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Study of undetermined atypias in relation to prevalence and disagreement percentile in cases of the Cervical Cancer Screening Program of Paraná, Brazil

BACKGROUND: The Bethesda Pap Smear System introduced two categories of undetermined atypias: atypical squamous cells of undetermined significance (ASCUS) and atypical glandular cells of undetermined significance (AGUS). The objective of this study is to report the prevalence and the disagreement percentile of ASCUS and AGUS as diagnosed by the Cervical Cancer Screening Program of Paraná and revised by the Unit for External Monitoring of Cytology Quality (UEMCQ). METHODS: The UEMCQ revised 65,753 cervical smears during 25 months and all undetermined atypias were selected. These cases were classified according to their agreement or not and then prevalence was obtained. RESULTS: Before the UEMCQ review, the number of undetermined atypias was 4,067 (5.45%); this number decreased to 3,584 after revising the data. Considering the whole sample, the ASCUS rate was 4.91% (3,235) and AGUS corresponded to only 0.51% (338). Most of the reclassified cases presented negative diagnoses (57.32%). The primary grouped diagnoses, including CIN I and HPV, was responsible for 51.1% of undetermined atypias after reclassification. DISCUSSION AND CONCLUSION: Undetermined atypias were the second most frequent among disagreement diagnosis groups.

Cervical cytology; Prevalence; Disagreement percentile; Cervical cancer; Atypical squamous cells of undetermined significance (ASCUS); Atypical glandular cells of undetermined significance (AGUS)


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