title: [Validity of cervicovaginal cytology in a Brazilian State with high incidence rate of cervical cancer].
abstract: OBJECTIVE
  To evaluate the validity of cervicovaginal cytology performed at LAPER, the main Laboratory of Pathology of the State of Roraima, Brazil, by interrater agreement (external monitoring) and agreement with histopathologic results.
  
  
  METHODS
  One hundred women were included, a population-based convenience sample. Their cervical cytological exams were evaluated by the laboratory staff and reviewed by expert medical pathologists, external to the laboratory. Cohen's Kappa index, sensitivity and specificity were evaluated. The study was approved by LAPER coordination and Federal University of Roraima Research Ethics Commitee.
  
  
  RESULTS
  Regarding the prevalence of human papillomavirus-related atypical, there was no concordance between the results issued by LAPER and by the external pathologists (k=0.21). A low sensitivity (28.5%) and specificity (89,2%) was detected for the diagnostic performance of LAPER, with a high proportion of false positive and false negative results. The cytological reports of the external pathologists showed higher sensitivity and specificity (71.4 and 98.9%, respectively), ruling out the possibility that errors related to collection methods and staining would explain the low performance of the laboratory.
  
  
  CONCLUSIONS
  A low diagnostic accuracy of cervicovaginal cytology can be a barrier against the control of cervical cancer in Roraima. We emphasize the need for professional training and internal and external monitoring in Brazilian states with a high incidence of cervical cancer.
authors.affiliation: Centro de Ciências da Saúde, Universidade Federal de Roraima, Boa Vista, RO, Brasil.
authors.forename: Allex Jardim
authors.initials: AJ
authors.lastname: da Fonseca
authors.affiliation: Hospital Geral de Roraima, Boa Vista, RO, Brasil.
authors.forename: Raisa Saron Wanderley
authors.initials: RS
authors.lastname: Murari
authors.affiliation: Centro de Ciências da Saúde, Universidade Federal de Roraima, Boa Vista, RO, Brasil.
authors.forename: Iane Santana
authors.initials: IS
authors.lastname: Moraes
authors.affiliation: Departamento de Patologia, Centro de Ciências da Saúde, Universidade Federal de Roraima, Boa Vista, RO, Brasil.
authors.forename: Robledo Fonseca
authors.initials: RF
authors.lastname: Rocha
authors.affiliation: Universidade do Estado de Roraima, Manaus, AM, Brasil.
authors.forename: Luiz Carlos de Lima
authors.initials: LC
authors.lastname: Ferreira
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002584:Cervix Uteri / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology*; D014621:Vagina / Q000473:pathology*; D014626:Vaginal Smears