Continuous quality improvement program and its results of Korean Society for Cytopathology

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Abstract

Background

Since 1995, the Korean Society for Cytopathology has overseen the Continuous Quality Improvement program for cytopathology laboratories. The Committee of Quality Improvement has carried out an annual survey of cytology data for each laboratory and set standards for proficiency tests.

Methods

Evaluations were conducted four times per year from 2008 to 2018 and comprised statistics regarding cytology diagnoses of previous years, proficiency tests using cytology slides provided by the committee, assessment of adequacy of gynecology (GYN) cytology slides, and submission of cytology slides for proficiency tests.

Results

A total of 206 institutes participated in 2017, and the results were as follows. The number of cytology tests increased from year to year. The ratio of liquid-based cytology in GYN gradually decreased, as most of the GYN cytology had been performed at commercial laboratories. The distribution of GYN diagnoses demonstrated nearly 3.0% as atypical squamous cells. The rate for squamous cell carcinoma was less than 0.02%. The atypical squamous cell/squamous intraepithelial lesion ratio was about 3:1 and showed an upward trend. The major discordant rate of cytology-histology in GYN cytology was less than 1%. The proficiency test maintained a major discordant rate less than 2%. The rate of inappropriate specimens for GYN cytology slides gradually decreased.

Conclusions

The Continuous Quality Improvement program should be included in quality assurance programs. Moreover, these data can contribute to development of national cancer examination guidelines and facilitate cancer prevention and treatment.

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Most cited references 10

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Overview of the National Cancer screening programme and the cancer screening status in Korea.

Yeonju Kim, Jae Jun, Kui Choi … (2011)

Organised cancer screening in Korea began in 1999. Operating system has been stabilised, target population have expanded and participation rate has been increased throughout its ten years. Here we present an overview of the organised cancer screening system in Korea and introduce the National Cancer Screening Programme including results from 2002 to 2008. Furthermore, we present the results of the Korea National Cancer Screening Survey, a survey that is representative of the population, from 2004 to 2009. Finally, we discuss our achievements and the future challenges.

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Liquid-based cytology in fine-needle aspiration biopsies of the thyroid gland.

Guido Fadda, Esther Rossi (2011)

Fine-needle aspiration biopsy is regarded as the most important diagnostic tool for thyroid lesions because of its simplicity, safety, and cost-effectiveness. However, its pivotal role in the correct characterization of the majority of nodules is impaired by the difficulties in discriminating benign from malignant follicular-patterned lesions. Liquid-based cytology (LBC) is a semiautomated device that has recently become widely available and has gained popularity as a method of collecting and processing both gynecologic and nongynecologic cytologic specimens. It achieves a diagnostic sensitivity as accurate as conventional preparations, especially for its excellent cell preservation and lack of background which decrease the amount of inadequate diagnoses. In many cases the cytologic features are similar in both methods, but the colloid film and the lymphocytic component are more easily evaluated on direct smears whereas nuclear details and colloid globules are better evaluated in LBC slides. The material stored in the preservative solution could be effectively used for the application of immunocytochemical and molecular techniques. LBC-processed biopsies represent a valid alternative to conventional cytology. The possibility of applying additional techniques enhances the efficacy of the cytologic diagnosis of thyroid lesions. Copyright © 2011 S. Karger AG, Basel.

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Bethesda 2001 implementation and reporting rates: 2003 practices of participants in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology.

T Colgan, R Mody, David Wilbur … (2004)

The 2001 Bethesda System for the reporting of cervical cytology specimens and the use of new liquid-based and human papillomavirus testing technologies have led to changes in cervical cytology reporting practices. To analyze current laboratory reporting practices using Bethesda 2001 terminology and to compare results with previous survey data from 1996. Questionnaire survey mailed to 1751 laboratories in mid-2003. Laboratories enrolled in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology. Of the 759 responding laboratories, most (85.5%) had implemented Bethesda 2001 terminology, and the majority had adopted major changes, such as elimination of the benign cellular changes category and the satisfactory but limited category. The median reporting rate for low-grade squamous intraepithelial lesion was 2.1%, compared to a 1996 median rate of 1.6%, but the increase was confined to liquid-based preparations. Reporting rates for high-grade squamous intraepithelial lesion (median, 0.5%) and atypical squamous cells (ASC) had changed little. Most ASC cases were subclassified as "undetermined significance" (median, 3.9%) with ASC, cannot exclude high-grade SIL accounting for a minority (median, 0.2%). The median ratio of ASC to squamous intraepithelial lesions and carcinomas (SIL+) was 1.4 and was lower than the 1996 median ratio of 2.0. Median reporting rates for squamous abnormalities for 2002 were noted to be significantly higher for liquid-based preparations than for conventional smears, while median ASC/SIL+ ratios were lower. Most laboratories offer human papillomavirus testing, but almost half (47%) of laboratories do not know the percentage of positive testing results in patients with ASC. Most laboratories have implemented Bethesda 2001 terminology. New criteria and liquid-based methods have led to an increase in low-grade squamous intraepithelial lesion reporting rates and a decrease in ASC/ SIL+ ratios when compared with 1996 data. Liquid-based preparations have higher median squamous intraepithelial lesion rates and lower ASC/SIL+ ratios than conventional smears.

