Cause and follow-up of inadequate cervical smears in the county of Funen
Dahl, M-Britt.; Ejersbo, D.; Hølund, B.
Ugeskrift for Laeger 164(37): 4280-4283
2002
ISSN/ISBN: 0041-5782 PMID: 12362869 Document Number: 450028
Inadequate cervical smears cause repetition of sampling, which is both costly and a cause of concern to the patient. The objective of this study was to examine why cervical smears were classified as inadequate and to elucidate the underlying diagnoses in order to make recommendations on how to improve smear quality and the interpretation of the sample. We investigated 2113 inadequate smears from the screening population in the County of Funen and they were classified according to the cause of inadequacy and the final diagnoses. Smears without endocervical cells (ECC) were classified as inadequate. In the study period a total number of 35,628 smears were taken. Most smears were inadequate because of the lack ECC, but inflammatory changes and poor technical quality also contributed. Two cases of cervical cancer and 31 cases of cervical intraepithelial neoplasia were found at follow-up. The results indicate that inadequate smears generally conceal benign diagnoses. However, it is still important to reduce the number and to secure follow up, as we found 31 cases of cervical intraepithelial neoplasia and two cervical cancers. Recommendations for obtaining a better smear quality, including the implementation of liquid-based cytology, are given.