Challenging the concept of "risk of malignancy" in cytology

Ilias P Nikas; Ricella Souza da Silva; Bernardo Sousa-Pinto; Fernando Schmitt

doi:10.1002/cncy.22787

Challenging the concept of "risk of malignancy" in cytology

Cancer Cytopathol. 2023 Dec 21. doi: 10.1002/cncy.22787. Online ahead of print.

Authors

Ilias P Nikas¹, Ricella Souza da Silva², Bernardo Sousa-Pinto^{3

4}, Fernando Schmitt^{2

4

5}

Affiliations

¹ School of Medicine, European University Cyprus, Nicosia, Cyprus.
² IPATIMUP - Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal.
³ MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
⁴ Faculty of Medicine, CINTESIS@RISE - Health Research Network, University of Porto, Porto, Portugal.
⁵ Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.

PMID: 38126672
DOI: 10.1002/cncy.22787

Abstract

Several standardized systems for nongynecological cytopathology have been published following the successful implementation of The Bethesda System for Reporting Cervical Cytology. Each of these systems comprises a set of reporting categories accompanied by a risk of malignancy. However, in most cases, these risk of malignancy estimates have not been based on high-quality evidence and often may not be consider proper "risks" (because they have been estimated based on cross-sectional studies). This commentary discusses the problems related to the data used to generate these risks. To make nongynecological cytopathology reporting more evidence-based, large-scale prospective cohort studies and randomized trials, in addition to high-quality systematic reviews and meta-analyses, should be performed.

Keywords: WHO Reporting Systems for Cytopathology; cancer; cytopathology; diagnosis; evidence-based medicine; fine-needle aspiration; risk of malignancy.