Gladwyn Leiman: An appreciation

Cancer Cytopathology has seen numerous milestones since it was launched 11 years ago. These include the beginning of online publication ahead of print, the adoption of a Web-based peer-review system, its rise to number one in impact factor among competing journals, the centralization of its editorial office to the American Cancer Society's home office in Atlanta, and, of course, its publication of seminal papers throughout its history. The publication of Cancer Cytopathology demonstrates the American Cancer Society's commitment to this expanding subspecialty. Cancer Cytopathology continues to break new ground. It was at the forefront of online submission and peer review for cytopathology journals, a path many others have now followed. Today, all articles are published online as much as 10 weeks before print publication. Online readership has increased by more than 40% during the last 3 years, and all online content more than 12 months old is available without a subscription. With this issue, Cancer Cytopathology will undergo another major change, this time in editorial leadership, as Dr. William J. Frable retires from his position as principal editor. The journal's success today results from Dr. Frable's dedication and vision. Feeling very strongly about having quality figures to illustrate the research published in Cancer Cytopathology, Dr. Frable worked very closely with our publisher to personally review photographic proofs. He participated in the new cover design of the journal, launched in 2008, by personally selecting the background image that made the journal more colorful and recognizable to its audience. Most importantly, Dr. Frable, with the assistance of his editors, ensured that this journal published excellent and timely articles. His efforts are reflected in the journal's impact factor, which continues to be the best among competing publications in the field of cytopathology. During Dr. Frable's tenure as principal editor, Cancer Cytopathology became the official journal of the American Society of Cytopathology (ASC) and published the first yearly ASC abstract book. This collaboration between the American Society of Cytopathology and the American Cancer Society was a significant achievement for the journal, and we continue to seek opportunities to connect the ASC membership and our readers. On behalf of the American Cancer Society, the editorial staff, and the associate editors, I would like to thank Dr. Frable for his contributions to this journal. His tenure as principal editor has made Cancer Cytopathology a great success. We are honored that he has lent his talent and expertise to Cancer Cytopathology for the last 11 years. To open the next chapter for Cancer Cytopathology, we extend our welcome to newly appointed Editor-in-Chief Dr. Celeste N. Powers.

An international panel of experts in the field of salivary gland cytology (SGC), supported by the American Society of Cytopathology (ASC) and the International Academy of Cytology, conducted a survey to seek evidence and practice patterns regarding SGC. Results were used to provide focus for the proposed Milan System for Reporting Salivary Gland Cytopathology. The study group, formed during the 2015 European Congress of Cytology held in Milan, Italy, generated a survey that included 49 specific questions related to the taxonomies, practices, and diagnostic entities of salivary cytology. Qualtrics software was used as the study platform. Software and server support were provided by the division of information technology at the University of Wisconsin. The survey was available online from November 2015 until February 2016. Participants were invited through the Web sites of the ASC, the International Academy of Cytology, and the Papanicolaou Society of Cytopathology as well as by the ASC e-mail "ListServe"; responses were evaluated by the Milan System editors. Responses from a total of 515 participants were collected and reviewed. A total of 347 participants provided demographic data information. Responses revealed variations in diagnostic practice and subsequent management. Participants believed that the acceptable rate for nondiagnostic samples should not be higher than 10%. There were varied opinions regarding the approach to neoplastic lesions of uncertain malignant potential, those that may or may have not local invasion and distant spread. Results of the survey demonstrated strong support for the development of a unified system for reporting SGC. Cancer Cytopathol 2017;125:757-66. © 2017 American Cancer Society.

