Bethesda System Reporting Rates for Conventional Papanicolaou Tests and Liquid-Based Cytology in a Large Chinese, College of American Pathologists–Certified Independent Medical Laboratory: Analysis of 1 394 389 Papanicolaou Test Reports

Abstract

Context Reports that use the Bethesda System categories for Chinese Papanicolaou test results are rare. Objective To document and analyze rates reported in the Bethesda System for conventional Papanicolaou tests and liquid-based cytology between 2007 and 2012 in China's largest College of American Pathologists–accredited laboratory. Design Results from 1 394 389 Papanicolaou tests, rendered between 2007 and 2012 by the Guangzhou Kingmed Diagnostics Cytology Laboratory, were documented by the Bethesda System report categories and Papanicolaou test methodology, which included both conventional Papanicolaou tests and 4 different liquid-based cytology preparations. Results Results were documented for 326 297 conventional Papanicolaou tests and 1 068 092 liquid-based cytology specimens, which included 928 884 ThinPrep (Hologic, Bedford, Massachusetts), 63 465 SurePath (BD Diagnostics, Franklin Lakes, New Jersey), 50 422 Liqui-Prep (LGM International, Melbourne, Florida), and 25 321 Lituo liquid-cytology (Lituo Biotechnology Co, Hunan, China) specimens. Abnormality rates reported were significantly higher with liquid-based cytology than they were with conventional Papanicolaou tests in all the Bethesda System categories (P < .001). Reporting rates were within the 2006 benchmark ranges from the College of American Pathologists, except for atypical glandular cells (low) and unsatisfactory rates for conventional Papanicolaou tests (low). Conclusion Participation in the international College of American Pathologists Laboratory Accreditation Program provides laboratory quality standards not otherwise available in many international settings.