J Pathol Transl Med.  2017 Nov;51(6):579-587. 10.4132/jptm.2017.08.11.

Current Cytology Practices in Korea: A Nationwide Survey by the Korean Society for Cytopathology

• Oh EJ
• Jung CK
• Kim DH
• Kim HK
• Kim WS
• Jin SY
• Yoon HK
• The Fellowship Council and Committee of Quality Improvement of the Korean Society for Cytopathology

• KMID: 2396541
• DOI: http://doi.org/10.4132/jptm.2017.08.11

Abstract

BACKGROUND
Limited data are available on the current status of cytology practices in Korea. This nationwide study presents Korean cytology statistics from 2015.
METHODS
A nationwide survey was conducted in 2016 as a part of the mandatory quality-control program by the Korean Society for Cytopathology. The questionnaire was sent to 208 medical institutions performing cytopathologic examinations in Korea. Individual institutions were asked to submit their annual cytology statistical reports and gynecologic cytology-histology correlation data for 2015.
RESULTS
Responses were obtained from 206 medical institutions including 83 university hospitals, 87 general hospitals, and 36 commercial laboratories. A total of 8,284,952 cytologic examinations were performed in 2015, primarily in commercial laboratories (74.9%). The most common cytology specimens were gynecologic samples (81.3%). Conventional smears and liquid-based cytology were performed in 6,190,526 (74.7%) and 2,094,426 (25.3%) cases, respectively. The overall diagnostic concordance rate between cytologic and histologic diagnoses of uterine cervical samples was 70.5%. Discordant cases were classified into three categories: category A (minimal clinical impact, 17.4%), category B (moderate clinical impact, 10.2%), and category C (major clinical impact, 1.9%). The ratio of atypical squamous cells of undetermined significance to squamous intraepithelial lesion was 1.6 in university hospitals, 2.9 in general hospitals, and 4.9 in commercial laboratories.
CONCLUSIONS
This survey reveals the current status and trend of cytology practices in Korea. The results of this study can serve as basic data for the establishment of nationwide cytopathology policies and quality improvement guidelines in Korean medical institutions.

Keyword

Cytology; Statistics; Surveys; Quality; Accuracy

MeSH Terms

Atypical Squamous Cells of the Cervix
Diagnosis
Hospitals, General
Hospitals, University
Korea*
Quality Improvement
Squamous Intraepithelial Lesions of the Cervix

Figure

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  Fig. 1. Number of cytopathology cases in 2015 according to the type of medical institution (A), specimen (B), and preparation method (C). GYN, gynecologic; FNA, fine needle aspiration; CS, conventional smear; LBC, liquid-based cytology.

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  Fig. 2. Number of gynecologic (GYN) cytology cases in 2105 according to the type of medical institution (A) and sample preparation method (B). CS, conventional smear; LBC, liquid-based cytology.

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  Fig. 3. Number of fine needle aspiration (FNA) cytology cases in 2105 according to the type of medical institution (A), specimen (B), and sample preparation method (C). CS, conventional smear; LBC, liquid-based cytology.

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  Fig. 4. Number of non-gynecologic (GYN), non-fine needle aspiration (FNA) cytology cases in 2105 according to the type of medical institution (A), specimen (B), and sample preparation method (C). CSF, cerebrospinal fluid; CS, conventional smear; LBC, liquid-based cytology.

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  Fig. 5. Usage of liquid-based cytology in 2015 according to number of institutions, number of specimens, and type of specimen.

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  Fig. 6. Ratio of atypical squamous cells of undetermined significance (ASCUS) to squamous intraepithelial lesions (SIL) according to the type of medical institution in 2015.

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  Fig. 7. Diagnostic accuracy of gynecologic cytology in 2015 according to the type of medical institution.

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  Fig. 8. Total number of gynecologic cytology cases according to the method of sample preparation at three different times. The number of cytology cases and the proportion of liquid-based cytology (LBC) have increased over time. CS, conventional smear.

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