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Interobserver Variability in Human Papillomavirus Test Results in Cervicovaginal Cytologic Specimens Interpreted as Atypical Squamous Cells

Kim R. Geisinger MD, Colleen Vrbin, Dana M. Grzybicki MD, PhD, P. Wagner, A. Julian Garvin MD, PhD, Stephen S. Raab MD
DOI: http://dx.doi.org/10.1309/J086T2UB1WDL1LQU 1010-1014 First published online: 1 December 2007


We studied interobserver variability in the proportions of human papillomavirus (HPV)-positive results for atypical squamous cells of undetermined significance (ASCUS) and atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) diagnoses among 5 pathologists from the same laboratory during a 2-year period. These proportions were compared with individual pathologist’s ASCUS/squamous intraepithelial lesion (SIL) ratios.

Of 1,299 ASCUS diagnoses, 32.3% had HPV testing; 49.4% were HPV+. Positive findings by individual pathologists ranged from 38% to 67% (P = .057). There was a difference in the proportions of high-risk HPV results for individual pathologists (P < .001). For the pathologist who diagnosed 38% (23/61) of samples as HPV+, the ASCUS/SIL was 0.58; the pathologist who diagnosed 67% (28/42) as HPV+ had a ratio of 1.02. Of the ASC-H diagnoses, 32.9% were tested for HPV; 63% (46/73) were positive. Although the HPV+ proportion by pathologist ranged from 54% to 83%, no significant differences were identified.

Within the same laboratory, interobserver variability exists in the proportions of HPV positivity for ASCUS and ASC-H interpretations.

Key Words:
  • Interobserver variability
  • Human papillomavirus
  • HPV
  • Atypical squamous cells