ASCCP Patient Management Guidelines: Pap Test Specimen Adequacy and Quality Indicators

Dd, Davey; Rm, Austin; Birdsong, George G.; Hw, Buck; Jt, Cox; Tm, Darragh; Elgert, Paul; Hanson, Mark D.; Mr, Henry; Waldman, Jeffrey

doi:10.1097/00128360-200207000-00008

Cited by 35 publications

(24 citation statements)

References 27 publications

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“…Squamous intraepithelial lesion cells are suggested to be more prevalent in specimens when EC/TZ cells are present. 16 Because the presence or absence of the EC/TZ component is considered to be a quality indicator, we also evaluated the ratio of Papanicolaou test specimens lacking the EC/TZ component as one of our secondary outcomes among the 4 subgroups of the study. The other secondary outcomes were the ratios of unsatisfactory cytology results and abnormal cells.…”

Section: Discussionmentioning

confidence: 99%

Association of Speculum Lubrication with Pain and Papanicolaou Test Accuracy

Uygur

Güler

Yaycı

et al. 2012

The Journal of the American Board of Family Medicine

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Purpose: To determine the effects of lubrication of the vaginal speculum before insertion during a Papanicolaou test on perceived pain and quality of the cytology specimen.Methods: Four hundred eligible women participating in cervical cancer screening and an early detection program were randomized with respect to lubricant gel use before speculum insertion. Perceived pain during speculum insertion and cytology results were assessed in study groups.Results: The mean age of the patients was 45.7 years (range, 23-77 years). Pain score of the NO GEL group was significantly higher than that of the GEL group (2.3 and 1.6, respectively; P < .05).

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Section: Discussionmentioning

confidence: 99%

Association of Speculum Lubrication with Pain and Papanicolaou Test Accuracy

Uygur

Güler

Yaycı

et al. 2012

The Journal of the American Board of Family Medicine

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“…According to recent guidelines, 22,23 the preferred management for the majority of women who lack an EC/TZS on their Pap test and who are undergoing routine screening is a repeat Pap test within 12 months. The option of an earlier repeat Pap test at 6 months has also been raised as a possibility for hrHPV indicates high-risk human papillomavirus; LSIL, low-grade squamous intraepithelial lesion; EC/TZS, endocervical/transformation zone sample; 95% CI, 95% confidence interval.…”

Section: Discussionmentioning

confidence: 99%

“…Current guidelines recommend that women with negative Pap test results and no EC/TZS return for screening within 12 months. 22,23 We recently reported that high-risk human papillomavirus (hrHPV) DNA detection is independent of sampling of the TZ and concluded that hrHPV DNA results provide for the first time an objective basis for the risk assessment of women with no EC/TZS. 24 To further document the usefulness of hrHPV DNA test results in assessing disease risk in women without an EC/TZS, we analyzed the correlation between hrHPV DNA testing and cytologic results in a large group of women of diverse ages both with and without an EC/TZS in their Pap test samples.…”

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confidence: 99%

Adjunctive high-risk human papillomavirus DNA testing is a useful option for disease risk assessment in patients with negative Papanicolaou tests without an endocervical/transformation zone sample

