Cytopathology 

About: Cytopathology is an academic journal published by Wiley-Blackwell. The journal publishes majorly in the area(s): Fine-needle aspiration & Cytology. It has an ISSN identifier of 0956-5507. Over the lifetime, 2688 publications have been published receiving 30356 citations. The journal is also known as: cytodiagnosis.

European guidelines for quality assurance in cervical cancer screening: recommendations for cervical cytology terminology

Abstract: There are many different systems of cytology classification used in the member states of the European Union (EU) and many different languages. The following short annexe to Chapter 3 of the European Guidelines for Quality Assurance in Cervical Cancer Screening provides a framework that will allow different terminologies and languages to be translated into standard terminology based on the Bethesda system (TBS) for cytology while retaining the cervical intraepithelial neoplasia (CIN) classification for histology. This approach has followed extensive consultation with representatives of many countries and professional groups as well as a discussion forum published in Cytopathology (2005;16:113). This article will describe the reporting of specimen adequacy, which is dealt with in more detail elsewhere in Chapter 3 of the guidelines, the optional general categorization recommended in TBS, the interpretation/cytology result and other comments that may be made on reports such as concurrent human papillomavirus testing and the use of automation review and recommendations for management. The main categories in TBS will be described in the context of CIN, dyskaryosis and dysplasia terminologies so that all may be translated into the same framework. These guidelines should allow European countries to adapt their terminology in such a way as to make their screening programmes comparable with each other as well as with programmes elsewhere in the world.

The presence of a cytopathologist increases the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration cytology for pancreatic adenocarcinoma: a meta-analysis

Abstract: Objective A meta-analysis has not been previously performed to evaluate critically the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of solely pancreatic ductal adenocarcinoma and address factors that have an impact on variability of accuracy. The aim of this study was to determine whether the presence of a cytopathologist, variability of the reference standard and other sources of heterogeneity significantly impacts diagnostic accuracy.

Rapid review: Rapid Review

Abstract: Every cytologist who examines cervical smears will make mistakes. This is inevitable for a task so subject to human fallibility. Unfortunately, these errors may cause harm to the woman whose smear has been misread and with this, a risk of litigation, damage to the reputation of the laboratory and loss of public faith in the screening programme. In any human pursuit ability varies and cervical cytology is not an exception. Because of this the number and nature of errors made will differ between individuals, ranging from ‘few and understandable’ to ‘many and obvious’. Various re-screening strategies have been proposed in order to reduce these mistakes and, it is hoped, identify those who make too many. As full re-screening of all negative smears is not practical within a national screening programme, the most used method in this country has in the past been targeted re-screening of selected cases combined with 10% random re-screening. There has been much debate about the usefulness of 10% random re-screening, but the fact remains that even when combined with targeted re-screening, the vast majority of negative smears are not re-examined and therefore the chance of any false-negative smears within that group being detected before issue of the cytology report is zero. Furthermore, it is also doubtful whether this method is able to provide enough data to indicate poor individual performance. There was therefore a requirement for a cost effective method of internal quality control that would both detect false-negative reports and identify cytologists performing below acceptable standards. Studies that have examined false-negative smears confirm what any cytologist who has reviewed negatively reported smears that have preceded a positive outcome will know, namely that many mistakes in cytology are blatant. How many of us when reviewing such slides have not thought ‘If only I had had just a quick look at this’? This sentiment partly lies behind what is now known as ‘Rapid review’, a method by which all negative and inadequate smears are re-examined for a shorter time than conventional primary screening before the report is issued. Cytopathology 1998, 9, 71–76

Achievable standards, benchmarks for reporting and criteria for evaluating cervical cytopathology.

Abstract: The cervical smear test, like all screening tests, is not 100% effective in detecting abnormality. In order to prevent 80-90% of invasive cancers, cervical screening requires cervical smears to be taken competently at regular intervals and correctly interpreted. With laboratories following the guidelines in this report, the NHSCSP should be able to meet the Health of the Nation target to reduce the incidence of invasive cervical cancer to less than 12 cases per 100 000 women in the UK by the year 2000.

European guidelines for quality assurance in cervical cancer screening: recommendations for clinical management of abnormal cervical cytology, part 1.

Abstract: The current paper presents the first part of Chapter 6 of the second edition of the European Guidelines for Quality Assurance in Cervical Cancer Screening. It provides guidance on how to manage women with abnormal cervical cytology. Throughout this article the Bethesda system is used for cervical cytology terminology, as the European guidelines have recommended that all systems should at least be translated into that terminology while cervical intraepithelial neoplasia (CIN) is used for histological biopsies (Cytopathology 2007; 18:213-9). A woman with a high-grade cytological lesion, a repeated low-grade lesion or with an equivocal cytology result and a positive human papillomavirus (HPV) test should be referred for colposcopy. The role of the colposcopist is to identify the source of the abnormal cells and to make an informed decision as to whether or not any treatment is required. If a patient requires treatment the colposcopist will decide which is the most appropriate method of treatment for each individual woman. The colposcopist should also organize appropriate follow-up for each woman seen. Reflex testing for high-risk HPV types of women with atypical squamous cells (ASC) of undetermined significance with referral for colposcopy of women who test positive is a first option. Repeat cytology is a second possibility. Direct referral to a gynaecologist should be restricted to special circumstances. Follow-up of low-grade squamous intraepithelial lesion is more difficult because currently there is no evidence to support any method of management as being optimal; repeat cytology and colposcopy are options, but HPV testing is not sufficiently selective, unless for older women. Women with high-grade squamous intraepithelial lesion (HSIL) or atypical squamous cells, cannot exclude HSIL (ASC-H) should be referred without triage. Women with glandular lesions require particular attention. In a subsequent issue of Cytopathology, the second part of Chapter 6 will be presented, with recommendations for management and treatment of histologically confirmed intraepithelial neoplasia and guidance for follow-up of special cases such as women who are pregnant, postmenopausal or immunocompromised.