Internal quality control for cervical cytopathology: comparison of potential false-negatives detected at rapid prescreening and at 100% rapid review.
OBJECTIVE
To evaluate the performance of rapid prescreening (RPS) and 100% rapid review (RR-100%) as internal quality control (IQC) methods assessed by outcome at colposcopy, histopathology and repeat cytopathology for cases with false-negative results on cervical cytopathology at routine screening (RS).


METHODS
Out of 12,208 cytology smears analyzed, 900 were abnormal. Of these, 656 were identified at RS, and 244 were false-negative, with 90.2% identified at RPS and 57.4% at RR-100%. Of the 900 abnormal cases, 436 were submitted for additional testing.


RESULTS
Of the 244 women with cytopathological abnormalities identified only by the IQC methods, 114 had supplementary examinations: 35 were submitted for colposcopy, 22 for biopsy and 99 for repeat cytopathology. The sensitivity of RPS for the detection of abnormalities identified on colposcopy, histopathology and repeat cytopathology was 87.5% (95% CI 67.6-97.3), 82.4% (95% CI 56.6-96.2) and 95.7% (95% CI 85.2-99.5), respectively. The sensitivity of RR-100% was 54.2% (95% CI 32.8-74.4), 52.9% (95% CI 27.8-77.0) and 47.8% (95% CI 32.9-63.1), respectively. RPS was more sensitive than RR-100% when compared to the findings on colposcopy (p = 0.011) and repeat cytopathology (p = 0.000). When compared to colposcopy, histopathology and repeat cytopathology, the sensitivity of RS was 83.2% (95% CI 76.1-88.9), 85.7% (95% CI 78.1-91.5) and 73.3% (95% CI 66.0-79.7), respectively.


CONCLUSIONS
RPS performed better than RR-100% when compared to the results of colposcopy and repeat cytopathology.
School of Pharmacy, Federal University of Goiás, Goiânia, Brazil.
Suelene Brito do Nascimento
SB
Tavares
Nádja L Alves
NL
de Souza
Edna J C
EJ
Manrique
Cinara Zago Silveira
CZ
Azara
Erika Aparecida
EA
da Silveira
Rita Goreti
RG
Amaral
D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000473:pathology*; D003127:Colposcopy / Q000706:statistics & numerical data; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D065006:Papanicolaou Test / Q000706:statistics & numerical data; D011786:Quality Control; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014626:Vaginal Smears / Q000706:statistics & numerical data; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology