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Influence of smear quality on the rate of detecting significant cervical cytologic abnormalities
1Department of Clinical Cytology, Newcastle General Hospital, Newcastle upon Tyne, UK.
Objective:
To determine the correlation between cervical smear quality and the rate of detecting significant epithelial abnormalities.
Study Design:
Smear quality was assessed routinely in a series of 68,328 cervical spatula and spatula/brush combination smears received by our laboratory during 1993. Quality was assessed using a semiquantitative method, evaluating the presence of endocervical cells, metaplastic squamous cells, endocervical mucus and overall squamous cellularity.
Results:
Smear quality was graded as unsatisfactory, poor (18,680 smears), fair (9,739 smears) or good (39,909 smears); unsatisfactory smears were eliminated from the analysis. There was a highly significant correlation between smear quality and the rate of detecting significant epithelial abnormalities (chi 2=127.52, df=2, P<.001).
Conclusion:
Smear quality is an important issue. Many significant abnormalities are potentially missed because of poor smear quality.