RAPID SCREENING OF CERVICAL SMEARS AS A METHOD OF INTERNAL QUALITY-CONTROL - FOR HOW LONG SHOULD WE RESCREEN

OBJECTIVE: To compare the effectiveness of vapid screening of cervical smears as a method of internal quality control with 10% random rescre ening. STUDY DESIGN: From June 5 to July 14, 1995 (6 weeks), all conse cutive cervical smears received in the department (n = 8,800) were ent ered into the study and were prescreezed for a duration of 30 seconds (n = 2,938), 1 minute (n = 2,925) or 2 minutes (n = 2,937) over a peri od of 2 weeks each. RESULTS: Rapid screening of all negative and unsat isfactory smears detected more cytologic abnormalities than would be e xpected with 10% random rescreening. Thirty-second rapid screening of all negative and unsatisfactory smears was more efficient in detecting false negatives than screening a proportion of the smears for longer periods of time. Rapid screening was also a very effective method of d etecting severe cytologic abnormalities in unscreened smears, detectin g over 90% of high grade lesions. CONCLUSION: Rapid rescreening of neg ative and unsatisfactory cervical smears is recommended as a very effe ctive method of internal quality control. It is superior to 10% random rescreening in reducing the false negative rate. Thirty-second rapid rescreening is the most efficient period for which smears should be sc reened. Rapid screening of unscreened smears could be used as a means of selecting patients for prompt referral when a laboratory backlog ex ists.