Prospective and Retrospective Review of Gynecologic Cytopathology: Findings From the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference Working Group 2
Autor: | Margaret H. Neal, Jennifer Brainard, Tarik M. Elsheikh, Rhona J. Souers, Michael R. Henry, David A. Hartley, Kalyani Naik, George G. Birdsong |
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Rok vydání: | 2013 |
Předmět: |
medicine.medical_specialty
Quality Assurance Health Care Best practice MEDLINE Uterine Cervical Neoplasms Pathology and Forensic Medicine Health care medicine Humans Prospective Studies Prospective cohort study Societies Medical Retrospective Studies Vaginal Smears Gynecology Retrospective review business.industry Data Collection Papillomavirus Infections Consensus conference Retrospective cohort study Cell Biology General Medicine Uterine Cervical Dysplasia United States humanities body regions Tumor Virus Infections Medical Laboratory Technology Cytopathology Family medicine Female Laboratories business |
Zdroj: | Archives of Pathology & Laboratory Medicine. 137:175-182 |
ISSN: | 1543-2165 0003-9985 |
Popis: | Two quality metrics for gynecologic cytology are the subject of this review: "prospective rescreening" and "retrospective rescreening."To offer consensus best practice approaches based on the College of American Pathologists' laboratory-based survey funded by the Centers for Disease Control and Prevention.The College of American Pathologists submitted a paper-based survey to 1245 laboratories. After review of initial results, follow-up Web-based survey results, and a literature review, consensus best practice statements were presented at a national consensus conference. These statements were discussed and voted upon by conference participants. Results.-A total of 541 laboratories responded to survey questions about prospective and retrospective rescreening. Most laboratories (85%) prospectively rescreen more than 10% of Pap tests interpreted as negative for intraepithelial lesion or malignancy. Most (72%) report inclusion of less than 20% high-risk cases. Most laboratories use multiple measures to define "high risk." Most laboratories (96.2%) retrospectively rescreen Pap tests from the preceding 5 years only. In most laboratories (71.4%) only Pap test results with high-grade squamous intraepithelial lesion or worse prompt retrospective review.The number of Pap tests from high-risk patients should be maximized in prospective and retrospective rescreening. Unsatisfactory Pap tests should also be included. All readily identifiable high-risk human papillomavirus-positive cases with an interpretation of negative for intraepithelial lesion or malignancy should be prospectively rescreened. Cervical biopsy results with high-grade cervical intraepithelial neoplasia or worse (CIN 2+) should trigger retrospective rescreening. Regular feedback should be provided to cytotechnologists and cytopathologists. Upgraded diagnoses from negative for intraepithelial lesion or malignancy to atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion, should be monitored. |
Databáze: | OpenAIRE |
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