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[New version of the pathology practice guideline for cervical cytology: sharpened criteria for adequacy; expanded use
F J van Kemenade1, Tj Wiersma, Th J M Helmerhorst
1VU Medisch Centrum, afd. Pathologie, Postbus 7057, 1007 MB Amsterdam. f.vkemenade@vumc.nl
Abstract:
The Dutch Pathology Association (NVVP) has modified the practice guideline for cervical cytology. The changes were made in consultation with the Dutch College ofGeneral Practitioners (NHG) and the Dutch Society for Obstetrics and Gynaecology (NVOG). The four most important changes are: (a) breastfeeding is no longer a contraindication for smear taking; (b) the rejection of smears, under certain conditions, if the cervix has not been visualised; the representativeness of a smear depends in part on the degree to which the requesting physician has verified that the smear was taken from the cervix; if the smear lacks endocervical cells, it must be considered inadequate if the requestor has not seen the cervix or designates the portio as abnormal; (c) the use of thin-layer cytology is accepted; (d) addition of the test for high-risk Human papilloma virus (hrHPV-test) may reduce the number of secondary repeat smears.
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