Prevalence of high-grade cervical intraepithelial neoplasia in women with persistent high-risk HPV genotypes and negative cytology.

Introduction: Primary HPV screening will be implemented into the English Cervical Screening Programme by 2019. Its impact upon women referred to colposcopy, with negative cytology but persistently positive high-risk HPV (hrHPV), remains unreported from UK Sentinel sites. HPV primary screening was introduced in Sheffield, UK in April 2013; this paper reports its impact on the service.

Cytology in the diagnosis of cervical cancer in symptomatic young women: a retrospective review.

Background: Cervical cancer in young women presents a diagnostic challenge because gynaecological symptoms are common but underlying disease is rare.

Aim: To explore the potential for using cytology as a diagnostic aid for cervical cancer in young women.

Design And Setting: Retrospective review of primary care records and cytology data from the national cervical screening database and national audit of cervical cancers.

Cytology training in the UK: a training centre prospective.

Training in both cervical and non-gynaecological cytology in the UK has never faced a more challenging environment. A national reconfiguration of cervical cytology services has focussed resources on large centres and damaged the traditional links and overlapping roles within non-gynaecological cytology. The UK is now at significant risk of falling behind most European countries in the use of non-gynaecological cytology.

Endometrial Adenocarcinoma in SurePath™ Cervical Samples: Cytological Features Revisited.

Objective: The cytomorphological criteria of malignant endometrial lesions in cervical samples are less well described than those of cervical lesions. We wished to investigate if there were features in SurePath™ liquid-based cytology samples that would facilitate more accurate differentiation between benign and malignant endometrial cells.

Study Design: This was a two-phase study, with a review of all SurePath™ samples reported as endometrial adenocarcinoma (n = 42) evaluating 12 cytological features in the first phase.

Does LLETZ excision margin status predict residual disease in women who have undergone post-treatment cervical cytology and high-risk human papillomavirus testing?

Objective: This study looks at the importance of large loop excision of the transformation zone (LLETZ) excision margins and residual cervical intraepithelial neoplasia (CIN) in women undertaking high-risk human papillomavirus (hrHPV) test of cure (TOC).

Methods: A retrospective cohort study with interval analysis performed June 2007 and June 2012 on all women undertaking treatment for CIN and subsequent hrHPV TOC 6 months post LLETZ.

Results: Final analysis group comprised 2093 women treated by LLETZ (1396 completely excised; 697 incompletely excised).

Cervical cytology and the diagnosis of cervical cancer in older women.

Objectives: Most non-screen-detected cervical cancers are advanced stage. We assess the potential for cytology to expedite diagnosis when used outside of routine call and recall screening for cervical cancer.

Methods: Two cohorts of women with cytology that did not appear to have been taken as part of routine screening, nested within a census of cervical cytology, in England between April 2007 and March 2010 were studied: 93,322 women aged 40-69 at first cytology, and 14,668 women aged ≥70.

Evaluating cytology for the detection of invasive cervical cancer.

Objective: To assess the sensitivity, the number needed to screen (NNS) and the positive predictive value (PPV) of cervical cytology for the diagnosis of cancer by age in a screening population.

Methods: A retrospective cohort of women with invasive cervical cancer nested within a census of cervical cytology. All (c.

High-risk HPV platforms and test of cure: should specific HPV platforms more suited to screening in a 'test of cure' scenario be recommended?

Objective: When the Sheffield screening laboratory changed the high-risk human papillomavirus (hrHPV) platforms from hybrid capture 2(®) (HC2; Digene Ltd) and to cobas 4800(®) (Roche) an unexpected and substantial increase in the number of cytology-negative/hrHPV-positive test-of-cure (ToC) samples after large loop excision of the transformation zone (LLETZ) was noted. We explore the potential reasons for these increased rates and discuss the implications this may have on the English NHS cervical screening programme (CSP).

Methods: A retrospective cohort study with interval analysis between June 2007 and June 2012.

Eight cases of malignant mixed Müllerian tumor (carcinosarcoma) of the uterus: findings in SurePath™ cervical cytology.

Malignant mixed Müllerian tumor (MMMT)/carcinosarcoma is a rare neoplasm of the female genital tract characterized by a mixture of epithelial and mesenchymal components. There are published reports of conventional cervical smear findings in uterine MMMT, but to the best of our knowledge the cytomorphology of MMMT in SurePath™ liquid-based cytology samples has not been described. We present a series of eight cases of uterine MMMT in SurePath™ cervical samples.

