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March 21, 2001

Implications of Low Diagnostic Reproducibility of Cervical Cytologic and Histologic Diagnoses

Author Affiliations

Author Affiliation: Department of Pathology, Loyola University Medical Center, Maywood, Ill.

JAMA. 2001;285(11):1506-1508. doi:10.1001/jama.285.11.1506

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.