Background: High rates of false-negative results constitute a routine problem in cytology laboratories. Of currently available internal quality control methods, 10% random review is the least effective in detecting false-negatives in routine screening. There is evidence that 100% rapid review and rapid prescreening perform well for this purpose. This study compared the performance of rapid prescreening and 100% rapid review as internal quality control methods for cervical cytology exams. Methods: Over 27 months, 12,208 cervical cytology smears were submitted to rapid prescreening and routine screening. The 100% rapid review method was performed on all smears classified as negative or unsatisfactory at routine screening. Conflicting results obtained with either method were reviewed in detail to define final diagnosis, which was considered the gold standard for evaluating the performance of rapid prescreening and 100% rapid review. Results: Compared with final diagnosis, the sensitivity of routine screening and rapid prescreening was 72.9% and 75.6%, respectively. Considering only smears classified as negative or unsatisfactory at routine screening, the sensitivity of rapid prescreening and 100% rapid review was 90.2% and 57,0%, respectively. Of 244 cases (2.0%) of false-negative results at routine screening, rapid prescreening identified 220 cases (1.80%), whereas 100% rapid review identified 140 (1.15%). Rapid prescreening detected all cases of HSIL identified as false-negatives. Conclusions: Rapid prescreening is more effective than 100% rapid review for the detection of false-negatives at routine screening, thus providing subsidies for the performance of cervical cytology, the principal function of which is to detect precursor lesions of cervical. © 2011 American Cancer Society.1196367376Trottier, H., Franco, E.L., Human papillomavirus and cervical cancer: Burden of illness and basis for prevention (2006) Am J Manag Care, 12, pp. S462-S472Faraker, C.A., Rapid review (1998) Cytopathology, 9, pp. 71-76Amaral, R.G., Zeferino, L.C., Hardy, E., Westin, M.C., Martinez, E.Z., Montemor, E.B., Quality assurance in cervical smears: 100% rapid rescreening vs. 10% random rescreening (2005) Acta Cytol, 49, pp. 244-248Djemli, A., Khetani, K., Auger, M., Rapid prescreening of Papanicolaou smears: A practical and efficient quality control strategy (2006) Cancer, 108, pp. 21-26Tavares, S.B., Alves De Sousa, N.L., Manrique, E.J., Pinheiro De Albuquerque, Z.B., Zeferino, L.C., Amaral, R.G., Comparison of the performance of rapid prescreening, 10% random review, and clinical risk criteria as methods of internal quality control in cervical cytopathology (2008) Cancer, 114, pp. 165-170Renshaw, A.A., Deschenes, M., Auger, M., ASC/SIL ratio for cytotechnologists: A surrogate marker of screening sensitivity (2009) Am J Clin Pathol, 131, pp. 776-781Dudding, N., Renshaw, A.A., Ellis, K., Improved sensitivity over time with rapid prescreening in gynecologic cytology (2011) Diagn Cytopathol., 39, pp. 428-430Elsheikh, T.M., Kirkpatrick, J.L., Ficher, D., Herbert, K.D., Renshaw, A.A., Does the time of day or weekday affect screening accuracy? A pilot correlation study with cytotecnologist workload and abnormal rate detection using the ThinPrep Imaging System (2010) Cancer Cytopathol., 118, pp. 41-46Dudding, N., Renshaw, A.A., Ellis, K., Rapid pre-screening is more sensitive in liquid-based cytology than in conventional smears (2011) Acta Cytol., 55, pp. 54-56Hutchinson, M.L., Assessing the costs and benefits of alternative rescreening strategies (1996) Acta Cytol, 40, pp. 4-8Renshaw, A.A., Experts in Wonderland: In search of the right test and the scientific method (2000) Diagn Cytopathol, 23, pp. 297-298(1970) Committee on Registration on Licensure: Certification of Cytology Laboratories, , International Academy of Cytology. Chicago: IACRegulations for implementing Clinical Laboratory Improvement Amendments of 1988: A summary (1992) JAMA, 267, pp. 1725-1727. , Centers for Disease Control. 1731-1734Dudding, N., Rapid rescreen: A viable alternative to 1:10? (2001) Diagn Cytopathol, 24, pp. 219-221Manrique, E.J., Amaral, R.G., Souza, N.L., Tavares, S.B., Albuquerque, Z.B., Zeferino, L.C., Evaluation of 100% rapid rescreening of negative cervical smears as a quality assurance measure (2006) Cytopathology, 17, pp. 116-120Simon, T.R., Ricci, A., The efficiency of vaginal and cervical smears (1957) Transaction Of The 5th Annual Meeting Of The Intersociety Cytology Council, , Augusta GABaker, A., Melcher, D.H., Rapid cervical cytology screening (1991) Cytopathology, 2, pp. 299-301Faraker, C.A., Partial rescreening of all negative smears: An improved method of quality assurance in laboratories undertaking cervical screening (1993) Cytopathology, 4, pp. 47-50Utagawa, M.L., Shirata, N.K., De Castro Ferraz Mda, G.M., Di Loreto, C., Dall'Agnol, M., Longatto-Filho, A., Performance of 3 methods for quality control for gynecologic cytology diagnoses (2008) Acta Cytol, 52, pp. 439-444Brooke, D., Dudding, N., Sutton, J., Rapid (partial) prescreening of cervical smears: The quality control method of choice? (2002) Cytopathology, 13, pp. 191-199Renshaw, A.A., Quality assessment in the age of machineaided cervical