Influence of smear quality on the rate of detecting significant cervical cytologic abnormalities

Acta Cytol. May-Jun 1996;40(3):529-35. doi: 10.1159/000333910.


Objective: To determine the correlation between cervical smear quality and the rate of detecting significant epithelial abnormalities.

Study design: Smear quality was assessed routinely in a series of 68,328 cervical spatula and spatula/brush combination smears received by our laboratory during 1993. Quality was assessed using a semiquantitative method, evaluating the presence of endocervical cells, metaplastic squamous cells, endocervical mucus and overall squamous cellularity.

Results: Smear quality was graded as unsatisfactory, poor (18,680 smears), fair (9,739 smears) or good (39,909 smears); unsatisfactory smears were eliminated from the analysis. There was a highly significant correlation between smear quality and the rate of detecting significant epithelial abnormalities (chi 2=127.52, df=2, P<.001).

Conclusion: Smear quality is an important issue. Many significant abnormalities are potentially missed because of poor smear quality.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Data Interpretation, Statistical
  • Epithelium / pathology
  • Female
  • Humans
  • Mass Screening / standards
  • Middle Aged
  • Quality Control
  • Specimen Handling / standards
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / pathology*
  • Vaginal Smears / standards*