Quality control analysis on cervical cytology of free cervical cancer screening for 35-64-year-old women in Beijing in 2013

Objective To analyze the data of cervical cytology quality control among women accepted free cervical cancer screening in Beijing in 2013. Methods Collected 286 781 cervical cytology smears information of free cervical cancer screening in medical screening units of 16 districts and counties in Beijing in 2013.Use probability random sampling method to get 9 907 cervical cytology smears for quality control analysis.Took the pathologists' diagnosis as golden standards. Detection positive rate, various indicators of quality control and unsatisfactory rate of smears were compared statistically between traditional Pap smear and liquid-based cervical cytology smear. Results ①The total detection positive rate and the detection positive rate of low-grade squamous intraepithelial lesion(LSIL) and high-grade squamous intraepithelial lesion(HSIL) of liquid-based cytology smear were higher than those of traditional Pap smear, and the differences were statistically significant(2.41% vs 2.05%, χ2=39.885, P=0.000; 0.58% vs 0.31%, χ2=113.772, P=0.000; 0.14% vs 0.11%, χ2=4.464, P=0.035). ②There were no significant differences between Pap smears and liquid-based cytology smears in false negative rate, specificity and coincidence rate(P>0.05). The false positive rate of Pap smears was lower than that of liquid-based cytology smears, while the sensitivity rate were higher, and the differences were statistically significant(0 vs 0.55%, χ2=18.342, P=0.000; 100.00% vs 75.00%, χ2=98.980, P=0.000). ③The dissatisfaction rate of smears was 4.17%(413/9 907) among 9 907 cervical cytology smears, and the primary reason was lighter dyeing and (or) unclear structure of cell (54.24%), followed by the lack of cell mass(43.09%). The dissatisfaction rate of Pap smears caused by lack of cell mass was higher than that of liquid-based cytology smears(2.45% vs 1.44%), while the dissatisfaction rate of liquid-based cytology smears caused by lighter dyeing and(or) unclear structure of cell was higher than that of Pap smears (3.34% vs 0.26%), and the differences were statistically significant(χ2=12.452, 93.311; P=0.000). Conclusions Cervical cytology detection positive rate of free cervical cancer screening in Beijing need to be further improved.And it is necessary to establish a quality control evaluation system on cervical cytology, focusing on improvement of cells collection, cytology smear producing and drum dyeing, to improve satisfaction rate and quality of cervical cytology smears. Key words: Uterine cervical neoplasms; Mass screening; Vaginal smears; Quality control