Weekly Rescreening of 10% of the Total Cervical Papanicolaou Smears: A Worthwhile Quality Assurance Scheme
Pichet Sampatanukul MD, MSc*, Pongsak Wannakrairot MD*, Usanee Promprakob MSc, CT(IAC)**, Sirisanpang Yodavudh MD***, Chaiyut Anansiriprapa CT(IAC)****
Affiliation : * Department of Pathology, Faculty of Medicine, Chulalongkorn University ** Pathology Division, National Cancer Institute *** Charoenkrung Pracharak Hospital **** Pathology Division, Rajavithi Hospital
Background : In awareness of possible false negative cervical Papanicolaou tests in routine service, the authors developed
and tested a new scheme that would be a practical adjunct in quality assurance.
Objective : To evaluate the value of a weekly rescreen of 10% of the total cervical Papanicolaou smears as a quality
assurance scheme.
Design : A prospective descriptive study.
Results : Of 31,914 slides in the 9-month study period, a total of 3,097 slides (9.7%) were picked up in the rescreen scheme.
There were 29 discordant cases (0.9%) consisting of 7 cases (0.2%) of errors from the initial reporting, 2 cases of errors
from the rescreening and 20 other cases from disagreements on designating atypical squamous cells of undetermined
significance. The errors of the initial reports could be further classified into 6 cases due to screening errors and one case
because of interpretation error. The proper diagnoses had been revised and resent to the attending gynecologists.
Conclusion : A weekly rescreening 10% of total cervical Papanicolaou smears scheme was worthwhile for quality
assurance. It could be used for evaluating screener performance and create internal quality improvement. The detected
false diagnoses were manageable.
Keywords : Cervical Pap smear, Pap test, Quality assurance, 10% rescreen
