{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T09:21:58Z","timestamp":1761988918524,"version":"build-2065373602"},"reference-count":6,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,11,13]],"date-time":"2015-11-13T00:00:00Z","timestamp":1447372800000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Negative gynecologic cytology cases (ie, those diagnosed as negative for intraepithelial lesion or malignancy) are manually reviewed by 2 methods using semiautomated screening: 1) immediate full slide review (FSR) after fields\u2010of\u2010view analysis (FOV) (FOV + FSR), and 2) quality\u2010assurance\/high\u2010risk, quintile\u2010directed full manual review (FMR). Data supporting current guidelines were limited. The authors investigated FMR, FOV + FSR, and the review process in general.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Gynecologic cytology cases from 2009 to 2014 at Massachusetts General Hospital were analyzed. The data comprised 93,169 patients, 194,656 specimens, and 49,979 human papillomavirus (HPV) tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>In patients who underwent FMR, the epithelial cell abnormality (ECA) rate was correlated with the HPV\u2010positive rate (correlation coefficient [r<jats:sup>2<\/jats:sup>] = 0.82; Y = 0.19X + 0.02), and both rates decreased with age. For patients who underwent FOV + FSR, the ECA rate was also related to the HPV\u2010positive rate (r<jats:sup>2<\/jats:sup> = 0.86; Y = 0.39X + 0.11), and both rates decreased with age. The FMR group had similar HPV\u2010positive rates compared to the FOV + FSR group (2%\u201052% vs 9%\u201068%, respectively). HPV\u2010positive patients had a higher risk of ECA than HPV\u2010negative patients (40% vs 8%; <jats:italic>P<\/jats:italic> &lt; .0001). Currently, manual review allocates resources inefficiently, to older, HPV\u2010negative patients as compared to younger, HPV\u2010positive patients. Additionally, too many patients who have HPV\u2010positive specimens with ECA proceed from primary screening to FMR. This imbalance can be observed in the slope of the line comparing the FMR ECA rate with the HPV\u2010positive rate (which might serve as a surrogate marker for adequacy of FOV + FSR screening). Therefore, laboratories should try to reduce the number of HPV\u2010positive cases that reach FMR.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Current review procedures devote too few resources to younger patients. FMR should be assigned according to HPV status and age. The slope of the line comparing the FMR ECA rate with the FMR HPV\u2010positive rate might be a useful surrogate marker of screening accuracy. <jats:bold><jats:italic>Cancer (Cancer Cytopathol)<\/jats:italic> 2015;123:650\u2013658<\/jats:bold>. \u00a9 <jats:italic>2015 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.21581","type":"journal-article","created":{"date-parts":[[2015,12,21]],"date-time":"2015-12-21T13:27:32Z","timestamp":1450704452000},"page":"650-658","source":"Crossref","is-referenced-by-count":1,"title":["Young investigator challenge: Comparison of 2 different methods of manual slide screening in semiautomated gynecologic cytology"],"prefix":"10.1002","volume":"123","author":[{"given":"Louis J.","family":"Vaickus","sequence":"first","affiliation":[{"name":"Department of Pathology Massachusetts General Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David C.","family":"Wilbur","sequence":"additional","affiliation":[{"name":"Pathology Associates Massachusetts General Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda J.","family":"Sweeney","sequence":"additional","affiliation":[{"name":"Department of Pathology Massachusetts General Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew A.","family":"Renshaw","sequence":"additional","affiliation":[{"name":"Department of Pathology Baptist Hospital of Miami Miami Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,11,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.22817"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.21439"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.20065"},{"issue":"5","key":"e_1_2_7_5_1","first-page":"307","article-title":"Effects of increasing cytotechnologist workload using the location guided imaging system FocalPoint GS on SurePath Pap tests [abstract]","volume":"118","author":"Levi A","year":"2010","journal-title":"Cancer Cytopathol."},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.80.12.3812"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.55.4.244"}],"container-title":["Cancer Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncy.21581","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncy.21581","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T16:42:09Z","timestamp":1760287329000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncy.21581"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11]]},"references-count":6,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2015,11]]}},"alternative-id":["10.1002\/cncy.21581"],"URL":"https:\/\/doi.org\/10.1002\/cncy.21581","archive":["Portico"],"relation":{},"ISSN":["1934-662X","1934-6638"],"issn-type":[{"type":"print","value":"1934-662X"},{"type":"electronic","value":"1934-6638"}],"subject":[],"published":{"date-parts":[[2015,11]]}}}