Can Benefits of Fine Needle Aspiration Cytology be Extended up to Community Level as a Baseline Investigation: A Nine-year Experience from a Tertiary Care Institute in Bankura, West Bengal, India

Abstract

Introduction: Aspiration cytology has recently become the first-line of investigation during the initial assessment of any swelling. It is also an effective tool for the early diagnosis of malignancy. In this study, the feasibility of extending the benefits of this simple, cost-effective procedure to the community level has been assessed. Aim: In the present study, attempts were made to prove that most aspirations and subsequent interpretations of aspirated samples could be accomplished by Junior Residents (JRs) even in a tertiary care centre. Materials and Methods: This cross-sectional study was conducted at Bankura Sammilani Medical College (BSMC), West Bengal, India for a period of nine years (01/01/2014 to 31/12/2022). Conventional aspirations without guidance were included in the study group. The majority of aspirations were successfully conducted by JRs, and only 4.5% (823) of conventional aspirations needed the help and supervision of senior faculties. All adequate aspirations were then independently interpreted by two separate JRs, and the proportion of cases with similar and dissimilar interpretations was duly noted. Finally, all the smears were assessed by senior faculties and compared with the interpretations of JRs. Result: During this study period, a total of 19,743 aspirations were done of which 18,391 were conventional. JRs aspirated 17,568 (95.5%) of these cases. Data analysis revealed that JRs were successful in 16,570 (83.9%) of total aspirations and also correctly interpreted 13,381 (67.8%) of total cases. Conclusion: This study proved that one year of training could be sufficient to achieve a desirable level of competency in aspiration and interpretation of cytological samples. So, willing doctors with the necessary training could perform as Community Cytopathologists (CCPs) to extend the benefits of Fine Needle Aspiration Cytology (FNAC) up to the block level, thus escalating the fight against malignancy