Comparison of cytotechnologists' and cytopathologists' ASCUS rates preimplementation and postimplementation of the...

The automated ThinPrep® Imaging System assists the cytotechnologists in the primary screening of ThinPrep® Pap Tests. This study compares the concordance of the cytotechnologists and cytopathologists in the interpretation of Pap Tests as Atypical Squamous Cells of Undetermined Significance (ASCUS) before and after implementation of the Imager in our laboratory.

From January 1-December 31, 2011, 12,853 ThinPrep® Pap Tests were processed on a ThinPrep® 3000 Processor, stained by the Papanicolaou method and screened manually by the cytotechnologists. In 2012, 26,581 Pap Tests were processed on a ThinPrep® 3000 Processor, stained with the ThinPrep® Stain, screened on the Image Processor, and reviewed on a Review Scope by the cytotechnologists. All cases interpreted as ASCUS were sent to the cytopathologist for final review.

Overall, 52% of the ASCUS Pap Tests were overcalled by the cytotechnologists on manual screening and 56% were overcalled by the cytotechnologists with use of the ThinPrep® Imaging System, as addressed by the cytopathologist as the final arbitrator.

In this study, initial use of a new technology resulted in over interpretation of negative cases as ASCUS. Increased usage and familiarity with the System should lead to pre-Imager rates.