How to identify and avoid common pitfalls and reporting errors in cervical smears in cytology

How to identify and avoid common pitfalls and reporting errors in cervical smears in cytology
Routine medical screening can save lives.A characteristic of most screening tasks is that cases of the disease are rare. In cervical cancer screening by cytology, rates of finding any abnormal cells in a well-screened population are usually around 5% or less in the United States, and the prevalence of cells of the most significant high-grade disease is less than 1%.4 The National Health and Social Care Information center in the United Kingdom reported in 2009 that, in well-screened populations, typically 5% to 6% of adequate samples contain mild abnormalities and 1% to 2% will have a severe abnormality. Under laboratory conditions, when targets are rare, non-expert searchers show increases in false-negative and decreases in false-positive errors compared with conditions where targets are common. Thus, using nonmedical stimuli, observers are more likely to miss the target if it is rare than if it is common. Furthermore, the observed prevalence effect is not due to vigilance failures or unfamiliarity with the target. If this prevalence effect from the laboratory also applies to experts, this could be an important contributor to medical error.
Cervical screening by cytologic examination of cells is one such example of medical screening where low target prevalence is a characteristic of the visual search task. Cytologists routinely screen samples daily in which the prevalence rate of the most significant pathology is usually less than 1%.4 Cytology audits suggest that low numbers of abnormal cells in individual cervical cytology slides are associated with false-negative reporting. In the era of human papillomavirus vaccination, the effects of declining disease prevalence on the performance of cytologic screening should be considered because the introduction of the vaccine is expected to eliminate significant numbers of high-grade lesions from the population.

[@Antonio-ew9pv]

Hi, do you have this NHS cytopathology atlas in pdf form in any case?