Negative for Intraepithelial Lesion/Malignancy (NILM) Pap Slides from Women ≥ 30 Years of Age with Positive High-Risk HPV DNA: Focused Rescreening Prior to Report Issuance, an Enhanced Quality Control Measure

Cormier, Karen; Schaaf, Michael; Hamilton, Stephanie; Tickman, Ronald; Perez‐Reyes, Nuria; Sturgis, Charles D.

doi:10.1016/j.jasc.2013.08.196

Cited by 8 publications

(16 citation statements)

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“…Our results along with those of previous studies raise questions regarding the effectiveness of mandatory routine 10% rescreening. In an effort to reduce the false‐negative rate of the Pep test, several investigators have proposed focused rescreening . In a study performed by Sturgis et al, 386 NILM Pap tests with positive hrHPV results were rescreened and 50 (13%) were upgraded to ASC‐US or higher, which resulted in detecting ten times more SIL lesions than routine 10% Pap slide review.…”

Section: Discussionmentioning

confidence: 99%

Negative Pap tests in women with high‐grade cervical lesions on follow‐up biopsies: Contributing factors and role of human papillomavirus genotyping

Goodman

Mody

Coffey

et al. 2017

Diagnostic Cytopathology

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Our study demonstrated that 5% of women underwent co-testing with negative Pap tests had HGCL on follow-up biopsy. Absence of diagnostic cells was the leading cause for cytology discrepancy and interpretation variances were influenced by marked obscuring inflammation. HPV testing and genotyping had limited value in risk stratification due to extremely low PPV. Focused rescreening of hrHPV-positive NILM with obscuring factors may help reduce interpretation variances.

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Section: Discussionmentioning

confidence: 99%

Negative Pap tests in women with high‐grade cervical lesions on follow‐up biopsies: Contributing factors and role of human papillomavirus genotyping

Goodman

Mody

Coffey

et al. 2017

Diagnostic Cytopathology

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“…To the best of our knowledge, there has been no similar previous report in the literature. Other groups have reported abnormalities detected by rescreening of negative cytology in women with concomitant positive hrHPV DNA test results [19,20]; however, these reports were not from the perspective of using an HPV test at follow-up as triage for colposcopy. An important strength of our study was that histological specimens were obtained on all participants, including patients with negative HPV tests.…”

Section: Discussionmentioning

confidence: 99%

High-Risk Types of Human Papilloma Virus DNA Testing in Women with False Negative Cytology

et al. 2018

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Objective: To determine whether high-risk types of human papilloma virus (hrHPV) DNA testing is reliable for selection patients in need of further investigation with colposcopy in women with increased risk of high-grade cervical lesions as a result of false negative cytology. The secondary objective was to compare the sensitivity of hrHPV testing on self-collected versus physician-collected samples for the detection of histological high-grade cervical intraepithelial neoplasia (CIN2+). Methods: Sixty-three patients identified with a missed abnormality following the re-evaluation of benign cervical cytology were included. A patient-collected and a physician-collected sample for HPV, colposcopy and cervical specimen collection for histology and cytology were performed. Results: The sensitivity of hrHPV testing of physician-collected samples for CIN2+ was 100% (95% CI 82.7–100), and the negative predictive value (NPV) was 100% (95% CI 93.3–100). The sensitivity of the self-sampling device to identify CIN2+ was 84.6% (95% CI 59.1–96.7), and the NPV was 94.4% (95% CI 83.4–98.8). The differences in the sensitivity and NPV between the 2 methods were non-significant. The agreement between the 2 methods regarding the HPV results was good, with a kappa value of 0.74 (95% CI 0.57–0.91). Conclusion: The current findings indicate that physician-collected samples for hrHPV DNA testing may be used as triage for the colposcopy of women with false negative cytology.

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“…IQC is required in routine cytology laboratories to reduce errors in the interpretation of screening tests, such as the Pap smear [12,13] . The accuracy of Pap smears has been associated with error collection, variability in cytomorphological interpretation, and errors in scrutiny.…”

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confidence: 99%

“…The accuracy of Pap smears has been associated with error collection, variability in cytomorphological interpretation, and errors in scrutiny. The Bethesda system was innovative because it introduced the analysis of smear adequacy into Pap smear reports, highlighting the presence of blood, inflammation, and fixing devices as factors related to the quality of a sample [13,14] .…”

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confidence: 99%

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Assessment of 100% Rapid Review as an Effective Tool for Internal Quality Control in Cytopathological Services

Filho

Freitas²,

Pessoa³

et al. 2017

Acta Cytologica

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Objective: The aim of this study was to evaluate the 100% rapid review (100%-RR) as an effective tool for internal quality control (IQC) in gynecological cytopathology services. Study Design: A total of 8,677 swabs were analyzed; the negative results were submitted to 100%-RR. Divergent cases were discussed in a consensus meeting to reach a conclusion on the final diagnosis. The data were entered into SAS statistical software, and the agreement of the 100%-RR results with the final diagnosis was tested with the weighted kappa statistic. Results: Of the 8,155 smears characterized as negative, 255 (3.13%) were abnormal smears, and 552 (6.77%) unsatisfactory smears were deemed negative. Regarding the results on the 8,155 smears subjected to 100%-RR when compared with the final diagnosis, there was agreement in 7,063 (86.60%) of them, and there were 1,092 (13.40%) discordant results (65.6%, unsatisfactory; 5.47%, atypical squamous cells of undetermined significance [ASC-US]). The κ index had an agreement of 0.867, with κ = 0.734 (p < 0.0001). Compared with the final diagnosis, the sensitivity of 100%-RR was 99.91% and its specificity was 99.4% for severe abnormalities. The sensitivity for high-grade squamous intraepithelial lesions was 88.2%, with a specificity of 100.00%. For abnormalities considered borderline, such as ASC-US, the sensitivity was 94.50% and the specificity was 99.5%. Conclusion: The 100%-RR was considered efficient when used as an IQC method.

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Negative for Intraepithelial Lesion/Malignancy (NILM) Pap Slides from Women ≥ 30 Years of Age with Positive High-Risk HPV DNA: Focused Rescreening Prior to Report Issuance, an Enhanced Quality Control Measure

Cited by 8 publications

References 0 publications

Negative Pap tests in women with high‐grade cervical lesions on follow‐up biopsies: Contributing factors and role of human papillomavirus genotyping

Negative Pap tests in women with high‐grade cervical lesions on follow‐up biopsies: Contributing factors and role of human papillomavirus genotyping

High-Risk Types of Human Papilloma Virus DNA Testing in Women with False Negative Cytology

Assessment of 100% Rapid Review as an Effective Tool for Internal Quality Control in Cytopathological Services

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