cytology screening (2004) Cancer, 102, pp. 345-347Smith, J., Nicholas, D., Boyd, K., Deacon-Smith, R., Rapid pre-screening: A validated quality assurance measure in cervical cytology (2003) Cytopathology, 14, pp. 275-280Djemli, A., Khetani, K., Case, B.W., Auger, M., Correlation of cytotechnologists' parameters with their performance in rapid prescreening of Papanicolaou smears (2006) Cancer, 108, pp. 306-310Deschenes, M., Renshaw, A.A., Auger, M., Measuring the significance of workload on performance of cytotechnologists in gynecologic cytology: A study using rapid prescreening (2008) Cancer, 114, pp. 149-154Brimo, F., Renshaw, A.A., Deschenes, M., Charbonneau, M., Auger, M., Improvement in the routine screening performance of cytotechnologists over time: A study using rapid prescreening (2009) Cancer Cytopathol, 117, pp. 311-317Wiener, H.G., Klinkhamer, P., Schenck, U., European guidelines for quality assurance in cervical cancer screening: Recommendations for cytology laboratories (2007) Cytopathology, 18, pp. 67-78Solomon, D., Nayar, R., (2004) The Bethesda System for Reporting Cervical Cytology, p. 191. , 1st. ed. New York, NY: Springer-VerlagPajtler, M., Audy-Jurković, S., Skopljanac-Macina, L., Antulov, J., Barisić, A., Milicić-Juhas, V., Rapid cervicovaginal smear screening: Method of quality control and assessing individual cytotechnologist performance (2006) Cytopathology, 17, pp. 121-126Tavares, S.B., De Sousa, N.L., Manrique, E.J., De Albuquerque, Z.B., Zeferino, L.C., Amaral, R.G., Rapid pre-screening of cervical smears as a method of internal quality control in a cervical screening programme (2008) Cytopathology, 19, pp. 254-259Lee, B.C., Lam, S.Y., Walker, T., Comparison of false negative rates between 100% rapid review and 10% random full rescreening as internal quality control methods in cervical cytology screening (2009) Acta Cytol, 53, pp. 271-276Repse-Fokter, A., Caks-Golec, T., Rapid prescreening as a quality assurance measure in cervical cytology (2009) Acta Cytol, 53, pp. 268-270Manrique, E.J.C., Souza, N.L.A.S., Tavares, S.B.N., Albuquerque, Z.B.P., Zeferino, L.C., Amaral, R.G., Analysis of the performance of 100% rapid review using an average time of 1 and 2 minutes to the quality of cervical cytology specimens (2011) Cytopathology., 22, pp. 195-201Wilgenbusch, H., Mueller, G., Neal, M., Renshaw, A.A., Rapid prescreening is as effective at reducing screening error as postcreening with the FocalPoint automated screening device (2010) Diagn Cytopathol., , [Epub ahead of print]Lemay, C., Meisels, A., 100% Rapid (partial) rescreening for quality assurance (1999) Acta Cytol, 43, pp. 86-88Diehl, A.R., Prolla, J.C., Rapid rescreening of cervical smears for internal quality control (1998) Acta Cytol, 42, pp. 949-953Arbyn, M., Schenck, U., Detection of false negative Pap smears by rapid reviewing. A metaanalysis (2000) Acta Cytol, 44, pp. 949-957Jensen, M.L., Dybdahl, H., Svanholm, H., (2000) Ugeskr Laeger, 162, pp. 3024-3027. , [Partial re-screening of all negative smears. A method of quality control of pathology department concerning smear screening against cervix cancer]Wilson, N.J., Molyneux, A.J., Rapid review in cervical cytology: A retrospective review of cases detected on rapid review within a DGH cytology department and subsequent outcome (2004) Cytopathology, 15, pp. 93-96Johnson, S.J., Hair, T., Gibson, L., Ridley, B., Wadehra, V., An assessment of partial rescreening as an internal quality control method for cervical smears (1995) Cytopathology, 6, pp. 376-387Faraker, C.A., Boxer, M.E., Rapid review (partial rescreening) of cervical cytology. Four years experience and quality assurance implications (1996) J Clin Pathol, 49, pp. 587-591Renshaw, A.A., Bellerose, B., Di Nisco, S.A., Minter, L.J., Lee, K.R., False negative rate of cervical cytologic smear screening Abstract: Determined by rapid rescreening (1999) Acta Cytol, 43, pp. 344-350Arbyn, M., Schenck, U., Ellison, E., Hanselaar, A., Metaanalysis of the accuracy of rapid prescreening relative to full screening of pap smears (2003) Cancer, 99, pp. 9-16Clarke, J., Thurloe, J.K., Bowditch, R.C., Roberts, J.M., Assuring the quality of quality assurance: Seeding abnormal slides into the negative Papanicolaou smears that will be rapid rescreened (2008) Cancer, 114, pp. 294-299Shield, P.W., Cox, N.C., The sensitivity of rapid (partial) review of cervical smears (1998) Cytopathology, 9, pp. 84-92Mitchell, H., Medley, G., Differences between Papanicolaou smears with correct and incorrect diagnoses (1995) Cytopathology, 6, pp. 368-375O'Sullivan, J.P., A'Hern, R.P., Chapman, P.A., A case-control study of true-positive versus false-negative cervical smears in women with cervical intraepithelial neoplasia (CIN) III (1998) Cytopathology, 9, pp. 155-161Franco, R., Amaral, R.G., Montemor, E.B., Montis, D.M., Morais, S.S., Zeferino, L.C., (2006) Rev Bras Ginecol Obstet, 28, pp. 479-485. , [Factors associated with false-negative cervical cytopathological results]Dudding, N., Hewer, E.M., Lancucki, L., Rice, S., Rapid screening: A comparative study (2001) Cytopathology, 12, pp. 235-248Faraker, C.A., Partial rescreening for quality assurance in gynecological cytology (1997) Diagn Cytopathol, 16, pp. 191-192