Performance of Candida--fungal-induced atypia and proficiency testing: observations from the College of American Pathologists proficiency testing program.

Abstract

Abstract Context.—Candida may elicit cellular changes on otherwise negative screening Papanicolaou tests that may be misinterpreted as atypical squamous cells of undetermined significance. Although these changes have been correctly interpreted in the educational program of the College of American Pathologists, the Interlaboratory Comparison Program in Gynecologic Cytology, the performance of negative slides with Candida faltered when the same field validated slides were included in proficiency testing (PT). Objective.—To identify the performance differences of negative for intraepithelial lesion (NILM) Candida challenges before and after PT. Design.—We compare the performance of NILM College of American Pathologists slides with Candida as a single reference diagnosis, prior to PT (1991–2006) and after PT (2006–2007). Results.—There were 147 186 responses for slides with NILM Candida from the College of American Pathologists programs from 1991 through 2007. After PT, 79.7% of incorrect participant response...