PMID: 16639993Apr 28, 2006Paper

Diagnostic precision and accuracy in interpretation of specimens from cancer screening programs

Seminars in Diagnostic Pathology
Elliott Foucar

Abstract

Few areas in modern medicine provide a better example of evidence-based data than the anatomic pathologists' classification of fully developed malignancies. Beginning with the Papanicolaou (Pap) smear, morphologic tools also were applied to specimens obtained in cancer screening programs directed at large, asymptomatic patient populations. The Papanicolaou test was quickly responsible for a reduction in the incidence of invasive squamous cell carcinoma of the cervix, proving the concept that screening could interdict the development of advanced malignancy. Other screening programs followed the Papanicolaou test initiative, producing a revolutionary change in the specimens submitted to pathologists. Cancer screening generates specimens containing morphologic deviations from normal that are thought to put currently healthy patients at risk of future malignancy. However, translating morphologic findings in such samples into risk estimates raises a number of statistical and ethical problems. When diagnostic thresholds are set to favor specificity, unwanted false-negative results accrue. Conversely, aiming at sensitivity over specificity is associated with biologically false-positive results, which are likewise undesirable. Patholog...Continue Reading

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Citations

Feb 24, 2007·Laboratory Investigation; a Journal of Technical Methods and Pathology·James M Crawford
Feb 1, 2019·NPJ Precision Oncology·Holli A Loomans-Kropp, Asad Umar
Apr 26, 2019·Laboratory Investigation; a Journal of Technical Methods and Pathology·Benjamin L MazerDavid L Rimm

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