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* Context.--The College of American Pathologists (CAP) surveys provide national benchmarks of pathology practice. Objective.--To investigate pancreaticobiliary cytology practice in domestic and international laboratories in 2021. Design.--We analyzed data from the CAP Pancreaticobiliary Cytology Practice Supplemental Questionnaire that was distributed to laboratories participating in the 2021 CAP Nongynecologic Cytopathology Education Program. Results.--Ninety-three percent (567 of 612) of respondent laboratories routinely evaluated pancreaticobiliary cytology specimens. Biliary brushing (85%) was the most common pancreaticobiliary cytology specimen evaluated, followed by pancreatic fine-needle aspiration (79%). The most used sampling methods reported by 235 laboratories were 22-gauge needle for fine-needle aspiration (62%) and SharkCore needle for fine-needle biopsy (27%). Cell block was the most used slide preparation method (76%), followed by liquid-based cytology (59%) for pancreatic cystic lesions. Up to 95% (303 of 320) of laboratories performed rapid on-site evaluation (ROSE) on pancreatic solid lesions, while 56% (180 of 320) performed ROSE for cystic lesions. Thirty-six percent (193 of 530) of laboratories used the Papanicolaou Society of Cytopathology System for Reporting Pancreaticobiliary Cytology in 2021. Among all institution types, significant differences in specimen volume, specimen type, ROSE practice, and case sign-out were identified. Additionally, significant differences in specimen type, slide preparation, and ROSE practice were found. Conclusions.--This is the first survey from the CAP to investigate pancreaticobiliary cytology practice. The findings reveal significant differences among institution types and between domestic and international laboratories. These data provide a baseline for future studies in a variety of practice settings. (Arch Pathol Lab Med. 2024;148:677-685; doi: 10.5858/arpa.2023-0167-CP), Cytology has proven to be a minimally invasive and cost-effective modality for accurately diagnosing pancreaticobiliary lesions, and in some patients, the only modality to diagnose lesions in this anatomic region. [...]

* Context.--Because the consequences of making an interpretive error on a proficiency test are more severe than those made on an educational challenge, the same slide may exhibit different performance characteristics in the 2 different settings. Objective.--The results of the 2006 College of American Pathologists Gynecologic Cytology Proficiency Testing Program (PAP PT) provide the opportunity to compare the performance characteristics of the field-validated slides in the PAP PT environment with those of the same graded slides in the College of American Pathologists Educational Program (formerly known as the PAP Program). Design.--All participant responses for negative (category B) and positive (categories C and D) validated slides in the 2006 PAP PT were used to determine the error rates of participants. These data were compared with the historical error rates observed on the same validated slides in the graded PAP Program. Results.--The performance characteristics of the slides in the PAP PT environment were statistically different from those in the Educational PAP Program. In proficiency testing both cytotechnologists (P < .001) and pathologists (P < .002) were more likely to interpret validated category B slides as category C or D and less likely to interpret category C slides as category B (P < .001). These differences were more pronounced among cytotechnologists than among pathologists. Conclusions.--In the test-taking environment, both cytotechnologists and pathologists appear to use a defensive strategy that results in "upgrading" of category B slides. This trend is more pronounced among cytotechnologists. (Arch Pathol Lab Med. 2009;133:279-282), The College of American Pathologists (CAP) Interlaboratory Comparison Program in Gynecologic Cytology (PAP) has existed for 18 years as an educational and laboratory accreditation activity for pathologists and cytotechnologists. (1-3) [...]

Context.--The use of Papanicolaou (Pap) test cytologichistologic correlation in quality improvement activities is not well studied. Objective.--To determine if continuous monitoring of correlation data improves performance. Design.--Participants in the College of American Pathologists Q-Tracks program (213 laboratories) self-reported the number of Pap test-histologic biopsy correlation discrepancies every quarter for up to 8 years. A mixed linear model determined if the length of participation in the Q-Tracks program was associated with improved performance. Main outcome measures were predictive value of a positive Pap test, Pap test sensitivity, sampling sensitivity, and proportion of positive histologic diagnoses following a Pap test diagnosis of atypical squamous cells or atypical glandular cells. Results.--Institutions evaluated 287570 paired Pap test--histologic correlation specimens and found 98 424 (34.2%) true-positive Pap test correlations, 19 006 (6.6%) false-positive Pap test correlations, and 6575 (2.3%) false-negative Pap test correlations. The mean predictive value of a positive Pap test, sensitivity, screening and interpretive sensitivity, sampling sensitivity, and proportion of positive histologic diagnoses following a Pap test diagnosis of atypical squamous or glandular cells were 83.6%, 93.7%, 99.2%, 94.2%, 60.3%, and 38.8%, respectively. Longer participation was significantly associated with a higher predictive value of a positive Pap test (P = .01), higher Pap test sensitivity (P = .002), higher Pap test sampling sensitivity (P = .03), and higher proportion of positive histologic diagnoses for a Pap test diagnosis of atypical squamous cells (P < .001). Conclusions.--Long-term monitoring of cytologic-histologic correlation is associated with improvement in cytologic-histologic correlation performance., Cytologic-histologic correlation is a means of error detection and evaluation of Papanicolaou (Pap) test and colposcopy performance. (1-5) Following the passage of the Clinical Laboratory Improvement Amendments of 1988,6 laboratories [...]