ETIOLOGIES FOR NON-CORRELATING CERVICAL CYTOLOGIES AND BIOPSIES

To investigate the etiologies for discrepancies between cervicovaginal smear and corresponding cervical biopsy results, 615 patients with cy tologic diagnoses of dysplasia or malignancy during 1 year were review ed ed. Sixty-nine patients (11%) were identified in which the cytologi c and histologic diagnoses differed. Utilizing an algorithm developed for the study, these cases were assigned an etiologic category for dis crepancy: colposcopic biopsy or cytologic sampling, cytologic screenin g, histotechnical processing, histologic or cytologic interpretation. The most common cause for a discrepancy was colposcopic biopsy samplin g (36 cases, 51%). There were nine errors (13%) in biopsy interpretati on, with seven underdiagnoses and two overdiagnoses, Eight errors (11% ) in cytologic interpretation occurred, with half of these representin g underdiagnoses. The other causes for discrepancy were less common-cy tologic sampling (6 cases), histotechnical processing (3 cases), cytol ogic screening (2 cases), and a combination of factors (5 cases). Use of this algorithm allows laboratories to identify problem areas and de sign specific corrective protocols to improve diagnostic accuracy and patient care.