title: An audit of cervicovaginal cytology in a teaching hospital: Are atypical glandular cells under-recognised on cytological screening?
abstract: BACKGROUND
  Cervical cytology screening for carcinoma of the cervix in India is mainly opportunistic in nature and is practiced mainly in urban centres. The effectiveness of cervical cytology screening depends on various factors. The quality of cervicovaginal cytology service is assessed by various quality indices and by cyto-histology correlation, which is the most important quality assurance measure.
  
  
  OBJECTIVE
  To describe the cervical cytology diagnoses, estimate the quality indices, and evaluate the discrepant cases on cytohistological correlation.
  
  
  METHODS
  Retrospective observational study from a tertiary care centre in South India.
  
  
  METHODS
  Using a database search, all the cervicovaginal cytology reported during the period of 2002-2006 was retrieved and various diagnoses were described. The data was analysed to assess the quality indices. The cytohistologically discrepant cases were reviewed.
  
  
  RESULTS
  A total of 10,787 cases were retrieved, of which 98.14% were labeled negative and 1.36% were unsatisfactory for evaluation. A few (0.81%) of the cases were labeled as squamous intraepithelial lesions and 0.38% as atypical squamous cells. The ASCUS: SIL ratio was 0.5. Cytohistological correlation revealed a total of ten cases with significant discrepancy. The majority of these were carcinomas that were misdiagnosed as atypical glandular cells. These cytology smears and the subsequent biopsies were reviewed to elucidate the reasons for the discrepancies.
  
  
  CONCLUSIONS
  The cervical cytology service at our centre is well within the accepted standards. An increased awareness of cytological features, especially of glandular lesions, a good clinician-laboratory communication and a regular cytohistological review would further improve the diagnostic standards.
authors.affiliation: Department of Pathology, St. John's Medical College, Bangalore - 560 034, India.
authors.forename: Julian A
authors.initials: JA
authors.lastname: Crasta
authors.forename: V
authors.initials: V
authors.lastname: Chaitra
authors.forename: Cm
authors.initials: C
authors.lastname: Simi
authors.forename: Marjorie
authors.initials: M
authors.lastname: Correa