CIN2 is a much less reproducible and less valid diagnosis than CIN3: results from a histological review of population-based cervical samples

Joseph D. Carreon, Mark E. Sherman, Diego Guillén, Diane Solomon, Rolando Herrero, Jose Jerónimo, Sholom Wacholder, Ana Cecilia Rodríguez, Jorge Morales, Martha Hutchinson, Robert D. Burk, Mark Schiffman

Research output: Contribution to journalArticle

149 Scopus citations

Abstract

We wished to compare the relative reproducibility and validity of cervical intraepithelial neoplasia (CIN) 2 and CIN3 diagnoses. In a population-based cohort study (1993-2001) of human papillomavirus (HPV) and cervical neoplasia in Costa Rica, we compared community pathologists' diagnoses with those of the 2 independent reviewers from the United States (total, n = 357). As measures of validity, we correlated primary and review diagnoses with HPV positivity and cytological interpretations. Two review pathologists agreed with 84% and 81%, respectively, of initial diagnoses of CIN3 compared with 13% and 31% of CIN2. The CIN3 diagnoses made by review pathologists were 94% oncogenic HPV positive, compared with 72% of CIN2 diagnoses. Eighty-one percent of CIN3 diagnoses versus 61% of CIN2 were correlated with high-grade cytological interpretations. The CIN3 is a substantially more reproducible diagnosis that can be validated more frequently with HPV tests and cytological interpretations than CIN2.

Original languageEnglish (US)
Pages (from-to)441-446
Number of pages6
JournalInternational Journal of Gynecological Pathology
Volume26
Issue number4
DOIs
StatePublished - Oct 2007

Keywords

  • CIN2
  • CIN3
  • Cervix
  • Pathology

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Obstetrics and Gynecology

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    Carreon, J. D., Sherman, M. E., Guillén, D., Solomon, D., Herrero, R., Jerónimo, J., Wacholder, S., Rodríguez, A. C., Morales, J., Hutchinson, M., Burk, R. D., & Schiffman, M. (2007). CIN2 is a much less reproducible and less valid diagnosis than CIN3: results from a histological review of population-based cervical samples. International Journal of Gynecological Pathology, 26(4), 441-446. https://doi.org/10.1097/pgp.0b013e31805152ab