Taking a satisfactory cervical cytologic smear: Is it really an easy procedure?

OBJECTIVE: To evaluate the correlation between the experience of the cervical cytologic smear provider and the quality of the smears in terms of the percentages of satisfactory smears and contribution of the various factors affecting the smears adequacy. STUDY DESIGN: A newly available quality control system was used to evaluate the adequacy of 4,000 smears. RESULTS: Of 4,000 smears, 660 (16.5%) were classified as “satisfactory but limited” or “unsatisfactory.” Technical factors contributed 1.0%, while 15.5% were due to sampling factors, considered human errors. Thus, human error accounted for 90% of the total number of unsatisfactory smears. CONCLUSION: Greater experience with smear sampling is associated with fewer unsatisfactory smears. The results correlate directly with the total number of smears taken annually. Sampling skill improves in steps, with improvement limited beyond a certain point.