Internal quality control in cytopathology: the subjectivity dilemma

Objective: The aim of this study was to conduct internal monitoring of cervical cytopathology quality in samples collected in the period between 2013 and 2014 and to identify possible false-negative results, relating them to the tests obtained by the Unified Health System (SUS). Methods: 313 cervical smears were analyzed by Papanicolaou method in the years 2013 and 2014. The internal quality control was conducted by a 100% review's of the smears. Samples with discordante results between the cytological analysis by Projetopap and internal quality control were reevaluated by a team of four cytologists. Results: Of the 313 samples analyzed by SUS 100% were NILM, by Projetopap 309 (98,8%) were NILM, one (0,3%) AIS and three (0,9%) unsatisfactory. In the internal quality control were 260 (83,1%) NILM, 44 (14%) unsatisfactory samples, seven (2,3%) ASC-US, one (0,3%) LSIL and one (0,3%) AIS. Conclusion: The study shows the importance of a quality control system in cytopathology and alert to the possibility of false-negative reports