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2000 CytoBase Report

Cervical Cytology Database Statistics
Volume 4, Number 1, December 31, 2000

This report presents database statistics for the period starting January 1^st, 2000 through December 31^st, 2000 representing the statistics for 2000.  This report produced by INSCYTE^* Corporation contains only a subset of the information that the CytoBase system is capable of providing.

All information in the database is from sources deemed reliable but no warranty or representation is made as to the accuracy thereof, thus reports submitted may be subject to errors and/or omissions beyond the control of INSCYTE Corporation.

The CytoBase Report is copyrighted by INSCYTE Corporation. The copyright holders grant to all parties, without written agreement and without license or royalty fees, limited rights to use, copy, and distribute for any purpose, so long as copyright is acknowledged on all copies and excerpted materials (e.g. CytoBase Report Vol. 4 No. 1 Copyright Ó INSCYTE Corp. - Used by permission)

Copyright © 2001 INSCYTE Corporation

Information Systems for Cytology Etc.

Table of Contents

2000  CytoBase Report Highlights. 1

Editorial Commentary. 2

What is CytoBase?. 4

Legend for Diagnostic Classes. 4

CytoBase Technical Summary (as of May 3^rd, 2001) 5

Submitting Laboratories. 6

Women Based Statistics. 7

Distribution of the Most Severe Diagnosis for Women by Age and Class. 7

Distribution of Women with Diagnosis of ASCUS or AGUS by Age. 8

Distribution of Women with Diagnosis of Low Grade or High Grade Squamous Intraepithelial 

Lesions by Age. 9

Distribution of Women with Cytological Diagnosis of Carcinoma by Age and Cell Type. 10

Distribution of Women by Age as a Percentage of the Female Population of Ontario. 11

Report Based Statistics. 12

Distribution of Reports by Age and Diagnostic Class. 12

Specimen Adequacy Statistics. 13

Reason for Specimen Limitations. 14

Reason for Specimen Inadequacy. 15

Cumulative Database - Distribution by Age and Diagnostic Class. 16

• Focus on women based as opposed to report based data.
• Information on 1.3 million women with 1 or more Pap smears read in Ontario Community Laboratories in 2000.
• Captured 94.5% (1.4 million) reports of Pap smears read in community laboratories and 80% of all Pap smear reports in the province.
• More than 2.3% reports than women.
• Difference between number of women and number of reports greater for women with ASCUS (4.9%) than other women.
• Reports meet international quality benchmarks.
• CytoBase now a Provincial Cervical Cancer Screening Registry.
• Ability for cytopathologists to examine on line the prior Pap smear history of women in reporting smears and making recommendations.
• Routine on line access for cytotechnologists to facilitate interpretation of Pap smears.

CytoBase is a patient-centered computerized medical record of Cytology reports with on-line submission and query capabilities. The system was designed, developed and made operational by Artificial Intelligence In Medicine Inc. (AIM), a Toronto based software engineering firm under contract to INSCYTE Corporation, a not for profit organization formed by six private medical laboratories¹ and subsequently Cancer Care Ontario. The system started operations on June 1, 1996.

Participating laboratories automatically download all cervical cytology results and related patient data to the central database on a daily basis.  The system software automatically registers new patients and links reports to patient records.  Cytotechnologists and pathologists reading smears at the participating laboratories have on-line access to this database to improve diagnostic accuracy, and ensure that pre-neoplastic and neoplastic lesions are not overlooked.

Legend for Diagnostic Classes

All cervical/vaginal cytologic specimen diagnoses are based on The Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses (The Bethesda System), which are categorized as follows:

Each CytoBase report also contains the following information (to the extent that it has been provided by the source):

*  Laboratories now merged with others.

The following tables and figures categorize women by the most severe diagnosis for the period of time specified (January 1, 2000 to December 31, 2000) and the woman’s age.  The age is calculated based on the  woman’s date of birth at the time the specimen was taken with the most severe diagnosis.

Distribution of the Most Severe Diagnosis for Women by Age and Class

January 1, 2000 to December 31, 2000

1. The “other malignancies” category includes unclassified malignancies (11), favour adenocarcinoma or squamous cell carcinoma (3) and poorly differentiated carcinoma (1)
2. The “other abnormal” category includes findings and/or suspicion of abnormalities that were not formally classified.
3. The total number of women in the above table is less than the number of women registered (1,405,756) because the age of the woman (1,204), or the diagnostic class according to the Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses cannot be determined (29,092) from submitted information.
   
   

Distribution of Women with Diagnosis of ASCUS or AGUS by Age

Atypical squamous cells of undetermined significance account for 2.44% (33,593) of reported findings.

Atypical glandular cells of undetermined significance account for 0.42% (5,773) of reported findings.

Distribution of Women with Diagnosis of Low Grade or High Grade Squamous Intraepithelial Lesions by Age

Low grade squamous intraepithelial lesions account for 1.11% (15,244) of reported findings.

High grade squamous intraepithelial lesions account for 0.36% (4,937) of reported findings.

Distribution of Women with Cytological Diagnosis of Carcinoma by Age and Cell Type

Carcinomas account for 0.01% (172) of reported findings.

A cytological diagnosis was made of

• Squamous Cell Carcinoma  (107 women)
• Endocervical Adenocarcinoma  (51 women)
• Adenocarcinoma Not Otherwise Specified  (14 women)

Distribution of Women by Age as a Percentage of the Female Population of Ontario

¹ Taken from Total by Age Group of the Distribution of the Most Severe Diagnosis for Women by Age and Class (page 11)

² Demography Division, Statistics Canada: preliminary post-census estimates for 2000 Ontario population.

The following table lists reported findings categorized by diagnostic class (most severe finding on the report) and the woman’s age.  The age is calculated based on the  woman’s date of birth at the time the specimen was taken with the most severe diagnosis.

Distribution of Reports by Age and Diagnostic Class

Specimens Received  from January 1, 2000 to December 31, 2000

¹    The “other abnormal” category includes findings and/or suspicion of abnormalities that were not formally classified.

²    The total number of reports in the above table is less than the number of reports received (1,438,948) because the age of the woman (1,243), or the diagnostic class according to The Bethesda System cannot be determined (22,626) from submitted information. Unsatisfactory reports, which included a diagnosis, are used in the above table and are allocated to in the appropriate age and diagnostic category.

Specimen Adequacy Statistics

Reason for Specimen Limitations

*This total includes 6,293 reports with missing clinical information.

Reason for Specimen Inadequacy

*Includes unsatisfactory specimens with a diagnosis