CIN2 is a much less reproducible and less valid diagnosis than CIN3: results from a histological review of population-based cervical samples.
We wished to compare the relative reproducibility and validity of cervical intraepithelial neoplasia (CIN) 2 and CIN3 diagnoses. In a population-based cohort study (1993-2001) of human papillomavirus (HPV) and cervical neoplasia in Costa Rica, we compared community pathologists' diagnoses with those of the 2 independent reviewers from the United States (total, n = 357). As measures of validity, we correlated primary and review diagnoses with HPV positivity and cytological interpretations. Two review pathologists agreed with 84% and 81%, respectively, of initial diagnoses of CIN3 compared with 13% and 31% of CIN2. The CIN3 diagnoses made by review pathologists were 94% oncogenic HPV positive, compared with 72% of CIN2 diagnoses. Eighty-one percent of CIN3 diagnoses versus 61% of CIN2 were correlated with high-grade cytological interpretations. The CIN3 is a substantially more reproducible diagnosis that can be validated more frequently with HPV tests and cytological interpretations than CIN2.
Carreon
Joseph D
JD
Division of Cancer Epidemiology and Genetics, The National Cancer Institute, National Institutes of Health, Department of Health and Human Services Rockville, Maryland 20852, USA.
Sherman
Mark E
ME
Guillén
Diego
D
Solomon
Diane
D
Herrero
Rolando
R
Jerónimo
Jose
J
Wacholder
Sholom
S
Rodríguez
Ana Cecilia
AC
Morales
Jorge
J
Hutchinson
Martha
M
Burk
Robert D
RD
Schiffman
Mark
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003364:Costa Rica; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D011230:Precancerous Conditions / Q000473:pathology / Q000821:virology; D015203:Reproducibility of Results; D014412:Tumor Virus Infections / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000821:virology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000821:virology
D004279:DNA, Viral