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A feasibility study of the use of the AutoPap screening system as a primary screening and location‐guided rescreening device
Author(s) -
Confortini Massimo,
Bonardi Lucia,
Bulgaresi Paolo,
Cariaggi Maria Paola,
Cecchini Silvia,
Ciatto Stefano,
Cipparrone Ida,
Galanti Laura,
Maddau Cristina,
Matucci Marzia,
Rubeca Tiziana,
Troni Grazia Maria,
Turco Patricia,
Zappa Marco,
Carozzi Francesca
Publication year - 2003
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.11077
Subject(s) - medicine , colposcopy , pap smears , referral , cervical intraepithelial neoplasia , gynecology , cytology , obstetrics , bethesda system , cervical screening , cervical cancer , cancer , pathology , family medicine
BACKGROUND The AutoPap 300 QC system (Tripath Imaging, Inc., Burlington, NC) is an automated device that was designed to screen conventionally prepared cervical smears and, more recently, thin‐layer slide preparations. The system has been tested in large clinical trials. METHODS A total of 14,145 cervical smears obtained from participants in the Florence screening program were eligible for the study. Smears were processed first with the AutoPap system and were classified into three different categories: 1) no further review (NFR), 2) review, and 3) process review (PR). Conventional manual reading was performed by 10 experienced cytopathologists. RESULTS After AutoPap processing, 2398 smears were classified as NFR (16.9%), and 1818 smears were classified as PR (12.8%). Overall, there were 188 inadequate smears (1.3%) at conventional review and 125 inadequate smears (0.88%) at AutoPap review. Six‐month repeat smears were prompted by 330 conventional reviews (2.3%) and by 222 AutoPap reviews (1.56%). Similarly, referral to colposcopy was prompted by 179 conventional reviews (1.2%) and by 147 AutoPap reviews (1.0%). Overall, 32 patients were diagnosed with high‐grade cervical intraepithelial neoplasia as a result of assessment. Conventional reading detected 31 patients (28 patients were referred for colposcopy, and 3 patients were referred for repeat cytology), and the AutoPap system detected 30 patients (27 patients were referred for colposcopy, and 3 patients were referred for repeat cytology). CONCLUSIONS The current experience suggested that conventional reading and AutoPap reading of cervical smears had essentially the same sensitivity, with slightly greater specificity for the AutoPap system. Thus, comparisons of the AutoPap system and conventional reading should focus mainly on cost analysis. Cancer (Cancer Cytopathol) 2003;99:129–34. © 2003 American Cancer Society.