Cytologic diagnosis of malignancy of the female generative tract—a pathologist's viewpoint

Abstract

M UCH has been written of late regarding cytologic studies in the diagnosis of malignant tumors of the female generative tract. These papers have presented the pros and cons of the value of the method, mostly favorable; some have hailed it with somewhat more than scientific enthusiasm. Rarely, however, does one hear from the other half of the team, those who must do the work, the microscopists and screeners who labor behind the scenes to produce the statistics. This paper is undertaken to present some thoughts and reflections gleaned from a fairly extensive personal experience and from innumerable informal conversations with fellow workers in this field. One often hears the statement made that pathologists oppose cytologic diagnosis of cancer. There are, no doubt, some individuals who actually do oppose this method on personal grounds, but pathologists certainly do not, as a group, oppose any method which will permit earlier and more accurate diagnosis of malignant disease. They, of all persons, know the results of diagnoses made too late, and of too little or incompetent treatment. Until we can attack cancer from a different angle than at present, i.e., that of stamping out the fire before it has gained too much headway, our only hope lies in earlier and earlier diagnosis, coupled with increasingly efficient therapy. Nevertheless, a number of pathologists do look upon cytodiagnosis with considerable coolness. Some of the reasons are given here :