Premium
Benefit of double‐reading cytology smears as a triage strategy among high‐risk human papillomavirus–positive women in Mexico
Author(s) -
RamírezPalacios Paula,
Chen Aiyu,
Flores Yvonne N.,
Crespi Catherine M.,
LazcanoPonce Eduardo,
AlvarezEscobedo Daniel,
TorresIbarra Leticia,
RiveraParedez Berenice,
LeónMaldonado Leith,
HernándezLópez Rubí,
MendiolaPastrana Indira R.,
MéndezHernández Pablo,
Cuzick Jack,
Carmona Enrique,
Figueroa Héctor,
MontielCordero Fernando,
MenesesLeón Joacim,
Rao Jianyu,
Salmerón Jorge
Publication year - 2020
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.29
H-Index - 57
eISSN - 1934-6638
pISSN - 1934-662X
DOI - 10.1002/cncy.22303
Subject(s) - medicine , colposcopy , triage , cytology , cervical cancer , gynecology , obstetrics , cervical cancer screening , cervical intraepithelial neoplasia , human papillomavirus , cancer , pathology , emergency medicine
Background The goal of this study was to determine whether the detection of histologically confirmed cases of cervical high‐grade squamous intraepithelial lesions or worse (HSIL+) can be increased by having each liquid‐based cytology (LBC) slide read by 2 cytotechnologists as part of routine screening. Methods Over 36,212 women aged 30 to 64 years participated in the Forwarding Research for Improved Detection and Access for Cervical Cancer Screening and Triage (FRIDA) Study in Mexico between 2013 and 2016. For each participant, 2 cervical samples were collected at the same clinic visit, one to test for high‐risk human papillomavirus (hrHPV) and the other for LBC, which was used to triage those with a hrHPV positive result. LBC slides were evaluated by 7 cytotechnologists, with each slide read independently by 2 blinded cytotechnologists. All women with atypical cells of undetermined significance or a worse result were referred to colposcopy for further evaluation and diagnosis. Three pathologists evaluated the biopsy specimens to confirm the final HSIL+ diagnosis. The HSIL+ detection rates for the single versus double reading were estimated and compared. Results A total of 3,914 women with a positive hrHPV result were triaged with LBC. The first and second cytology readings resulted in 43 HSIL+ cases detected; the double‐reading strategy detected 9 additional HSIL+ cases, resulting in a total of 52 HSIL+ cases. The HSIL+ detection rate increased from 10.99/1000 with a single reading to 13.29/1000 with the double‐reading strategy ( P = .004). Conclusion A 20.9% increase in HSIL+ cases detected was achieved with a double reading of the LBC slides in this sample of hrHPV‐positive women.