Reevaluation von Zervixabstrichen bei Zervixkarzinompatientinnen

Regitnig, Peter; Dinges, H. P.; Ropp, E.; Fladerer, H; Moinfar, Farid; Breitenecker, G.

doi:10.1007/s00292-007-0931-9

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…In Austria, only a small number of studies on the quality of opportunistic Pap screening have been conducted so far [16-18]. Our study shows again that failures in Pap smear taking and interpretation of smears exist.…”

Section: Discussionmentioning

confidence: 58%

“…Only a small number of scientific articles have hitherto studied the quality of opportunistic screening in Austria. These publications identified failures in Pap smear taking as well as in the interpretation of the smears [16-18]. The results have led the statutory health insurance providers of some provinces to implement a number of measures in order to improve Pap smear taking [19,20].…”

Section: Introductionmentioning

confidence: 99%

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Quality of screening with conventional Pap smear in Austria – a longitudinal evaluation

et al. 2013

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BackgroundIn recent decades, the incidence of cervical cancer and cervical cancer mortality in Austria has declined by varying degrees. The Pap smear is to be considered a causal factor for this decline.MethodsThis longitudinal analysis is based on a data set of Pap smear assessments collected by the Committee for Quality Assurance of the Austrian Society of Cytology. Data from 15 laboratories participating in a voluntary self-monitoring program was analyzed for the time span 2004–2008. The data was analyzed in terms of smear quality and assessment quality.A rank-correlation-test for a monotonic trend analysis in the proportion of the three parameters Pap 0, “satisfactory, but limited/SBL”, and Pap IIID/IV for the timespan 2004 to 2008 was carried out.ResultsFor this study, we analyzed an average number of 730,000 smears per year over a five-year period. Specimens from all but two laboratories, i.e. < 2% of all smears, met the quality criterion for Pap 0 (Bethesda 2001 equivalent: Specimen processed and examined, but unsatisfactory for evaluation of epithelial abnormality), whilst only four laboratories, i.e. < 10% of all smears, reached the national requirement for smears classified as “satisfactory, but limited/SBL”.When using the Pap IIID/IV ratio (LSIL: HSIL/AIS ratio) of 3:1 to 8:1 as a surrogate quality marker for the interpretation of smears, only five laboratories met this criterion during the survey period.The trend analysis indicated only that an increasing number of samples per year is correlated with an increased proportion of Pap 0 and “satisfactory, but limited/SBL” smears.ConclusionsAlthough participants get regular feedback about their results, no general improvements in smear taking or assessment were observed over the years, so mandatory quality management, including the possibility of sanctions, is suggested in order to reduce adverse health effects for women.

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Section: Discussionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Quality of screening with conventional Pap smear in Austria – a longitudinal evaluation

et al. 2013

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“…Tissue samples, already described in a previous study were used for this analysis [22] . After Haematoxylin-Eosin (H&E) staining, a pathologist diagnosed the grades of CIN according to international guidelines.…”

Section: Methodsmentioning

confidence: 99%

Fractal Analysis of Cervical Intraepithelial Neoplasia

et al. 2014

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IntroductionCervical intraepithelial neoplasias (CIN) represent precursor lesions of cervical cancer. These neoplastic lesions are traditionally subdivided into three categories CIN 1, CIN 2, and CIN 3, using microscopical criteria. The relation between grades of cervical intraepithelial neoplasia (CIN) and its fractal dimension was investigated to establish a basis for an objective diagnosis using the method proposed.MethodsClassical evaluation of the tissue samples was performed by an experienced gynecologic pathologist. Tissue samples were scanned and saved as digital images using Aperio scanner and software. After image segmentation the box counting method as well as multifractal methods were applied to determine the relation between fractal dimension and grades of CIN. A total of 46 images were used to compare the pathologist's neoplasia grades with the predicted groups obtained by fractal methods.ResultsSignificant or highly significant differences between all grades of CIN could be found. The confusion matrix, comparing between pathologist's grading and predicted group by fractal methods showed a match of 87.1%. Multifractal spectra were able to differentiate between normal epithelium and low grade as well as high grade neoplasia.ConclusionFractal dimension can be considered to be an objective parameter to grade cervical intraepithelial neoplasia.

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Qualität des konventionellen PAP-Abstrichs

2012

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The success of cytology in screening programs for cervical cancer is highly dependent on the smear quality. Interdisciplinary projects which evaluate the smear quality and the results of collection devices could be helpful for an improvement and a successful example for quality improvement is presented here. An average of 83% technically adequate and representative smears was documented for 12 million conventional PAP smears; however only an average of 68% technically adequate and representative smears was found for the group of least successful smear takers of all laboratories. This indicates a potential for improvement. Following an interdisciplinary project on smear quality improvement the average rate of representative smears increased from 69 to 83% and in another project this rate remained stable at 86%. Based on 158,411 conventional smears, representative smears were achieved in 92% using Cervex-Brush®, 86% using Szalay Spatula and 82% Cytobrush methods. The combinations of Cytobrush with the Ayre wooden spatula, cotton wool swab or Szalay Spatula achieved 97%, 94% and 92% representative smears, respectively.

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Reevaluation von Zervixabstrichen bei Zervixkarzinompatientinnen

Cited by 6 publications

References 15 publications

Quality of screening with conventional Pap smear in Austria – a longitudinal evaluation

Quality of screening with conventional Pap smear in Austria – a longitudinal evaluation

Fractal Analysis of Cervical Intraepithelial Neoplasia

Qualität des konventionellen PAP-Abstrichs

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