CERVICAL CYTOLOGY AND CARCINOMA IN SITU

Abstract

IF cytology is helping to overcome one problem in cervical cancer-that of early diagnosis-it is creating many others. It will be the aim of this paper, based on observations made on a series of 278 cases of cervical carcinoma in situ dealt with at the National Women's Hospital in the 12 years 1951-62 and all having a minimum follow-up period of 18 months, to discuss some of the problems cytology has created in the discovery of 237 of them. Tables I and I1 show what cytology has accomplished in this hospital in 8 years; the number of smears examined annually has risen from 3,250 in 1955 to 27,820 in 1962. It is interesting to note that as increasing numbers of the population are screened the detection rate for preclinical cancer is falling. Possibly the fall is contributed to by increasing conservatism in the histological diagnosis of carcinoma in silu as increasing numbers of cases are revealed by An additional 36 cases of intra-epithelial cancer were treated which were revealed by cytology smears examined in other laboratories, so that of the 278 cases dealt with 237 (85-3 per cent) owe their diagnosis to cytology. In the years 1960-62 the proportion of cases discovered by cytology was 95.8 per cent. cytology. RESULTS FROM 8 YEARS OF CYTOLOGY