From the Guidelines
You should order the ThinPrep Imaging System (TIS) test code instead of the discontinued manual ThinPrep Pap test. Contact your laboratory provider to obtain the correct TIS test code for ordering, as this is now the standard replacement for the manual method. When placing the new order, ensure you communicate to the patient that this is the same type of Pap test but with an improved screening method. The ThinPrep Imaging System uses computer-assisted technology to identify potentially abnormal cells for cytologist review, which improves detection rates and reduces false negatives compared to the manual method. The collection process remains the same for the patient, requiring a cervical sample collected with a brush or spatula and placed in ThinPrep preservative fluid. The change to TIS represents a technological advancement rather than a fundamental change in the test itself, as it maintains the liquid-based cytology approach while enhancing the analysis process through automated imaging technology. According to the American Cancer Society guidelines for cervical cancer screening 1, the recommended screening method for cervical cancer includes the Pap test, and the ThinPrep Imaging System is a type of liquid-based Pap test. It is essential to follow the current guidelines and recommendations for cervical cancer screening to ensure the best possible outcomes for patients. In this case, ordering the TIS test code is the most appropriate course of action to replace the discontinued manual ThinPrep Pap test. By doing so, you can ensure that your patient receives the most up-to-date and effective screening method for cervical cancer. It is also important to note that the patient's clinical information, such as their last menstrual period (LMP), previous Pap test results, and any previous biopsies, should be taken into consideration when ordering the TIS test code. However, based on the provided information, ordering the TIS test code is the most appropriate recommendation.
From the Research
Resolution of Discontinued Manual ThinPrep Test
- The manual ThinPrep test has been discontinued, and an alternative form of ThinPrep, called ThinPrep Imaging System (TIS), is available 2, 3, 4.
- To resolve the issue, you need to provide a comparable TIS test code and return it to Quest using the provided fax number.
- You can find the TIS test code conversion charts on the website www.Questwomenshealth.com/Resources by navigating to Well-Woman>Physicians Materials.
- Alternatively, you can call 1.833.813.5224 for test code assistance.
Importance of ThinPrep Imaging System (TIS)
- The TIS has been shown to increase the detection of dysplastic cells and reduce the false-negative rate of Pap examinations 3, 5, 4.
- Studies have demonstrated that TIS is effective in aiding human interpretive skills and reducing the laboratory false-negative rate 3, 4.
- The use of TIS has also been associated with increased job satisfaction among cytotechnologists 4.
Underrecognized Patterns of High-Grade Squamous Intraepithelial Lesion
- There are underrecognized patterns of high-grade squamous intraepithelial lesions (HSIL) in cervical cytology, including atypical metaplastic cells, atypical repair, and rare syncytial groups 6.
- These patterns can be missed by the TIS, highlighting the importance of careful review and interpretation of Pap test results 6.