CAP TODAY Pathology/Laboratory Medicine/Laboratory Management
The interobserver agreement was similar to a previous study by Lytwyn, et al. (Cancer. 2005; 103[7]:1447–1456) that used four pathologists to independently assess anal cytology specimens. The Lytwyn study also made interesting observations as the authors found anal cytology interobserver agreement compares similarly to overall kappa agreement for anal biopsy specimens (0.54 and 0.59, respectively). Additionally, they found that reliability for the Bethesda classification system was moderate, except for the ASC-US category, which had a kappa of 0.12.
This study by Darragh, et al., along with its comparison to the previous study by Lytwyn, et al., is recommended reading for cytopathologists and their respective laboratories that interpret and/or process anal cytology specimens. In addition to addressing the important issue of interobserver reproducibility regarding anal cytologies, they provide good insight into the subject of using biomarkers as objective standards that may help maintain the performance standard for anal cytology interpretations.
Dr. Witt, a member of the CAP Cytopathology Committee, is an assistant professor of anatomic pathology at the University of Utah where he works in general surgical pathology and cytopathology. He is the director of the cytopathology rotation for residents and supervises the medical student rotation on the anatomic pathology service.