title: Interobserver variability in the diagnosis of anal cancer precursor lesions: study of the usual scenario.
abstract: OBJECTIVE
  To assess interobserver variability in the diagnosis of anal cancer precursor lesions in the usual scenario of a service consisting of pathologists without previous experience in the diagnosis of these lesions.
  
  
  METHODS
  Five hundred and two anal specimens taken from 372 HIV-positive and HIV-negative patients were analyzed at the Pathology Department of the Tropical Medicine Foundation of Amazonas by three pathologists with extensive experience in the diagnosis of infectious and tropical diseases, but without significant prior experience in the diagnosis of anal cancer precursor lesions. The individual readings of each pathologist were compared to the one following the consensus diagnosis in shared optical microscope by kappa statistics.
  
  
  RESULTS
  The absolute agreement between each individual diagnosis and corresponding consensus was poor (kappa = -0.002). Considering only the positive or negative results for anal squamous intraepithelial lesions, we obtained a fair agreement between observers (kappa = 0.35), while the agreement was moderate when the histopathological findings were considered positive or negative for high-grade squamous intraepithelial lesion or cancer (kappa = 0.52).
  
  
  CONCLUSIONS
  The interobserver variability in histopathologic diagnosis of anal cancer and its precursor lesions among pathologists with little experience in the area is such that the diagnoses in this field and this scenario should always be a consensus.
authors.affiliation: Tropical Medicine Foundation of Amazonas. itramujas@ufam.edu.br
authors.forename: Ivan T
authors.initials: IT
authors.lastname: Costa e Silva
authors.forename: José R
authors.initials: JR
authors.lastname: Araújo
authors.forename: Rosilene V
authors.initials: RV
authors.lastname: Andrade
authors.forename: Celso Rômulo B
authors.initials: CR
authors.lastname: Cabral
authors.forename: Felicidad S
authors.initials: FS
authors.lastname: Gimenez
authors.forename: Adriana G D P
authors.initials: AG
authors.lastname: Guimarães
authors.forename: Priscila R
authors.initials: PR
authors.lastname: Santos
authors.forename: Laila Cristina A
authors.initials: LC
authors.lastname: Rojas
authors.forename: Luiz Carlos L
authors.initials: LC
authors.lastname: Ferreira
mesh_terms: D001005:Anus Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D006801:Humans; D015588:Observer Variation; D011230:Precancerous Conditions / Q000453:epidemiology* / Q000473:pathology*