Quality assurance in cervical smears: 100% rapid rescreening vs. 10% random rescreening.
OBJECTIVE
To compare 100% rapid rescreening of cervical smears with 10% random rescreening as a method of quality assurance.


METHODS
A total of 5215 smears, randomly selected from smears reported as negative by cytotechnologists during routine screening, underwent 100% rapid rescreening by senior cytotechnologists. Ten percent of these smears, selected at random, were rescreened by other senior cytotechnologists. The gold standard was defined by cytopathologists, who rescreened all 5215 smears. After excluding unsatisfactory smears detected by cytopathologists, 4271 were included in the analysis.


RESULTS
The 100% rapid rescreening method identified 69.9%, 95.7% and 100%, respectively, of atypical squamous cells of undetermined significance, low grade squamous intraepithelial lesion and high grade squamous intraepithelial lesion cases reported by the cytopathologists. The 100% rapid rescreening method showed a sensitivity of 73.5% and specificity of 98.6%. The 10% rescreening method showed sensitivity of 40.9% and specificity of 98.8%.


CONCLUSIONS
One hundred percent rapid rescreening is an efficient method of internal quality assurance in cervical smear diagnosis. It can reduce the false negative rate and therefore can provide greater certainty to women who have received negative results. Well-trained cytotechnologists are able to identify abnormal smears in 1-minute rapid rescreening.
Amaral
Rita Goreti
RG
School of Pharmacy, Universidade Federal de Goiás, Goiânia, Goiás, Brazil.
Zeferino
Luiz Carlos
LC
Hardy
Ellen
E
Westin
Maria Cristina do Amaral
MC
Martinez
Edson Zangiacomi
EZ
Montemor
Eliana Borin
EB
D005260:Female; D006801:Humans; D008403:Mass Screening; D011786:Quality Control; D002583:Uterine Cervical Neoplasms / Q000473:pathology; D014626:Vaginal Smears / Q000592:standards*