Which are more correctly diagnosed: conventional Papanicolaou smears or ThinPrep samples? A comparative study of 9 tears of external quality-assurance testing

Cummings, Margaret C., Marquart, Louise, Pelecanos, Anita M., Perkins, Gail, Papadimos, David, O'Rourke, Peter and Ross, Jennifer A. (2015) Which are more correctly diagnosed: conventional Papanicolaou smears or ThinPrep samples? A comparative study of 9 tears of external quality-assurance testing. Cancer Cytopathology, 123 2: 108-116. doi:10.1002/cncy.21498


Author Cummings, Margaret C.
Marquart, Louise
Pelecanos, Anita M.
Perkins, Gail
Papadimos, David
O'Rourke, Peter
Ross, Jennifer A.
Title Which are more correctly diagnosed: conventional Papanicolaou smears or ThinPrep samples? A comparative study of 9 tears of external quality-assurance testing
Journal name Cancer Cytopathology   Check publisher's open access policy
ISSN 1934-662X
1934-6638
Publication date 2015-02-01
Year available 2014
Sub-type Article (original research)
DOI 10.1002/cncy.21498
Volume 123
Issue 2
Start page 108
End page 116
Total pages 9
Place of publication Hoboken NJ, United States
Publisher John Wiley & Sons
Collection year 2015
Language eng
Formatted abstract
BACKGROUND

The Royal College of Pathologists of Australasia Cytopathology Quality Assurance Program offers external testing in gynecologic cytology to Australasian and international laboratories. Laboratory interpretation of conventional Papanicolaou (Pap) smears is compared with interpretation of liquid-based cervical cytologic (ThinPrep) samples.

METHODS

Conventional Pap smears and ThinPrep samples were distributed to participating laboratories annually over 9 years (from 2004 to 2012), and a range of entities was tested. Target responses and major error rates and diagnostic trends over time were explored.

RESULTS

In total, 23,373 conventional Pap smears and 14,104 ThinPrep samples were reported. Both Australasian (P = .003) and international (P < .001) laboratories achieved a higher percentage of the target diagnosis of squamous dysplasia with ThinPrep samples. Australasian laboratories more accurately diagnosed endocervical adenocarcinoma in situ with conventional smears (P = .036), whereas international laboratories performed better with ThinPrep samples (P = .006). Sampling of the lower uterine segment was more accurately diagnosed by both Australasian (P < .001) and international (P = .001) laboratories using conventional Pap smears. Significant improvements in achieving the target diagnosis over time for squamous dysplasias using both modalities were observed for Australasian and international laboratories (P < .001 for both). There was improvement in diagnosing high sampling using ThinPrep for both groups (P = .001 and P = .015, respectively). Australasian performance declined over time in reaching the target of normal (no infections) for both conventional (P = .001) and ThinPrep (P < .001) techniques and for international laboratories with the ThinPrep technique (P < .001).

CONCLUSIONS

Participation in external proficiency testing in cervical cytology allows an analysis of performance, the identification of areas of diagnostic difficulty, a review of trends over time, and the highlighting of topics for ongoing education.
Keyword Cytology
Papanicolaou smears
Cervical smears
Proficiency testing
Cervical cytology
Glandular lesions
Pap test
Performance
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online ahead of print 8 Dec 2014

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2015 Collection
School of Medicine Publications
 
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