pathology*; D014626:Vaginal Smears / Q000191:economics*; D002578:Uterine Cervical Dysplasia / Q000191:economics / Q000473:pathology*