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Revista Colombia Médica
Universidad del Valle - Facultad de Salud
ISSN: 0120-8322
EISSN: 1657-9534
Vol. 37, No. 2, 2006, pp. 142-147
Bioline Code: rc06022
Full paper language: Spanish
Document type: Research Article
Document available free of charge

Revista Colombia Médica, Vol. 37, No. 2, 2006, pp. 142-147

 en Utility of a guided reading technique for cervical cancer screening
Hernando Pardo, Luis Alfonso Díaz, María Eugenia Niño

Abstract

Background: Reading of Papanicolaou test slides follows a pattern that could omit sectors with abnormal cell nests. A low-cost guided reading strategy has been designed.
Aim: To establish criteria validity and reproducibility of guided reading strategy in cervical uterine Pap smear.
Methodology: To each of 300 women without cervical cancer history in order to apply Papanicolaou test, two slides were taken; both slides were read by regular method, and then reevaluated in blinded conditions with a guided technique. Diagnosis accuracy of regular and guided techniques was determined using pathologist's reading as a gold standard.
Results: When regular readings were used 65 (21.7%) of women had abnormal cytology, and 64 (21.3%) had also abnormal readings with the guided technique. Concordance of the regular reading (Kappa 0.354; 95% CI 0.250-0.457) improved with the guided technique (Kappa 0.395; 95% CI 0.285-0.505), while 24.3% slides were found abnormal in gold standard (2.7% with a high degree of malignancy). The guided reading improves all criteria validity indicators.
Conclusion: This study demonstrated that the guided reading improves criteria validity indicators, correcting some technician mistakes; however, a populational study is necessary to confirm these results.

Keywords
Cervical cancer; Cervicovaginal cytology; Screening.

 
 es Validez de criterio y reproductividad de la lectura guiada en la citología cérvico-vaginal
Hernando Pardo, Luis Alfonso Díaz, María Eugenia Niño

Resumen

Contexto: La lectura de la citología cérvico-vaginal sigue un patrón que puede omitir sectores donde haya nidos de células anormales. Se ha diseñado una estrategia de guía de la lectura de bajo costo.
Objetivo: Establecer la validez de criterio y la reproductividad de la lectura guiada sobre la capacidad de discriminar la citología cérvico-vaginal.
Metodología: En 300 mujeres sin historia de cáncer de cuello uterino se tomaron dos láminas de citología cérvico-vaginal; ambas se leyeron con el método regular para posterior reevaluación oculta con técnica guiada. Se calcularon los indicadores diagnósticos de las lecturas regular y guiada de cada lámina (patrón de oro: lectura por patólogo).
Resultados: Hubo 65 (21.7%) mujeres con citología positiva en la lectura regular, mientras que 64 (21.3%) lo fueron en la lectura guiada. La concordancia de la lectura regular (Kappa 0.354; IC 95% 0.250-0.457) mejoró con la lectura guiada (Kappa 0.395; IC 95% 0.285-0.505). De las placas 24.3% fueron positivas en la lectura por patólogo (2.7% con lesión de alto grado de malignidad). La lectura guiada mejoró los indicadores de validez de criterio.
Conclusión: La lectura guiada mejora los indicadores de desempeño, y corrige parcialmente las fallas humanas en la lectura. Sin embargo, esto se debe verificar en estudios poblacionales.

Palabras-clave
Cáncer de cuello uterino; Citología cérvico-vaginal; Discriminación.

 
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Alternative site location: http://colombiamedica.univalle.edu.co

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