An accurate and precise methodology for routine determination of the false-negative rate of Papanicolaou smear screening

Authors
Citation
Aa. Renshaw, An accurate and precise methodology for routine determination of the false-negative rate of Papanicolaou smear screening, CANC CYTOP, 93(2), 2001, pp. 86-92
Citations number
19
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
CANCER CYTOPATHOLOGY
ISSN journal
0008-543X → ACNP
Volume
93
Issue
2
Year of publication
2001
Pages
86 - 92
Database
ISI
SICI code
0008-543X(20010425)93:2<86:AAAPMF>2.0.ZU;2-1
Abstract
BACKGROUND. Although the false-negative rate (FNR) is the most important qu ality control measure for Papanicolaou smear screening, accurate, precise, and feasible methods for determining this value are lacking. METHODS. The author undertook an analysis and review of the literature. RESULTS. The best estimates of the FNR using atypical squamous cells of und etermined significance (ASCUS) as a threshold range from 17% to 61%. Source s of error in the accuracy of this measure that must be accounted for inclu de the FNR of the review method, differences in diagnostic thresholds betwe en the original diagnostic method and the review method, and differences in diagnostic accuracy between the original diagnostic method and the review method. Statistically precise (valid to within 10%) measurement of this val ue in laboratories with an ASCUS+ rate of 7% can be made from interlaborato ry rescreening of approximately 1200-1500 randomly selected normal and abno rmal slides along with both laboratories rediagnosing without rescreening 3 00-400 benign cellular change and ASCUS slides to determine the difference in diagnostic threshold. Consensus for each slide is not required with this method. Changing the threshold to low grade squamous intraepithelial lesio n (best estimate FNR, 14-58%) requires review of significantly more slides to achieve the same statistical level of precision. CONCLUSIONS. Detailed analysis of the sources of error in determining the F NR allow creation of methods that are relatively unbiased, feasible, and te stable and whose accuracy and precision can be determined. Cancer (Cancer C ytopathol) 2001;93:86-92. (C) 2001 American Cancer Society..