Title: Comparison of the cervical cytology test using the PAPNET method and conventional microscopy.

POPLINE Document Number: 121032

Author(s):

Weissbrod D
Torres M
Rodriguez A
Urena I
Estrada J
Reyes ME
Carreto AJ

Source citation:

BULLETIN OF THE PAN AMERICAN HEALTH ORGANIZATION, 1996 Dec;30(4):339-47.

Abstract:

Comparison of cervical smear analyses conducted in Mexican laboratories through conventional microscopy with the results of quality control studies conducted by the National Institute of Epidemiologic Diagnosis and Reference (INDRE) using both conventional and automated (PAPNET) methods revealed an alarming lack of agreement. A total of 10,098 slides prepared by technicians working at state public health laboratories in 28 Mexican states and the federal district were reviewed. Most slides (about 78%) yielded negative results or an inflammatory process; 8-14% indicated mild or moderate cervical dysplasia, and 2-3% revealed severe dysplasia or cervical cancer. The Kappa correlation coefficient for agreement between positive and negative diagnoses made by the states and INDRE was 0.62, near the lower limit, while comparison of diagnoses made by INDRE and PAPNET produced a coefficient of 0.80, near the upper limit. Diagnostic agreement between state laboratories and INDRE was greatest (93%) with slides classified as normal or exhibiting inflammatory changes. Agreement rates were lowest when it was necessary to differentiate degrees of abnormality: unspecified carcinoma (13.3%), invasive carcinoma (51.4%), and moderate dysplasia (63.1%). PAPNET generated substantially more false-negative results than traditional microscopy performed either by INDRE or the states and underestimated the presence of human papillomavirus virus, Candida infection, and trichomoniasis. Inadequate fixing, staining, and mounting of the slides compromised PAPNET analysis. Overall, these findings indicate a need to improve the quality of cervical cytology diagnoses at state laboratories through increased training and supervision.

Keywords:

Mexico
Research Report
Comparative Studies
Cervical Cancer
Laboratory Examinations and Diagnoses
Screening
Cytology
Prevention and Control
North America
Latin America
Americas
Developing Countries
Studies
Research Methodology
Cancer
Neoplasms
Diseases
Examinations and Diagnoses
Biology