Perceptions of Paris: an international survey in preparation for The Paris System for Reporting Urinary Cytology 2.0 (TPS 2.0).

Abstract

An international panel of experts in the field of urinary cytopathology conducted a survey, supported by the American Society of Cytopathology, to seek opinions, gather evidence, and identify practice patterns regarding urinary cytology before and after the introduction of The Paris System for Reporting Urinary Cytopathology (TPS). Results from this survey were utilized in the development of the second edition of TPS (TPS-2.0). The study group, originally formed during the 2013 International Congress of Cytology, reconvened at the 2019 annual meeting of the American Society of Cytopathology. To prepare for the second edition of TPS, the group generated a survey that included 43 questions related to the taxonomy and practice of urinary cytology. A total of 523 participant responses were collected, and 451 from 54 countries passed a qualifying screen. Three hundred ninety-four participants provided information about their work settings. Eighty-two percent (218/266) of responding participants use TPS. One hundred sixty-eight people who responded on their urinary cytology atypia rates reported an average decrease from 21.6% to 16%. Over three fourths of participants felt that the same criteria should be used for upper and lower tract interpretations and for instrumented and voided samples. There were varied opinions on addressing atypical squamous cells and suggestions for an expanded discussion of the issue to be included in TPS 2.0. Results of the survey demonstrate strong support for TPS and show a decreased self-reported atypia rate in the laboratories using TPS. The majority of participants related that the criteria put forth for the reporting categories were user-friendly and applied with relative ease. The comment section of the survey included suggestions from the participants for further improvement of TPS. Results of this survey have been useful in fine-tuning and advancing TPS. They were considered along with recent literature to generate the second edition of TPS.