title: Educational needs and causes of false diagnosis of atypical squamous cells of unknown significance at a university hospital.
abstract: The entity of atypical squamous cells of undetermined significance (ASCUS) in The Bethesda System 2001 for reporting cervical cytology is characterized by equivocal diagnosis, poor reproducibility and debatable management. This retrospective study was done to analyse the causes of false ASCUS if any and identify the educational needs as part of quality assurance programme. Cervical smears of all ASCUS cases reported over the one-year period were reviewed by the Cytopathologist. Relevant clinical data was retrieved. ASCUS was the most common type of abnormality representing 43.0 % cases among 294 abnormal smears reported during study period. 16.0% cases were found to be non ASCUS on review. The main four causes of over use of ASCUS diagnosis were poor quality smears and cellular atypia associated with Candida infection, atrophy and squamous metaplasia. Educational measures are being undertaken to avoid over diagnosis and improve the patient management.
authors: Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya. kumar_neeta@hotmail.com
authors: Neeta
authors: N
authors: Kumar
authors: Shahin
authors: S
authors: Sayed
authors: Zahir
authors: Z
authors: Moloo
mesh_terms: D000328:Adult; D001284:Atrophy / Q000175:diagnosis; D001706:Biopsy; D002181:Candidiasis, Vulvovaginal / Q000175:diagnosis*; D002584:Cervix Uteri / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008679:Metaplasia; D008875:Middle Aged; D020380:Needs Assessment; D015588:Observer Variation; D011785:Quality Assurance, Health Care / Q000592:standards; D012189:Retrospective Studies; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000592:standards*