Author Affiliation: Department of Pathology, Loyola University Medical Center, Maywood, Ill.
Since its introduction by Papanicolaou in 19431
cytologic examination of cervical smears has led to early detection of cervical
carcinoma and its precursors, with a reduction in both morbidity and mortality.
And even though Koss has suggested that the cervical smear was perhaps the
only effective cancer screening test,2 screening
for cervical cancer has not eliminated the disease in any population studied.
Reported estimates of the false-negative rate have ranged from 6% to 50% of
all cervicovaginal samples.2,3
Three major sources of error include variability among clinicians obtaining
the sample and the area of the cervix sampled; the cell collection and preparation
techniques used; and errors in interpretation, with lack of diagnostic reproducibility
for some cervical abnormalities.
Selvaggi SM. Implications of Low Diagnostic Reproducibility of Cervical Cytologic and Histologic Diagnoses. JAMA. 2001;285(11):1506-1508. doi:10.1001/jama.285.11.1506