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Biopsies obtained from women who were positive on either test were reviewed by two pathologists blinded to the histological diagnoses originally made by pathologists working at the Chittaranjan National Cancer Institute.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The interobserver agreement between the pathologists' diagnoses and the diagnoses made by the expert reviewers on 424 slides was fair (kappa = 0.26). There was a distinct difference in agreement in detecting CIN 2 (kappa = 0.21) and detecting CIN 3 (kappa = 0.74). The overall agreement in diagnosis improved when the slides obtained from the HPV\u2010positive women were considered (kappa = 0.5). Almost half of the discordant CIN 2 cases were high\u2010risk HPV negative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Diagnosis of CIN 2 is poorly reproducible. The natural history of CIN 2 lesions is more similar to CIN 1 than CIN 3; it is therefore necessary to re\u2010evaluate whether to consider CIN 2 lesions as high\u2010grade squamous intraepithelial lesions with CIN 3, as in the Bethesda system of classification.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.ijgo.2014.03.037","type":"journal-article","created":{"date-parts":[[2014,5,29]],"date-time":"2014-05-29T06:47:51Z","timestamp":1401346071000},"page":"227-231","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":16,"title":["Reproducibility of cervical intraepithelial neoplasia diagnosis on histological review of cervical punch biopsies from a visual inspection with acetic acid and HPV detection\u2010based screening program"],"prefix":"10.1002","volume":"126","author":[{"given":"Srabani","family":"Mittal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ishita","family":"Ghosh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dipanwita","family":"Banerjee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priyanka","family":"Singh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaydip","family":"Biswas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raje","family":"Nijhawan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radhika","family":"Srinivasan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chinmayi","family":"Ray","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Partha","family":"Basu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,5,29]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.LGT200570"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/pgp.0b013e31805152ab"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.633"},{"issue":"5","key":"e_1_2_6_5_2","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1309\/K7C9-X5P0-001B-2HK5","article-title":"Variance in the interpretation of cervical biopsy specimens obtained for atypical squamous cells of undetermined significance","volume":"114","author":"Grenko R.T.","year":"2000","journal-title":"Am J Clin Pathol"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/PGP.0b013e31827b26b1"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0046-8177(93)90009-6"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1309\/A8MFC18TWANC8QFH"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.298.6675.707"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1309\/EWYGWFRRM8798U5P"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(07)60005-8"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPBRK7D1YIUWFP"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/PAP.0b013e31802e0de7"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(94)00225-F"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.11.1500"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31818f5008"},{"issue":"6","key":"e_1_2_6_18_2","first-page":"2319","article-title":"Short\u2010term outcome of cervical intraepithelial neoplasia grade 2: considerations for management strategies and reproducibility of diagnosis","volume":"30","author":"Guedes A.C.","year":"2010","journal-title":"Anticancer Res"},{"key":"e_1_2_6_19_2","first-page":"4","article-title":"Histology, classification and natural history of cervical intraepithelial neoplasia (CIN)","volume":"14","author":"Syrjanen K.J.","year":"2009","journal-title":"CME J Gynecol Oncol"},{"issue":"5","key":"e_1_2_6_20_2","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1136\/jcp.2005.036426","article-title":"Our approach to squamous intraepithelial lesions of the uterine cervix","volume":"60","author":"Kalof A.N.","year":"2007","journal-title":"J Clin Pathol"}],"container-title":["International Journal of Gynecology &amp; 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