Zhao

Austin

2008

Cancer

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BACKGROUND. Current guidelines recommend that women with negative Papanicolaou (Pap) test results and no endocervical/transformation zone (EC/TZ) sample return for screening within 12 months. For some women, this represents earlier follow‐up than advocated in several routine screening guidelines. Controversy remains with regard to the correlation between sampling of the EC/TZ, Pap test quality, and disease risk assessment. METHODS. A retrospective study was conducted reviewing the results from 143,438 liquid‐based cervical Pap tests performed at a large academic women's hospital between July 2005 and December 2006. Vaginal Pap tests were excluded from the study. Women with any Pap result, women with low–grade squamous intraepithelial lesions (LSILs), and patients with high–grade squamous intraepithelial lesion (HSIL) Pap test results were stratified by 10‐year age groups and according to the presence or absence of an EC/TZ sample (EC/TZS). Women with LSIL and HSIL Pap test results with and without an EC/TZS were also compared for rates of high–risk human papillomavirus (hrHPV) DNA detection. RESULTS. Of the total of 143,438 cervical Pap tests performed, 27,359 (19.1%) were reported to be lacking an EC/TZS. The absence of an EC/TZS was found to be highest in adolescents and in mature women aged ≥50 years. The overall detection rate of LSIL was 4.29% and that of HSIL was 0.64%. Both the LSIL and HSIL rates were found to be significantly higher in Pap tests with an EC/TZS compared with Pap tests without an EC/TZS (LSIL: 4.51% vs 3.37% and HSIL: 0.72% vs 0.29%). However, when women with LSILs and HSILs were divided into a group in which EC/TZS was present and a group in which EC/TZS was absent, no significant differences were found to be present with regard to hrHPV DNA rates between the 2 groups. CONCLUSIONS. Adjunctive hrHPV DNA testing is effective in stratifying risk for the presence of SIL in women with and without an EC/TZS. This finding is consistent with recently reported data from >9000 patients with negative Pap results, which found that hrHPV DNA–positive test rates are independent of the presence or absence of an EC/TZS. hrHPV DNA results provide a useful new optional adjunctive tool for the objective stratification of disease risk in women with negative Pap tests and no EC/TZS. Cancer (Cancer Cytopathol) 2008. © 2008 American Cancer Society.

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“…10 The current American Society for Colposcopy and Cervical Pathology (ASCCP) management guidelines recommend a repeat PT within 2 to 4 months for women who have unsatisfactory PTs (UPTs). [11][12][13] This recommendation is based largely on evidence derived from studies on conventional Pap smears. However, the significance of unsatisfactory LBPTs is uncertain, because the 'obscuring' factors (inflammation, blood, thick smearing) that typically are associated with unsatisfactory conventional Pap smears are less important in LBPTs.…”

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confidence: 99%

Unsatisfactory SurePath liquid‐based Papanicolaou tests

Alsharif

McKeon

Gulbahce

et al. 2009

Cancer Cytopathology

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BACKGROUND:The introduction of liquid‐based Papanicolaou (Pap) tests (LBPTs) has reduced the incidence of unsatisfactory Pap tests (UPTs), but little is known about their causes and significance, especially in the case of SurePath LBPTs.METHODS:All unsatisfactory LBPTs from January 1, 2003 to December 31, 2006 were retrieved. The characteristics of patients, providers, and LBPTs; the reason for UPTs; and any cytologic or histologic follow‐up within 24 months were recorded. Negative Pap tests that were evaluated immediately after a UPT served as a control group.RESULTS:Of 243,006 Pap tests (95.5% SurePath LBPTs), 0.23% were unsatisfactory. Scant cellularity was the primary cause of SurePath UPT. Women in this UPT group were older, had more diagnostic Pap tests taken, less frequently were taking contraceptives or were pregnant, and were more likely to be menopausal or posthysterectomy. The 278 women who had UPTs had significantly higher rates of follow‐up Pap tests (65.1% vs 22.2%), abnormal Pap tests (5.4% vs 1.4%), biopsies (10% vs 1%), and abnormal biopsies (5% vs 1%) than the 284 women in the control group, including 7 women with cervical intraepithelial neoplasia 1 (CIN‐1), 1 woman with CIN‐2, 4 women with CIN‐3, and 2 women with endometrial hyperplasia. The UPT rates varied little between provider groups (physicians vs nonphysicians and gynecologists vs nongynecologists).CONCLUSIONS:The frequency of UPTs in a predominantly SurePath LBPT‐screened population was very low and was caused mainly by low cellularity. Similar to conventional Pap smears, unsatisfactory SurePath LBPTs had a higher risk of significant histologic abnormalities on follow‐up than negative satisfactory Pap tests and could have benefited from a repeat Pap test or other evaluation, according to current management guidelines. Cancer (Cancer Cytopathol) 2009. © 2009 American Cancer Society.

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ASCCP Patient Management Guidelines: Pap Test Specimen Adequacy and Quality Indicators

Cited by 35 publications

References 27 publications

Association of Speculum Lubrication with Pain and Papanicolaou Test Accuracy

Association of Speculum Lubrication with Pain and Papanicolaou Test Accuracy

Adjunctive high-risk human papillomavirus DNA testing is a useful option for disease risk assessment in patients with negative Papanicolaou tests without an endocervical/transformation zone sample

Unsatisfactory SurePath liquid‐based Papanicolaou tests

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