Evaluation of the 5-year review of negative cervical smears in patients with high grade squamous intraepithelial lesions

✍ Scribed by Sana O. Tabbara; Mary K. Sidawy

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 509 KB
• Volume: 15
• Category: Article
• ISSN: 8755-1039
• DOI: 10.1002/(sici)1097-0339(199607)15:1<7::aid-dc3>3.0.co;2-h

✦ Synopsis

Federal regulations require laboratories to re-examine negative cervical smears from the 5 yr preceding a diagnosis of high-grade squamous intraepithelial lesion (HSIL) or carcinoma. To assess the value of this regulation as a quality assurance measure, we evaluated the previous cervical smears f m m 47 patients with a diagnosis of HSIL rendered during a 9-mo period. Fifteen patients had a total of 24 previous smears initially reported as squamous intraepithelial lesions (SIL). The remaining 32 patients had a total of 58 smears that carried a diagnosis lesser 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 1-yr review, 12 (75%) with the 2-yr review, 15 (94%) with the 3-yr review, and 16 (100%) with the S-yr review. The authors conclude that the negative smear review is a benejcial quality assurance and teaching method that may lead to quality improvement. A 3-yr retrospective review is effective and detects 94% of the undercalls.