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Results of AutoPap system-assisted and manual cytologic screening. A comparison
1Unilab, Tarzana, CA 91356, USA. pwertlake@unilab.com
Objective:
To determine the effectiveness of AutoPap QC System rescreening of all qualified negative cervical cytologic smears with selection of approximately 10% for cytotechnologist rescreening as compared to a random selection of 10% of negative cases.
Study Design:
The study included 1,141,913 consecutive smears. In February 1997 an AutoPap-based QC program was implemented to select a population for rescreening. Negative cases were studied prospectively by the AutoPap QC System. Detection rates by diagnostic classification of false negative cases were compared to rates obtained using a randomly selected 10% rescreening of negative cases from the immediately preceding time period.
Results:
The AutoPap QC System was 5.2-fold more effective for the detection of high grade squamous intraepithelial lesion + false negatives, 2.0-fold for low grade squamous intraepithelial lesions, 2.8-fold for atypical squamous cells of undetermined significance and 5.1-fold for atypical glandular cells of undetermined significance.
Conclusion:
In a large reference laboratory a QC program utilizing the AutoPap QC System was significantly more effective in the detection of false negative smears as compared to a QC program utilizing 10% random rescreening of negative smears.