Non-Correlating Pap Tests: Histological Follow-up of Abnormal Pap Tests Classified Using the 2001 Bethesda System

The purpose of this report is to study the correlation between abnormal cervical Pap smears reported using the revised 2001 Bethesda system and their corresponding cervical biopsies, in order to identify discrepant non-correlating positive smears and analyze the smear characteristics causing the discrepancy in those cases. All abnormal cervical smears results classified using the revised 2001 Bethesda system and their follow-up cervical biopsies were retrieved and correlated. The total number, percentage and smear characteristics of all non-correlating positive Pap smears are presented. One hundred and thirty seven (137) (85 positive and 52 atypical but not positive) abnormal smears had follow-up cervical biopsies. The 85 positive smears were further studied and an exact cyto-histological correspondence was seen in 58 (68.23%) out of the 85 positive smears, while 27 (31.7%) smears were discordant. Nine (10.58%) out of the 27 discordant cases revealed a more severe lesion on follow-up biopsy, 7 (8.23%) cases with a less severe lesion and 11 (12.94%) smears were falsely positive. This study shows that concordance rate of cervical Pap smears reported using the revised 2001 Bethesda system with their follow-up biopsies is moderate and increases with the rise of the cytological grade of dysplasia.