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Rásky, É; Regitnig, P; Schenouda, M; Burkert, N; Freidl, W.
Quality of screening with conventional Pap smear in Austria - a longitudinal evaluation.
BMC Public Health. 2013; 13(11):998-998 Doi: 10.1186/1471-2458-13-998 [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz
Rasky Eva
Co-Autor*innen der Med Uni Graz
Burkert Nathalie
Freidl Wolfgang
Regitnig Peter
Schenouda Michel

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In recent decades, the incidence of cervical cancer and cervical cancer mortality in Austria has declined by varying degrees. The Pap smear is to be considered a causal factor for this decline. This longitudinal analysis is based on a data set of Pap smear assessments collected by the Committee for Quality Assurance of the Austrian Society of Cytology. Data from 15 laboratories participating in a voluntary self-monitoring program was analyzed for the time span 2004-2008. The data was analyzed in terms of smear quality and assessment quality.A rank-correlation-test for a monotonic trend analysis in the proportion of the three parameters Pap 0, "satisfactory, but limited/SBL", and Pap IIID/IV for the timespan 2004 to 2008 was carried out. For this study, we analyzed an average number of 730,000 smears per year over a five-year period. Specimens from all but two laboratories, i.e. < 2% of all smears, met the quality criterion for Pap 0 (Bethesda 2001 equivalent: Specimen processed and examined, but unsatisfactory for evaluation of epithelial abnormality), whilst only four laboratories, i.e. < 10% of all smears, reached the national requirement for smears classified as "satisfactory, but limited/SBL".When using the Pap IIID/IV ratio (LSIL: HSIL/AIS ratio) of 3:1 to 8:1 as a surrogate quality marker for the interpretation of smears, only five laboratories met this criterion during the survey period.The trend analysis indicated only that an increasing number of samples per year is correlated with an increased proportion of Pap 0 and "satisfactory, but limited/SBL" smears. Although participants get regular feedback about their results, no general improvements in smear taking or assessment were observed over the years, so mandatory quality management, including the possibility of sanctions, is suggested in order to reduce adverse health effects for women.
Find related publications in this database (using NLM MeSH Indexing)
Female -
Humans -
Incidence -
Longitudinal Studies -
Papanicolaou Test - standards
Quality of Health Care - standards
Reproducibility of Results -
Uterine Cervical Neoplasms - diagnosis
Vaginal Smears - standards

Find related publications in this database (Keywords)
Quality assurance
Pap smear
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