Abstract
Inadequate Pap smears do not provide satisfactory cell samples for evaluation, thus making it more difficult to detect cervical cytological abnormalities. The objective of this study was to determine the cytological and histological follow-up results from women with inadequate smear reports in primary healthcare centers in Santiago, Chile 2010-2011. Prospective cohort study at primary healthcare clinics in Santiago, Chile. The population was taken from the "Cito-Expert" database of 2010. The data were then organized according to the cytological and histological follow-up results of 2,547 women with inadequate cervical cytological reports over the 12-month period. The samples were assigned to groups based on the cause of inadequacy (smears with endocervical cells alone; insufficient, hemorrhagic, inflammatory or poorly fixed samples; insufficient and hemorrhagic samples; or insufficient and inflammatory specimens). The data were analyzed using the "conditional probability tree diagram" and descriptive statistics. Half of the women (n = 1,285) met the requirements of the Ministry of Health for repeating these inadequate smears, and 1,104 of these women had normal cytological results (85.9%). The detection rate for cervical lesions according to group ranged from 0% (smears with endocervical cells alone or insufficient and hemorrhagic specimens) to 4.1% (poor fixation). The large proportion of normal results justifies revision of the current clinical guidelines. The results showed that it is not necessary to repeat the Pap test early on, with the exception of inadequate hemorrhagic and inflammatory cytological results.
Highlights
Inadequate Pap smears are those that do not provide satisfactory cell samples for evaluation, making it more difficult to detect cervical cytological abnormalities and making it necessary to repeat the test, according to the current requirements of the National Cervical Cancer Research and Control Program in Chile.1,2 Trained professionals are involved in this process
The objective of this study was to determine the cytohistological follow-up results from women attended within primary healthcare centers in the Southern Metropolitan Area of Santiago, Chile, in 2010-2011, whose cytological reports presented inadequacies. This was a descriptive, prospective, observational and quantitative epidemiological study based on following up cohorts of women with inadequate Pap test results that were reported within the National Cervical Cancer Research and Control Program in Chile
We found that compliance with the recommendation for repetition of inadequate smears was deficient
Summary
Inadequate Pap smears are those that do not provide satisfactory cell samples for evaluation, making it more difficult to detect cervical cytological abnormalities and making it necessary to repeat the test, according to the current requirements of the National Cervical Cancer Research and Control Program in Chile. Trained professionals (midwives or gynecologists) are involved in this process. Trained professionals (midwives or gynecologists) are involved in this process. They are guided by regulations that establish uniform criteria for the patient’s prior clinical condition and for applying the conventional technique for collecting cervical cytology smears.. The diagnostic codes of the Chilean National Program are used for reporting, and they are equivalent to the 2001 Bethesda System.. The diagnostic codes of the Chilean National Program are used for reporting, and they are equivalent to the 2001 Bethesda System.3 These codes define the adequacy of cytological smears in categories that are considered to be satisfactory or unsatisfactory for evaluation. “Adequate samples” that are satisfactory for evaluation are classified as G8. “Inadequate samples” and their specific causes are classified between G0 and G7 and from G9 onwards.
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