Interobserver Variability in Cervical Smears from Patients with a History of Abnormal Cytology: Comparison of Conventional Pap Smears and Liquid-Based Cytology

Objective: One of the problems encountered when assessing cervical precancerous lesions is intra- and interobserver variability. The aim of this study was to determine the degree of interobserver variation in conventional PAP smears (CPS) and liquid-based cytology (LBC). Materials and Methods: The diagnostic variability among three pathologists was assessed using 120 smears (67 conventional CPS and 53 LBC). The cases were selected retrospectively from the archives of the Pathology Department among the patients with follow-up, such as biopsy confirmation and/or persistent/ resolving disease in the follow-up smear. The observers examined the slides in a blinded fashion. Results: Diagnostic agreement on the presence or absence of intraepithelial lesions was found in 30 of 51 slides (58.82%) of LBC (kappa=0.42) and in 44 of 67 slides (65.67%) of conventional cytology (kappa=0.50). The agreement was slightly higher in conventional smears. The highest agreement was in the LSIL category with a kappa value of 0.50 in LBC and 0.62 in conventional cytology, while ASCUS was the least reproducible diagnosis. Conclusion: Our results are in agreement with the literature in that the reproducibility of cervical cytology shows low to moderate consistency. The study showed no significant difference between LBC and CPS in the reproducibility of the diagnosis.