RETROSPECTIVE ANALYSIS OF NON-CORRELATING CERVICAL SMEARS AND COLPOSCOPICALLY DIRECTED BIOPSIES

The purpose of this study is to evaluate the cause of discrepancies be tween non-correlating cytologic and histologic cervical samples. The b iopsy results of 433 women examined colposcopically were compared to t heir referral cervical smears (RS). There was a discrepancy between th e RS and the subsequent biopsy in 120 women (28%). One hundred of thes e 120 RS were available for review; and in each case, a reason for the discrepancy was established and classified as RS overcall, RS underca ll, RS sampling error, or biopsy sampling error. Fifty-one discrepant RS were overcalled. They were reported initially as condyloma (19), mi ld dysplasia (22), and moderate dysplasia (10). One RS was undercalled . Nine RS were nor diagnostic of the biopsy-proven lesion due to smear sampling error. The discrepancies in the remaining 39 cases were due to biopsy sampling error. Twenty-one of these 39 cases had additional biopsies or smears that confirmed the presence of condyloma/dysplasia, and 18 had negative follow-up, In summary, discrepancies were a resul t of pathologists' interpretative error, predominantly overcalls, in 5 2% of non-correlating cases, and smear or biopsy sampling error in the remaining 48%. (C) 1994 Wiley-Liss, Inc.