The outcome for women with microinvasive cervical cancer with stromal invasion 1 mm or less: should we always re-excise?

To assess the management and outcome for women with microinvasive cervical cancer with stromal invasion 1 mm or less, examining the impact of re-excision. A retrospective cohort study with interval analysis performed between December 2000 and December 2010. Sheffield Gynaecological Cancer Centre and Jessop Wing Colposcopy Unit, Sheffield, UK.

Atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion: diagnostic features in surepath™ cervical samples.

This study was undertaken to identify the situations in which a diagnosis of "Atypical squamous cells, cannot exclude a high-grade squamous intraepithelial lesion (ASC-H)" is offered in SurePath™ cervical samples and to identify cytological criteria helpful in predicting high-grade disease. 2,335 (3.4%) SurePath samples reported as atypical squamous cells (ASC) over a period of 2 years, including 1,112 cases with known hrHPV status were retrieved.

Factors contributing to false-negative and potential false-negative cytology reports in SurePath™ liquid-based cervical cytology.

Objectives: The characteristics of false-negative conventional cervical cytology smears have been well documented, but there is limited literature available for liquid-based cytology (LBC), especially SurePath™ samples. We aimed to assess the characteristics of false-negative SurePath LBC samples.

Methods: Over a period of 5 years, an audit of false-negative reports in SurePath cervical cytology was undertaken.

Outcome of SurePath™ cervical samples reported as borderline nuclear change by cytological subtype and high-risk HPV status.

Background: The average borderline rate in cervical cytology samples for English laboratories was 3.8% with the range being 2.0-6.

Individual estimated sensitivity and workload for manual screening of SurePath gynecologic cytology.

Data correlating individual screening sensitivity in gynecologic cytology and workload is limited. We compared the estimated sensitivity of manual screening of SurePath slides with individual workload. Estimated sensitivity determined by rapid prescreening was correlated with total workload in a laboratory performing manual screening of SurePath preparations for a 1 year period.

Glandular neoplasia and borderline endocervical reporting rates before and after conversion to the SurePath(TM) liquid-based cytology (LBC) system.

Reporting rates for glandular neoplasia in 464,754 cervical samples reported at six laboratories in 12-month periods before and after the implementation of Surepath™ LBC processing are compared. The introduction of LBC processing is seen to have resulted in a significant (P = 0.001) increase in the detection rate for endocervical glandular neoplasia (from 2.

Improved sensitivity over time with rapid prescreening in gynecologic cytology.

Rapid prescreening (RPS) is a powerful tool to measure and improve performance in the cytology laboratory. Long-term use of RPS has been shown to result in improved sensitivity and precision in routine screening. The effect of long-term RPS on RPS itself is not known.

Rapid pre-screening is more sensitive in liquid-based cytology than in conventional smears.

Rapid pre-screening (RPS) is a useful tool to measure and improve performance in the cytology laboratory. Whether RPS is more or less effective in liquid-based cytology than in conventional smears is unknown. We compared the estimated sensitivity in a laboratory of 11 cytotechnologists which converted from conventional smears to SurePath™ (Becton Dickinson, Franklin Lakes, N.

The multidisciplinary colposcopy meeting: recommendations for future service provision and an analysis of clinical decision making.

Objective: In 2004 the NHS Cervical Screening Programme (NHSCSP) recommended that multidisciplinary meetings should be incorporated into patient management. No data has been provided since then regarding its functionality or benefits. We aim to address this issue.

Accuracy and perceptions of virtual microscopy compared with glass slide microscopy in cervical cytology.

Objective: To evaluate virtual microscopy in terms of diagnostic performance and acceptability among practising cytologists.

Methods: Twenty-four experienced cytologists were recruited to examine 20 SurePath® cervical cytology slides by virtual microscopy. Diagnostic accuracy was compared with glass slide microscopy using an unbiased crossover experimental design.

The revised BSCC terminology for abnormal cervical cytology.

The BSCC terminology was originally published in 1986 and although highly successful, requires revision. Through a process of professional consensus and literature review this has been undertaken by the BSCC. The revision takes account of recent developments and improvements in understanding of morphology and disease process and is compatible with other terminologies in use elsewhere, whilst still maintaining a focus on practice in the UK cervical screening programmes.