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Related Experiment Videos

Laboratory differences in cervical cytology.

C M Rutledge1, R V van Wolkenten, J S Levin

  • 1Department of Family and Community Medicine, Eastern Virginia Medical School, Norfolk.

Family Practice Research Journal
|June 1, 1991
PubMed
Summary
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Laboratories show significant differences in reporting endocervical cells on Papanicolaou smears. This variation in Pap smear analysis persists even after accounting for patient and collection factors.

Area of Science:

  • Gynecologic pathology
  • Laboratory medicine
  • Public health

Background:

  • Papanicolaou (Pap) smears are crucial for cervical cancer screening.
  • Reporting of endocervical cells in Pap smears is an indicator of specimen adequacy.
  • Variability in laboratory reporting practices may impact screening effectiveness.

Purpose of the Study:

  • To investigate differences in the reporting of endocervical cells in Papanicolaou smears among laboratories serving an urban, academic family practice.
  • To address a gap in the literature regarding inter-laboratory comparison of Pap smear results for endocervical cell presence.

Main Methods:

  • Prospective study evaluating 140 Papanicolaou smears from women aged 16–83.
  • Smears were analyzed by three different laboratories for the presence of endocervical cells.

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  • Statistical analysis included analysis of variance (ANOVA) and analysis of covariance (ANCOVA).

    • Main Results:

    • A statistically significant difference (p < .001) was observed in the frequency of reporting endocervical cells across the three laboratories.
    • Reported presence of endocervical cells varied widely, from 50.6% to 91.3% among laboratories.
    • ANCOVA, controlling for age, menstrual cycle phase, collection method, and clinician experience, did not explain the observed inter-laboratory differences.

    Conclusions:

    • Significant inter-laboratory variability exists in reporting endocervical cells on Papanicolaou smears.
    • This variability is not explained by known factors influencing smear quality or patient characteristics.
    • Further investigation is warranted to understand and standardize Pap smear evaluation criteria for optimal cervical cancer screening.