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An explanation for the problem of false-negative cervical smears
S E Barton1, D Jenkins, A Hollingworth
1Department of Gynaecology, Whittington Hospital, London.
British Journal of Obstetrics and Gynaecology
|April 1, 1989
Summary
False-negative cervical cytology results, often caused by sampling errors, are linked to smaller areas of cervical intraepithelial neoplasia (CIN). This suggests new screening methods like cervicography could improve detection of these subtle lesions.
Area of Science:
- Gynecologic Oncology
- Cervical Pathology
- Diagnostic Cytology
Background:
- False-negative results in cervical cytology are a significant clinical challenge.
- Sampling errors contribute to missed diagnoses of cervical intraepithelial neoplasia (CIN).
Purpose of the Study:
- To investigate the relationship between the extent of cervical intraepithelial neoplasia (CIN) and false-negative cervical cytology results.
- To explore the potential of cervicography as an adjunct screening tool.
Main Methods:
- Studied 47 women with histologically confirmed CIN, undergoing two cervical smears.
- Performed cervicography, colposcopy, and biopsy during the second smear.
- Measured the area of acetowhite lesions and the atypical transformation zone (ATZ) from photographs.
Main Results:
- Women with false-negative smears (no dyskaryosis) had a significantly smaller proportion of their ATZ affected by CIN.
- This suggests smaller CIN lesions may be missed by conventional cytology sampling.
Conclusions:
- The size of the cervical intraepithelial neoplasia (CIN) lesion may explain sampling errors leading to false-negative cervical cytology.
- Cervicography shows promise as a tool to detect and assess smaller cervical lesions, potentially improving screening accuracy.