Interobserver variability in subclassification of squamous intraepithelial lesions: Results of the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology

Arch Pathol Lab Med. 1999 Nov;123(11):1079-84. doi: 10.5858/1999-123-1079-IVISOS.

Abstract

Objective: To determine whether, on a national cytology proficiency test, a competent cytologist can consistently distinguish grades of squamous intraepithelial lesions.

Design: Results for low- and high-grade squamous intraepithelial lesion referenced slides from the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology for 1996 and 1997 were analyzed including educational, nongraded vs graded validated slides.

Results: The discrepant rate between low- and high- grade lesions ranged from 9.8% to 15% for cytotechnologist, pathologist, laboratory, and all responses. There was a statistically significant difference in performance on graded, validated slides vs educational slides with better performance on validated slides.

Conclusion: This significant interobserver variability in subclassification of squamous lesions should be considered in management guidelines for abnormal Papanicolaou test results and implementation of national cytology proficiency testing.

Publication types

  • Comparative Study

MeSH terms

  • Carcinoma, Squamous Cell / classification*
  • Carcinoma, Squamous Cell / diagnosis
  • Cervical Intraepithelial Neoplasia / classification*
  • Cervical Intraepithelial Neoplasia / diagnosis
  • Female
  • Humans
  • Observer Variation*
  • Papanicolaou Test*
  • Reference Standards
  • Societies, Medical
  • United States
  • Uterine Cervical Neoplasms / classification*
  • Uterine Cervical Neoplasms / diagnosis
  • Vaginal Smears / classification*
  • Vaginal Smears / standards
  • Vaginal Smears / statistics & numerical data