Cervical Cytology Reporting Rates from China's Largest College of American Pathologists-Certified Laboratory with a Focus on Squamous Cell Carcinoma Cytology and Its Histopathological Follow-Up Results

Abstract

Objective: No organized cervical screening programs or national cervical cytology quality control standards currently exist in China. This study reported cervical cytology performance in China's largest independent laboratory with accreditation from the College of American Pathologists. Design: Results from over 2 million Papanicolaou (Pap) tests by the KingMed Diagnostics Laboratory were categorized according to The Bethesda System (TBS) from 2007 and 2014. Pap reports and histopathologic follow-up results of squamous cell carcinomas (SCC) were analyzed. Results: Data on 676,445 conventional Pap smears (CPS) and 1,696,284 liquid-based cytology (LBC) specimens were available. Abnormality rates reported were significantly higher with LBC than with CPS in all TBS categories (p < 0.001). A total of 800 SCC cytology reports were identified, representing a laboratory SCC reporting rate of 0.0337%. The SCC reporting rate with LBC (0.0457%) was significantly higher than the reporting rate with CPS. Histopathologic invasive cervical carcinoma and cervical intraepithelial neoplasia 2/3 were diagnosed in 80.7 and 17.6% of the 119 patients with SCC Pap cytology. Conclusions: Reporting rates for most TBS categories from this CAP-accredited laboratory in China were within the CAP benchmark ranges except for low atypical glandular cell and unsatisfactory case rates. Histological follow-up results in patients with SCC cytology reports demonstrate very high specificity of SCC Pap cytology.