Comparison of Ex-House and In-House Cytology for the New Cervical Cancer Screening Assessment.

IF 2.6 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Geburtshilfe Und Frauenheilkunde Pub Date : 2026-07-20 eCollection Date: 2026-08-01 DOI:10.1055/a-2900-6511

Lena Sophia Nieberle, Anna Katharina Dietl, Anja Seibold, Lena Brückner, Oliver Schleicher, Carla Schulmeyer, Julius Emons, Annika Sophie Behrens, Sebastian Trnovec, Arndt Hartmann, Matthias W Beckmann, Antje Knöll, Grit Mehlhorn, Werner Adler, Carol Geppert, Frederik Alexander Stübs

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引用次数: 0

Abstract

Purpose: The introduction of an organized cervical cancer screening program in Germany in 2020 changed screening algorithms and referral patterns, increasing the number of patients referred to specialized centers. This study examines the concordance between ex-house Pap smear findings and in-house colposcopy-guided cytology and relates both to colposcopy-guided biopsy and histopathological outcomes within the new screening program.

Methods: In this retrospective study, data from 3161 patients referred for colposcopy to a certified university dysplasia unit between January 2020 and May 2024 were analyzed. All patients underwent standardized assessment including Pap smear, HPV testing, colposcopy, and colposcopy-guided biopsy, with surgical treatment when indicated.

Results: Concordance between ex-house and in-house cytology was moderate (Spearman's ρ = 0.453, p < 0.001; weighted Cohen's κ = 0.581). Compared with histology, ex-house cytology showed overdiagnosis in 252 cases (14.29%), underdiagnosis in 631 cases (35.79%), and concordant findings in 880 cases (49.91%). In contrast, in-house cytology demonstrated lower rates of overdiagnosis (183 cases, 9.48%) and underdiagnosis (495 cases, 25.65%), with agreement in 1252 cases (64.87%). HPV positivity increased with cytological severity, with HPV16 being the most prevalent genotype in high-grade lesions. Among low-grade cytological findings, CIN3+ yield differed markedly according to HPV status.

Conclusion: In the setting of the cervical cancer screening program, in-house cytology performed in a specialized dysplasia unit demonstrated closer agreement with histology than ex-house cytology. HPV status emerged as a key modifier of risk within low-grade cytological categories, highlighting the importance of risk-adapted triage and reassessment colposcopy in contemporary screening practice.

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新子宫颈癌筛检评估的前院及院细胞学比较。

目的：2020年，德国引入了一项有组织的宫颈癌筛查计划，改变了筛查算法和转诊模式，增加了转诊到专业中心的患者数量。本研究探讨了房前子宫颈抹片检查结果与室内阴道镜指导下的细胞学检查之间的一致性，并与阴道镜指导下的活检和新筛查方案中的组织病理学结果相关。方法：在这项回顾性研究中，分析了2020年1月至2024年5月期间3161名经认证的大学发育不良病房进行阴道镜检查的患者的数据。所有患者都进行了标准化评估，包括巴氏涂片、HPV检测、阴道镜检查和阴道镜指导下的活检，并在有指征时进行手术治疗。结果：院外细胞学检查与院内细胞学检查的一致性中等（Spearman’s ρ = 0.453, p）。结论：在宫颈癌筛查项目中，在专门的异常增生单位进行的院内细胞学检查与组织学检查的一致性比院外细胞学检查更强。HPV状态成为低级别细胞学分类中风险的关键修饰因子，强调了在当代筛查实践中适应风险的分诊和重新评估阴道镜检查的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Geburtshilfe Und Frauenheilkunde 医学-妇产科学

CiteScore

2.50

自引率

22.20%

发文量

828

审稿时长

6-12 weeks

期刊介绍： Geburtshilfe und Frauenheilkunde (GebFra) addresses the whole field of obstetrics and gynecology and is concerned with research as much as with clinical practice. In its scientific section, it publishes original articles, reviews and case reports in all fields of the discipline, namely gynecological oncology, including oncology of the breast obstetrics and perinatal medicine, reproductive medicine, and urogynecology. GebFra invites the submission of original articles and review articles. In addition, the journal publishes guidelines, statements and recommendations in cooperation with the DGGG, SGGG, OEGGG and the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF, Association of Scientific Medical Societies, www.awmf.org). Apart from the scientific section, Geburtshilfe und Frauenheilkunde has a news and views section that also includes discussions, book reviews and professional information. Letters to the editors are welcome. If a letter discusses an article that has been published in our journal, the corresponding author of the article will be informed and invited to comment on the letter. The comment will be published along with the letter.