Quality Evaluation of Cervical Cytopathology Laboratories in Brazil

Abstract

Introduction: Cytological examination of the cervix is the world’s most widely adopted strategy for the screening of cervical cancer and is the only one that has proven impact on reducing the incidence and mortality caused by this disease. Ensuring the quality of this procedure is a priority for the effectiveness of the Brazilian program for cervical cancer control. Objective: To show the profile of cervical cytopathology laboratories in 2010 for all Brazilian states and the Federal District, by analyzing some Internal Quality Monitoring indicators (MIQ). Method: Data of the Brazilian information system for cervical cancer (SISCOLO ) relating to 2010, by federal States, were used in the calculation of quality indicators studied. Results: Brazil has a large amount of cytopathology services concentrated in positivity ranges below 2.0%. Part of the positive results registered in the system did not bring a conclusive diagnosis due to the high percentage of atypical squamous cells of undetermined significance. Another finding was the limited ability of the laboratory network to identify high-grade squamous intraepithelial lesions. Conclusion: The results point to the risk of not identifying suggestive cases of cellular alteration and alert to the possibility of emitting false negative reports. It is important to implement quality control programs of cytopathology tests. Furthermore, the study may help managers in the organization of the laboratory networks.