ABSTRACT
OBJECTIVE: This study investigates the role of liquid-based cytology with ThinPrep technique, in the detection of endometrial lesions, using direct endometrial sampling from postmenopausal women with the Endogyn endometrial device. METHODS: It was performed on 491 postmenopausal women referred to our clinic for abnormal bleeding or other symptoms and/or a thickness of endometrium >5 mm on ultrasound. Endometrial sampling, dilatation and curettage (D&C) and hysterectomy were performed on all patients. For the diagnosis, the WHO classification scheme was used. RESULTS: According to our findings a sensitivity of 98.08%, specificity of 100%, positive predictive value of 100%, negative predictive value of 100% and overall accuracy of 98.98% were observed in both endometrial sampling and in D&C. CONCLUSIONS: Endometrial sampling is complementary to D&C for the diagnosis of endometrial lesions and it is necessary for it to be performed before D&C and/or hysterectomy.
Subject(s)
Cytodiagnosis/methods , Dilatation and Curettage/methods , Endometrial Neoplasms/diagnosis , Postmenopause , Atrophy/diagnosis , Carcinoma, Endometrioid/diagnosis , Endometrial Hyperplasia/diagnosis , Endometrium/pathology , Female , Humans , Hysterectomy , Middle Aged , Predictive Value of Tests , Sensitivity and SpecificityABSTRACT
The aim of this study was to describe the state of the art in cervical cancer screening in Greece by presenting the two regionally organised screening programmes that currently operate in the country. Both programmes were initiated in 1991 and are partly funded by the European Union. The Ormylia screening programme covers the population of Halkidiki (Northern Greece), a predominantly rural area. The second programme covers the regions of Messinia and Ilia (Southern Greece). Both programmes are targeted at women aged 25-64 years of age and a Papanicolaou (Pap) smear test is recommended every 2-3 years. Electoral and municipal registries are used to identify the target population and personal invitations are sent to the eligible women in the screening programme. The Ormylia programme is based at the Centre 'Our Lady Who Loves Mankind', whereas mobile units are used by the Messinia and Ilia programme. Slide reading for the Ormylia programme is performed in the cytology laboratory of Alexandra Hospital in Athens and epidemiological support is provided by the Department of Hygiene and Epidemiology (Medical School, University of Athens). A specifically designed database is used for data recording. Over 80% of the target population in the region have already been screened. Communication of results is by means of a personal letter upon a negative result and in person upon a suspicious result. Quality assurance in both programmes is based on the European protocol. These two programmes are the sole organised cervical cancer screening activities in Greece in the absence of a national programme. They employ well-trained personnel, they use modern equipment and have strict quality assurance procedures.
Subject(s)
Mass Screening/organization & administration , Uterine Cervical Neoplasms/prevention & control , Adult , Data Collection/methods , Female , Greece , Humans , Mass Screening/standards , Middle Aged , Patient Acceptance of Health Care/statistics & numerical data , Patient Selection , Program Development , Program Evaluation , Quality Assurance, Health Care/organization & administration , Uterine Cervical Neoplasms/diagnosisABSTRACT
OBJECTIVE: To validate the efficacy of PAPNET for cervical cytology screening. STUDY DESIGN: From a total of 50,000 gynecologic cases we selected 24 primarily negative smears from patients who, during follow-up, developed a precancerous lesion or cancer in a short time, ranging from a few months to two years. These negative smears were rescreened by the PAPNET automated system and reevaluated by two observers. A third observer blindly reevaluated the same cases manually. RESULTS: Reevaluation after PAPNET screening showed one false negative smear, for a rate comparable to that of manual reevaluation, which also reclassified the same case. The time required to interpret a smear using the PAPNET system was approximately one minute, while the time required for conventional manual screening was approximately five. CONCLUSION: PAPNET is an efficient and fast screener for the detection of precancerous cervical lesions and cancer.
Subject(s)
Mass Screening/instrumentation , Mass Screening/standards , Neural Networks, Computer , Vaginal Smears/instrumentation , Vaginal Smears/standards , False Negative Reactions , Female , Follow-Up Studies , Greece , Humans , Image Processing, Computer-Assisted/instrumentation , Image Processing, Computer-Assisted/standards , Laboratories, Hospital/standards , Pathology, Clinical/instrumentation , Pathology, Clinical/standards , Quality Control , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/pathologyABSTRACT
It is well known that cervical intraepithelial neoplasia (CIN) and human papilloma virus (HPV) infection are closely related to cervical cancer. The cervical cytology examination (pap-test), followed by a colposcopic examination and a biopsy are the common tools for the early detection and the establishment of diagnosis of the cervical precancerous lesions. The monitoring and surveillance of those precancerous lesions is essential for the prevention of cervical cancer and for effective patient management. Nowadays, the long-term care of patients with a chronic and/or serious disease is feasible with the use of computerized follow-up registers or through more complex information systems. Nevertheless, manual recording is still the predominant method of data collection in 'Alexandra' University Hospital and this is the case in most health services in Greece due to scarcity of resources. A 'circulating' outpatient card, where information on gynecologic cytology, colposcopy and biopsy examinations is recorded, was the basis for the development of a computerised follow-up register and information system for cervical cytology in the Department of Cytopathology.
