Cytopathology. 2022 Sep 23. doi: 10.1111/cyt.13182. Online ahead of print.
OBJECTIVE: Cytology histology correlation (CHC) is gold standard quality assurance in cytology laboratories to ensure appropriate patient treatment and as an educational tool for cytology laboratory personnel. If cervical pap smears (CP) and cervical biopsies (CB) are performed at different institutions, these benefits may be lost.
METHODS: All CB performed at our institution from 1/1/2019 to 12/31/2019 with adequate CP performed in six months prior to CB were included in this retrospective review. We compared CHC for CP and CB performed at a single institution compared to CHC for CP and CB performed at different institutions, with a focus on proportion of overcalls on CP, as those are most challenging discrepant CHC to manage clinically. We used the American Society of Cytology guidelines for our discrepancy assessment grid. Chi-squared test was used to compare proportions of populations. P-value was set at <0.05.
RESULTS: Of 305 CB in our study population, 69 had CP performed at our institution and 236 had CP performed at an outside institution. CHC for CB and CP performed at a single institution had statistically significantly less disagreement than for those performed at different institutions (p<0.05). Further, CB and CP performed at as single institution had statistically significantly fewer overcalls than CB and CP performed at different institutions (p<0.05).
CONCLUSION: This study further supports the use of CHC and encourages performance of CP and CB as the same institution. If performing CP and CB at the same institution is not feasible, prospective consultation review of CP by institution performing CB should be strongly considered. Further study, including evaluation of reason for discrepancy in discordant cases may be considered to better elucidate reasons for better CHC agreement when CP and CB are performed at the same institution.