Internal quality control indicators of cervical cytopathology exams performed in laboratories monitored by the External Quality Control Laboratory

Abstract

An improvement was found in the indicators represented by the positivity index and the percentage of exams compatible with a high-grade squamous intraepithelial lesion, showing that the role played by the external quality control laboratory in providing continued education contributed towards improving laboratory staff skills in detecting cervical cancer precursor lesions.

Internal quality control indicators in cervical cytopathology of a university laboratory

“…The correct identification of HSIL, in combination with diagnostic confirmation, treatment and appropriate follow‐up, can prevent the evolution of the lesion to cervical cancer . Ázara et al observed that, in around 90% of laboratories not monitored by the National Cancer Institute, this indicator was less than 0.4%, and in monitored laboratories, this index ranged from 0.1% to 1.4%.…”

“…When the percentage of detected HSIL among satisfactory examinations is below the recommended level, this can be a sign of high rates of false‐negative results, which consequently delays appropriate clinical management and treatment of women with intraepithelial lesions . It is important to note that the detection of HSIL is the focus of screening programmes for cervical cancer, in an attempt to decrease its incidence and mortality .…”

“…Their rates were consistent with those reported from other studies in which the false‐negative rate results ranged from 0.0% to 9.8% with rapid prescreening and from 1.07% to 33.1% with RR . Laboratories with high ASC/SIL rates need to determine the cause of such results and it may be necessary for individual staff members to review and revise cytological criteria for ASC and SIL . Careful review of borderline cases and follow‐up studies can provide information to improve the performance of the laboratory…”

“…Internal quality monitoring (IQM) in cervical cytopathology allows laboratories to identify any nonconformity, with the aim of improving the detection of epithelial abnormalities and, consequently, reduce false‐negative results . IQM should comprise a regular set of systematized actions, including specimen adequacy monitoring, scrutiny time observation, observers’ workload control, hierarchical review and review of negative smears .…”

Quality Indicators of Cervical Cytopathology Tests in the Public Service in Minas Gerais, Brazil

“…This result demonstrates the importance of EQC in improving the capacity of detecting cervical cancer precursor lesions in professionals that perform cytopathology tests. 23 The correct identification, diagnostic confirmation, treatment, and follow-up of these cellular alterations, which represent true cervical cancer precursor lesions, might prevent their progression to invasive cancer. 12,24 In Minas Gerais, cervical cancer is the cancer with the second highest incidence among women, 25 and our results show that several laboratories either do not detect or detect a low number of cervical cancer precursor lesions.…”