Detection of unsuspected cervical cancer by cell study

Abstract

1. 1. Two cases of early carcinoma of the cervix, which were diagnosed by routine selective cervical cytology smears, are presented. 2. 2. Clinical Judgment is not sufficient grounds upon which cancer of the cervix can be ruled out. The most innocent-appearing cervix may be the seat of a silent, but active, cancer. 3. 3. The pathologist can report only what he sees. Unless the tissue sent to the laboratory contains the cancer, the pathologist cannot be expected to make the diagnosis. 4. 4. In preclinical lesions the common practice, on the part of men unskilled in intravaginal manipulations, of using the biopsy punch to obtain a single tiny bit of tissue provides an inferior specimen and leads to false impressions. 5. 5. The single surgical specimen is better, but a single bit of tissue may miss the lesion. 6. 6. Multiple biopsy specimen method is still better, but this is not a practical procedure. We cannot expect the practitioner to admit to the hospital every one of his female patients to have this procedure carried out. Yet how is one to pick out the suspicious cases? The selective cervical cytology test performs this function. 7. 7. The basic principles of the cytology test and the various methods of taking the smears are briefly described. 8. 8. Reasons are given for our belief that the cervical modification of the test is superior to the original vaginal smear technic. 9. 9. The advantages of the cervical cytology test as a routine procedure are listed. 10. 10. A case with positive cytology deserves a complete investigation including, if necessary, cervical amputation followed by serial sectioning as well as curettage of the fundus. 11. 11. Stress is laid on the importance of cooperation and teamwork among the various members of the profession if we are to achieve the goal of finding cancer of the cervix in an early curable stage.