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Author and article information

Journal

Journal ID (nlm-ta): J Pathol Transl Med

Journal ID (iso-abbrev): J Pathol Transl Med

Journal ID (publisher-id): JPTM

Title: Journal of Pathology and Translational Medicine

Publisher: The Korean Society of Pathologists and the Korean Society for Cytopathology

ISSN (Print): 2383-7837

ISSN (Electronic): 2383-7845

Publication date (Print): May 2020

Publication date (Electronic): 15 April 2020

Volume: 54

Issue: 3

Pages: 246-252

Affiliations

[1 ]The Committee of Quality Improvement of Korean Society for Cytopathology, Seoul, Korea

[2 ]Department of Pathology, Chonnam National University Medical School, Gwangju, Korea

[3 ]Department of Pathology, Daegu Catholic University School of Medicine, Daegu, Korea

[4 ]Department of Pathology, Seegene Medical Foundation, Busan, Korea

[5 ]Department of Pathology, Chungnam National University School of Medicine, Daejeon, Korea

[6 ]Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

[7 ]Department of Pathology, National Medical Center, Seoul, Korea

[8 ]Department of Pathology, Fatima Hospital, Daegu, Korea

[9 ]Department of Pathology, National Health Insurance Service, Ilsan Hospital, Goyang, Korea

[10 ]Department of Pathology, Seoul Clinical Laboratories, Seoul, Korea

[11 ]Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

[12 ]Department of Pathology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea

[13 ]Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea

[14 ]Department of Pathology, Sure Quest Lab, Yongin, Korea

[15 ]Department of Pathology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea

[16 ]Department of pathology, Dankook University Hospital, Cheonan, Korea

[17 ]Department of Pathology, Ewha Laboratory of Medicine, Seoul, Korea

[18 ]Department of Pathology, Pusan National University Hospital, Busan, Korea

[19 ]Department of Pathology, Busan Paik Hospital, Inje University, Busan, Korea

Author notes

Corresponding Author: Hoon-Kyu Oh, MD, PhD, Department of Pathology, Daegu Catholic University School of Medicine, 33 Duryugongwon-ro 17-gil, Namgu, Daegu 42472, Korea Tel: +82-53-650-4156, Fax: +82-53-650-3456, E-mail: ap510@ 123456cu.ac.kr

Author information

Yoo-Duk Choi http://orcid.org/0000-0002-4385-1759

Hoon-Kyu Oh http://orcid.org/0000-0001-8793-1948

Su-Jin Kim http://orcid.org/0000-0001-5954-5281

Kyung-Hee Kim http://orcid.org/0000-0003-0214-0296

Yun-Kyung Lee http://orcid.org/0000-0001-6821-8653

Bo-Sung Kim http://orcid.org/0000-0002-2344-7230

Eun-Jeong Jang http://orcid.org/0000-0003-1482-5022

Yoon-Jung Choi http://orcid.org/0000-0002-5701-8864

Eun-Kyung Han http://orcid.org/0000-0002-7521-5095

Dong-Hoon Kim http://orcid.org/0000-0001-5722-6703

Younghee Choi http://orcid.org/0000-0002-3882-4000

Chan-Kwon Jung http://orcid.org/0000-0001-6843-3708

Sung-Nam Kim http://orcid.org/0000-0001-9235-7805

Kyueng-Whan Min http://orcid.org/0000-0002-4757-9211

Seok-Jin Yoon http://orcid.org/0000-0001-5879-1392

Hun-Kyung Lee http://orcid.org/0000-0002-9802-5235

Kyung Un Choi http://orcid.org/0000-0002-3848-1781

Hye Kyoung Yoon http://orcid.org/0000-0003-0714-8537

Article

Publisher ID: jptm-2020-02-22

DOI: 10.4132/jptm.2020.02.22

PMC ID: 7253955

PubMed ID: 32460477

SO-VID: 899922c4-637f-4f45-93ed-536ffe915e5c

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 27 December 2019

Date revision received : 16 February 2020

Date accepted : 22 February 2020

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Continuous quality improvement program and its results of Korean Society for Cytopathology

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Abstract

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SDG 4: Quality Education

Most cited references 10

Overview of the National Cancer screening programme and the cancer screening status in Korea.

Liquid-based cytology in fine-needle aspiration biopsies of the thyroid gland.

Bethesda 2001 implementation and reporting rates: 2003 practices of participants in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology.

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