Revisão rápida de esfregaços cervicais como método de garantia interna de qualidade
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Data
2003
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Resumo
Introduction: One of the most frequently cited disadvantages of cervical cancer screening is its high
false negative rate. The most widely used quality assurance method is 10% random re-screening.
Recent studies have shown that 100% rapid re-screening is an efficient method for reduction of the
false negative rate. Objective: The aim of this study was to compare the performance of 100% rapid
re-screening with that of 10% random re-screening as an internal quality assurance method.
Methods: 2,750 first screening negative smears were submitted to 100% rapid re-screening by a
senior cytotechnologist followed by 10% random re-screening by another senior cytotechnologist.
After re-screening, all smears were analyzed by two independent cytopathologists. Whenever results
were divergent the smears were analyzed by a third cytopathologist and the panel established a
consensus gold standard diagnosis. Results: 98 suspect smears were selected by rapid re-screening,
62 of which were confirmed as abnormal by the gold standard: 45 Ascus, 11 LSIL and six HSIL
(sensitivity 73.8%). Of the nine abnormal smears detected by the 10% random re-screening, six
were confirmed by the gold standard, three Ascus, two LSIL and one HSIL (sensitivity 50%). The gold
standard detected 57 Ascus, ten LSIL and five HSIL cases among the 2,489 smears that were not
submitted to 10% re-screening. Conclusions: 100% rapid re-screening is an efficient alternative for
reduction of cervical screening false negative rates. It also allowed to monitor the individual
performance of members of the team.
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Palavras-chave
Câncer de colo uterino, Teste de papanicolaou, Revisão rápida, Garantia de qualidade, Controle de qualidade, Cervical cancer, Pap test, Rapid screening, Quality assurance, Quality control
Citação
AMARAL, Rita Goreti et al. Revisão rápida de esfregaços cervicais como método de garantia interna de qualidade. Jornal Brasileiro de Patologia e Medicina Laboratorial, Rio de Janeiro, v. 39, n.2, p. 151-155, 2003.