Context.—: Cervical cancer screening laboratory practices may evolve with new terminology and technologies. Objective.—: To investigate changes in cervical cytopathology practice resulting from the 2014 Bethesda System updates and screening technologies. Design.—: Questionnaires accompanied 2016 and 2017 mailings of the College of American Pathologists PAP Education program. Results.—: In 2016, most laboratories surveyed had adopted or were planning to adopt 2014 Bethesda System updates, and the majority (53%; 365 of 689) used an age cutoff of 45 for reporting benign-appearing endometrial cells. However, 51.3% (354 of 690) of laboratories used the term low-grade squamous intraepithelial lesion, cannot exclude high-grade squamous intraepithelial lesion, for cases with indeterminate features, and 44.9% (298 of 664) of laboratories used a 5000-cell cutoff for minimum squamous cellularity for posthysterectomy and posttherapy specimens. Reporting rates for cervical cytology metrics changed very little from 2013 to 2016, and the median ratio of atypical squamous cells to squamous intraepithelial lesion cases was 1.9 for ThinPrep and 1.8 for SurePath preparations. Most laboratories (59.4%; 389 of 655) did not offer stand-alone primary human papillomavirus (HPV) testing in 2017, and primary HPV testing accounted for a low proportion of HPV testing volumes. The Roche Cobas method was the most common platform for HPV primary screening. Conclusions.—: These questionnaire surveys provide data about the current status of cervical cytology screening, including changes related to the 2014 Bethesda System updates and the adoption of HPV primary screening techniques.

Accurate and robust human immune system assessment through white blood cell evaluation require computer-aided tools with pathologist-level accuracy. This work presents a multi-attention leukocytes subtype classification method by leveraging fine-grained and spatial locality attributes of white blood cell. The proposed framework comprises three main components: texture-aware/attention map generation blocks, attention regularization, and attention-based data augmentation. The developed framework is applicable to general CNN-based architectures and enhances decision making by paying specific attention to the discriminative regions of a white blood cell. The performance of the proposed method/model was evaluated through an extensive set of experiments and validation. The obtained results demonstrate the superior performance of the model achieving 99.69 % accuracy compared to other state-of-the-art approaches. The proposed model is a good alternative and complementary to existing computer diagnosis tools to assist pathologists in evaluating white blood cells from blood smear images.

Context.—: The College of American Pathologists (CAP) updated the Laboratory Accreditation Program Cytopathology Checklist to assist laboratories in meeting and exceeding the Clinical Laboratory Improvement Amendments standards for gynecologic cytologic-histologic correlation (CHC). Objective.—: To survey the current CHC practices. Design.—: Data were analyzed from a survey developed by the committee and distributed to participants in the CAP Gynecologic Cytopathology PAP Education Program mailing. Results.—: Worldwide, CHC practice is nearly universally adopted, with an overall rate of 87.0% (568 of 653). CHC material was highly accessible. CHC was commonly performed real time/concurrently at the time the corresponding surgical pathology was reviewed. Investigation of CHC discordances varied with North American laboratories usually having a single pathologist review all discrepant histology and cytology slides to determine the reason for discordance, while international laboratories have a second pathologist review histology slides to determine the reason for discordance. The cause of CHC discordance was primarily sampling issues. The more common statistical metrics for CHC monitoring were the total percentage of cases that correlated with subsequent biopsies, screening error rate by cytotechnologist, and interpretative error rate by cytotechnologist. Conclusions.—: Many laboratories have adopted and implemented the CHC guidelines with identifiable differences in practices between North American and international laboratories. We identify the commonalities and differences between North American and international institutional practices including where CHC is performed, how CHC cases are identified and their accessibility, when CHC is performed, who investigates discordances, what discordances are identified, and how the findings affect quality improvement.