Impact of Implementing 100% Rapid Review as a Quality Control Tool in Cervical Cytology

Abstract

Objective: We aimed to evaluate the impact of implementing 100% rapid review (100% RR) as a quality control tool in cervical smear cytology. Design: A cross-sectional study was conducted in which cytology findings, false-negative results, and quality indicators were evaluated. The variables were analyzed in 2004, the year in which 100% RR was implemented, and again in 2013, i.e., 10 years on. Results: Detection of atypical squamous cells of undetermined significance (ASC-US) increased from 0.90% in 2004 to 2.47% in 2013 by routine screening. Detection of atypical squamous cells, cannot exclude a high-grade squamous intraepithelial lesion (ASC-H) increased from 13.33% in 2004 to 36.27% in 2013 by 100% RR. Detection of high-grade squamous intraepithelial lesion (HSIL) increased from 0.64% in 2004 to 4.29% in 2013 by routine screening, and increased from 0% in 2004 to 19.61% in 2013 by 100% RR. There was a significant increase (p = 0.00001) in the identification of false-negative results of ASC-US, low-grade squamous intraepithelial lesion, ASC-H, HSIL, and atypical glandular cells. All quality indicators had increased in 2013 when compared to 2004 results. Conclusions: Ten years after the implementation of the 100% RR method, improvements were found in the detection of atypia and precursor lesions and in quality indicators.

One-Year Experience of Implementation of 100% Cervical Cytology Rapid Review

“…Compared with Magalhães et al [1] and Queiroz-Filho et al [2], our results after implementation of 100% rapid review showed significant increases in atypical squamous cells of undetermined significance; atypical squamous cells cannot exclude the categories of high-grade and low-grade squamous intraepithelial lesions.…”

“…In quality control programs regarding cervical cytology, one goal is to reduce the number of false-negative results [1, 3]. Thus, despite the few differences between our study and the previous published studies, we may assume that 100% rapid review is an important tool to improve the effectiveness of screening programs.…”

“…We read two recent articles entitled “Impact of Implementing 100% Rapid Review as a Quality Control Tool in Cervical Cytology” [1] and “Does 100% Rapid Review Improve Cervical Cancer Screening?” [2]. Here, we would like to compare these data with our 1-year experience.…”

“…One possible explanation may be that their method of quality control has been consolidated by more than 10 years of experience [1] and ours is at the beginning of the process. We also assume that the fact that our smears were from medical offices, collected only by doctors, might have had an influence.…”

Performance of Laboratories after 10 Years of Participating in External Quality Monitoring in Cervical Cytology

“…Of these, 8 were reclassified as ASC-H, and 2 were classified as HSIL. The type I laboratories classified 583 as positive smears, and the type II laboratory review reclassified 42 FP that had been previously classified as ASC-US (27), LSIL (1), ASC-H (5), HSIL (1), and AGC (8). All were reclassified as negative.…”