The effect of the quality of Papanicolaou smears on the detection of cytologic abnormalities

Mintzer, Melanie; Curtis, P.; Resnick, Jacqueline C.; Morrell, Daphne

doi:10.1002/(sici)1097-0142(19990625)87:3<113::aid-cncr3>3.0.co;2-v

Cited by 44 publications

(19 citation statements)

References 16 publications

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“…These findings are in contrast to the evidence surrounding the absence of a TZ component on cervical Pap slides, which recently was summarized in the publication of the 2014 Bethesda System for Reporting Cervical Cytology. 6 Although cross-sectional studies have shown that abnormalities are more common in cervical Pap tests with, rather than without, a TZ component, [16][17][18] to the best of our knowledge longitudinal studies have not demonstrated a higher risk of HSIL after negative Pap tests with and without a TZ component. [19][20][21][22][23][24] Retrospective case-control studies also have shown no association between the absence of a TZ component and false-negative results.…”

Section: Discussionmentioning

confidence: 99%

The value of a transformation zone component in anal cytology to detect HSIL

Roberts

Jin

Thurloe

et al. 2016

Cancer Cytopathology

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Section: Discussionmentioning

confidence: 99%

The value of a transformation zone component in anal cytology to detect HSIL

Roberts

Jin

Thurloe

et al. 2016

Cancer Cytopathology

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“…The main difference in specimen quality was the presence of transformation zone cells: over 90% of clinician-collected specimens contained these cells compared to 18% of Screener specimens. Cross-sectional studies have found an association between presence of these cells, especially endocervical cells, and concurrent abnormal cytological findings [18]. Longitudinal studies, however, have found no association between the absence of transformation zone cells among women with negative cytology and subsequent high grade lesions [19], [20].…”

Section: Discussionmentioning

confidence: 99%

Validity and Reliability of Using a Self-Lavaging Device for Cytology and HPV Testing for Cervical Cancer Screening: Findings from a Pilot Study

et al. 2013

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Self-sampling could increase cervical cancer screening uptake. While methods have been identified for human papillomavirus (HPV) testing, to date, self-sampling has not provided adequate specimens for cytology. We piloted the validity and reliability of using a self-lavaging device for cervical cytology and HPV testing. We enrolled 198 women in New York City in 2008–2009 from three ambulatory clinics where they received cervical cancer screening. All were asked to use the Delphi Screener™ to self-lavage 1–3 months after clinician-collected index cytological smear (100 normal; 98 abnormal). Women with abnormal cytology results from either specimen underwent colposcopy; 10 women with normal results from both specimens also underwent colposcopy. We calculated sensitivity of self-collected cytology to detect histologically confirmed high grade lesions (cervical intraepithelial neoplasia, CIN, 2+); specificity for histology-negative (CIN 1 or lower), paired cytology negative, or a third cytology negative; and kappa for paired results. One hundred and ninety-seven (99.5%) women self-collected a lavage. Seventy-five percent had moderate to excellent cellularity, two specimens were unsatisfactory for cytology. Seven of 167 (4%) women with definitive results had CIN2+; one had normal and six abnormal cytology results with the self-lavage (sensitivity = 86%, 95% Confidence Interval, CI: 42, 100). The kappa for paired cytology was low (0.36; 95% CI: 0.25, 0.47) primarily due to clinician specimens with atypical squamous cells of undetermined significance (ASC-US) and low grade squamous intraepithelial lesion (LSIL) coded as normal using Screener specimens. However, three cases of HSIL were coded as ASC-US and one as normal using Screener specimens. Seventy-three women had paired high-risk HPV tests with a kappa of 0.66 (95% CI: 0.49, 0.84). Based on these preliminary findings, a larger study to estimate the performance of the Screener for co-testing cytology and HPV or for HPV testing with cytology triage is warranted.Trial RegistrationClinicalTrials.gov NCT00702208

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“…The report that atypia was more likely to be present in limited smears than satisfactory smears[7] should not be the argument used to defend inadequacy of smears.…”

Section: Discussionmentioning

confidence: 99%

Plastic spatula with narrow long tip provides higher satisfactory smears for Pap test

Kaur

Kushtagi

2013

J Cytol

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Background:Ayre spatula for cervical smear collection is being used despite the suggestion that different modified spatulas provide more satisfactory sampling.Aims:To see whether the cytological pickup improves with the use of long tipped spatula.Setting and Design:Rurally based University Hospital; crossover study.Materials and Methods:Pap smear using Ayre spatula in 500 and with plastic narrow long tip (Szalay) spatula in 500 clinic attending women was taken and analyzed. Crossover smears were taken with modified spatula in 163 and using Ayre spatula in 187 women after 2 weeks of initial smears. The same pathologist made cytological reporting for all smears and was unaware of the type of spatula used.Results:Smears from Ayre spatula had significantly higher reports of inadequate smears (94 of 500 vs. 68 of 500 for Ayre and Szalay, respectively; P = 0.032) and it remained so even after crossover (94 of 187 vs. 70 of 163 for Ayre and Szalay, respectively; P = 0.2). Cellular quality appeared better with smears taken using Szalay spatula, but the overall abnormal smear detection rate remained similar with either collection tool (χ2 = 1.5; P = 0.2).Conclusions:Proportion of satisfactory smears is higher when long tip plastic spatula is used for collection of sample.

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The effect of the quality of Papanicolaou smears on the detection of cytologic abnormalities

Cited by 44 publications

References 16 publications

The value of a transformation zone component in anal cytology to detect HSIL

The value of a transformation zone component in anal cytology to detect HSIL

Validity and Reliability of Using a Self-Lavaging Device for Cytology and HPV Testing for Cervical Cancer Screening: Findings from a Pilot Study

Plastic spatula with narrow long tip provides higher satisfactory smears for Pap test

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