Quality assurance in cervical cytology: the Papanicolaou Smear

Article Abstract:

The Papanicolaou (Pap) smear, the cytologic evaluation of cells collected from the cervix and female genital tract, is related to a 70 percent reduction in mortality from cervical cancer in the United States over the past 40 years. Earlier diagnoses of cervical cancer, cervical cell changes prior to the development of malignancy, and other infections of the vaginal region have been documented by the use of Pap smears. In the past two years some publications have alleged that the Pap smear is not a reliable or effective means of screening for the proportionately small number of cervical cancers which cause approximately 7.000 deaths annually. The American Medical Association's Council on Scientific Affairs presents recommendations for optimizing the clinical use of the Pap smear. Physicians should receive satisfactory training in collecting cells and preparing smears. Cytologic diagnosis should be performed in laboratories which meet quality standards and receive accreditation. Certified cytotechnologists should have adequate time to evaluate each smear and should not be paid on a piece-work basis. They should be required to obtain continuing education. Results of Pap smears should be reported in descriptive terms and the absence of necessary cells for proper examination should also be reported. Third-party payers should compensate laboratories in a manner which supports these recommendations.

Reports, Cancer, Cytodiagnosis, Cancer diagnosis, American Medical Association. Council on Scientific Affairs

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The Papanicolaou smear: medicine's most successful cancer screening procedure is threatened

Article Abstract:

Physicians should continue to encourage their female patients to get regular Pap smears. The Pap smear is probably partly responsible for reducing the US death rate from cervical cancer from 26,000 in 1941 to 4,900 in 1996. However, lawsuits have been filed by women who had a negative Pap smear but subsequently developed cervical cancer. Managed care organizations in their effort to reduce costs may send the smears to a laboratory that is not equipped to handle them. Automation of the procedure can also increase its cost. Patients should understand that a Pap smear is only a screening tool, not a diagnostic test.

Usage, Medical screening, Health screening

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Assessing, controlling, and assuring the quality of medical information on the Internet: caveant lector et viewor - let the reader and viewer beware

Article Abstract:

Groups that sponsor sites on the World Wide Web should adhere to certain standards. These include publicizing the names of authors of Web content and disclosing information about the site sponsor. Many groups are already developing such standards to forestall government intervention. Anyone with a computer, a modem and communications software can post messages on the Internet. But this causes a wealth of information that may or may not be beneficial. All medical information found on the Internet should be used in conjunction with traditional health information resources.

Information services, World Wide Web

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