So. Tabbara et Mk. Sidawy, EVALUATION OF THE 5-YEAR REVIEW OF NEGATIVE CERVICAL SMEARS IN PATIENTS WITH HIGH-GRADE SQUAMOUS INTRAEPITHELIAL LESIONS, Diagnostic cytopathology, 15(1), 1996, pp. 7-10
Federal regulations require laboratories to re-examine negative cervic
al smears from the 5 yr preceding a diagnosis of high-grade squamous i
ntraepithelial lesion (HSIL) or carcinoma. To assess the value of this
regulation as a quality assurance measure, we evaluated the previous
cervical smears from 47 patients with a diagnosis of HSIL rendered dur
ing a 9-mo period. Fifteen patients had a total of 24 previous smears
initially reported as squamous intraepithelial lesions (SIL). The rema
ining 32 patients had a total of 58 smears thar carried a diagnosis le
sser than SIL. Upon re-screening 22/58 (38%) smears, from 16 patients,
were upgraded to SIL (8 low grade, 14 high grade). Underdiagnosed SIL
was detected in seven (44%) patients with the I-yr review, 12 (75%) w
ith the 2-yr review, 15 (94%) with the 3-yr review, and 16 (100%) with
the 5-yr review. The authors conclude that the negative smear review
is a beneficial quality assurance and teaching method that may lead to
quality improvement. A 3-yr retrospective review is effective and det
ects 94% of the undercalls. (C) 1996 Wiley-Liss, Inc.