Unsatisfactory Reporting Rates: 2006 Practices of Participants in the College of American Pathologists Interlaboratory Comparison Program in Gynecologic Cytology (Cap Laboratory Improvement Programs) (Survey‪)‬

The College of American Pathologists (CAP) assesses practice patterns using survey questionnaires sent to laboratories participating in CAP programs. Cervicovaginal cytology surveys have been used since 1994 and have evaluated practices related to implementation of the Bethesda System (TBS) terminology and reporting rates for interpretive categories used in Papanicolaou (Pap) testing. Benchmarks for unsatisfactory rates were last reported in 2004, (1) soon after implementation of the third version of TBS, which defined cellular criteria for adequacy for both liquid-based preparations and conventional smears. (2) Since the publication of the 2003 practice patterns, the use of liquid-based Pap specimens has expanded, whereas use of conventional preparations has decreased. (3) Although there was no increase in median unsatisfactory rates and no difference in unsatisfactory rates reported between liquid-based or conventional preparation types in the prior 2003 CAP Interlaboratory Comparison Program in Gynecologic Cytology (PAP Education) supplemental questionnaire (SQ), some authors reported changes in adequacy rates after implementing TBS criteria for adequacy. (4) Liquid-based preparations are marketed as decreasing unsatisfactory rates by eliminating or diminishing the effects of obscuring inflammation, blood, and air-drying. Therefore, unsatisfactory rates could be expected to change with increased implementation of liquid-based preparations. Because of the expansion of liquid-based preparations in the United States since the 2003 PAP SQ and because the survey includes results from a larger segment of laboratories using liquid-based preparations, the 2007 SQ may more accurately represent current cytology practices.