Rapid rescreen: a viable alternative to 1:10?

A rapid screen of those Pap smears designated as within normal limits is a quality control requirement of all UK laboratories. However in the United States standard QC involves a combination of 1:10 and selective rescreening procedures. Forty participants at the joint ASCT/ACP meeting in Las Vegas rapid screened 50 slides as part of a rapid screening workshop. They used different patterns of screening but were allowed only 60 seconds for each slide. Thirty of the slides contained abnormal cells but all had originally been called negative or unsatisfactory and as such were "false negatives". Ability to identify the abnormal smears varied considerably between individuals but overall rapid screening correctly identified 54% of the ascus or LGSIL cases and 61% of the HGSIL cases. The results demonstrate the superiority of such a rapid screen over 1:10 and question what if any role this outdated practice should have.