Field test results using the BioPEPR cervical smear prescreening system

BioPEPR is a cathode ray tube scanning device that has been developed for the prescreening of cervical smears. Cervical samples are collected in suspension, syringed, counted and spread across a microscope slide. Feulgen-Thionine with Congo Red is used as the staining procedure. Fields of 6 X 8 mm are scanned at 1 mu resolution, using an intermediate photographic step. Morphologic parameters of the cells are measured, as called for by a hierarchical decision strategy. Analysis speed is currently about 4 min per smear; improvements of at least a factor of four are expected. A field test of BioPEPR is being undertaken in cooperation with a local population screening program. In the study two smears are made from each woman; the first is prepared according to the Papanicolaou technique while the second is prepared and stained according to the BioPEPR methods. In addition to smears from the population screening program a number of possibly abnormal smears are obtained from several gynecological clinics. To date approximately 3500 "second" smears have been analyzed by the BioPEPR system. The results show a missed positive rate on the order of a few percent (no missed positives were more severe than a slight dysplasia), and a false alarm rate of about 24%. A further analysis of the age distribution of the false alarm rate shows that a large proportion came from women above the age of 50; the false alarm rate is about 20% for women under the age of 50.