A group of international experts in breast fine needle aspiration biopsy (FNAB) cytopathology, supported by the International Academy of Cytology (IAC), drafted a comprehensive system for reporting breast FNAB cytopathology in 2017-2018. The editorial team produced a survey to assess the international response to the proposed category structure, definitions, and management recommendations in this draft. A web-based survey of 186 questions was generated using the Qualtrics software package (Provo, Utah) supported by the Division of Information Technology at the University of Wisconsin-Madison. The survey was advertised widely-including through the IAC, American Society of Cytopathology, Japanese Society of Clinical Cytology, Papanicolaou Society of Cytopathology, and Australian Society of Cytology and to audiences at national and international meetings-and was available from April to June 2018. The data obtained from the 265 respondents was assessed by the editorial team. The survey provided a snapshot of the current role and use of breast FNAB and the international variations. Demographic questions were followed by specific questions based on the draft category definitions and statements and focused on issues that had generated discussion among the authors, including the FNAB diagnosis of ductal carcinoma in situ. The survey results strongly supported the development of the IAC Yokohama System and informed subsequent discussions among the authors regarding the final text.

These guidelines were approved by the governing boards of the following six societies represented in the Intersociety Working Group for Cytology Technologies: American Society for Cytotechnology (ASCT), American Society of Clinical Pathologists (ASCP), American Society of Cytopathology (ASC), College of American Pathologists (CAP), International Academy of Cytology (IAC), and Papanicolaou Society of Cytopathology (PSC). The proposed guidelines as written reflect the current status of technologies in early 1997. These guidelines may evolve over time as newer technologies are developed.

The current state of digital cytology and artificial intelligence (AI): global survey results from the American Society of Cytopathology Digital Cytology Task Force

These guidelines were approved by the governing boards of the following six societies represented in the Intersociety Working Group for Cytology Technologies: American Society for Cytotechnology (ASCT), American Society of Clinical Pathologists (ASCP), American Society of Cytopathology (ASC), College of American Pathologists (CAP), International Academy of Cytology (IAC), and Papanicolaou Society of Cytopathology (PSC). The proposed guidelines as written reflect the current status of technologies in early 1997. These guidelines may evolve over time as newer technologies are developed. Diagn. Cytopathol. 1998;18:371–376. © 1998 Wiley-Liss, Inc.

Bending the virtual conference learning curve: After COVID-19 forced cytopathology conferences and meetings online, organizers have adapted and found some unexpected benefits amid the downsides.

This method for evaluating secondary screening (rescreening) instruments for gynecologic cytology was approved by the governing boards of 6 societies represented in the Intersociety Working Group for Cytology Technologies: American Society for Cytotechnology, American Society of Clinical Pathologists, American Society of Cytopathology, College of American Pathologists, International Academy of Cytology, and Papanicolaou Society of Cytopathology. The proposed method, as written, reflects the current status of technologies in early 1998.

The guidelines for the cytopathologic diagnosis of epithelioid and mixed-type malignant mesothelioma produced by the International Mesothelioma Interest Group and which are endorsed by the International Academy of Cytology and the Papanicolaou Society of Cytopathology are reviewed and discussed. This (predominantly) evidence-based document provides a robust and useful framework for diagnosticians and guideline producers to emphasise and promote the value, power and role of cytology in mesothelioma diagnosis and management with comments and suggestions about how the guidelines can be updated and improved in the future.

Breast Fine Needle Aspiration Biopsy: Prevailing Recommendations and Contemporary Practices

To provide practical guidelines for the cytopathologic diagnosis of malignant mesothelioma. Cytopathologists with an interest in the field involved in the International Mesothelioma Interest Group (IMIG) and the International Academy of Cytology (IAC) contributed to this update. Reference material includes peer-reviewed publications and textbooks. This article is the result of discussions during and after the IMIG 2012 conference in Boston, followed by thorough discussions during the 2013 IAC meeting in Paris. Additional contributions have been obtained from cytopathologists and scientists who could not attend these meetings, with final discussions and input during the IMIG 2014 conference in Cape Town.

To provide practical guidelines for the cytopathologic diagnosis of malignant mesothelioma (MM). Cytopathologists involved in the International Mesothelioma Interest Group (IMIG) and the International Academy of Cytology (IAC), who have an interest in the field contributed to this update. Reference material includes peer-reviewed publications and textbooks. This article is the result of discussions during and after the IMIG 2012 conference in Boston, followed by thorough discussions during the 2013 IAC meeting in Paris. Additional contributions have been obtained from cytopathologists and scientists, who could not attend these meetings, with final discussions and input during the IMIG 2014 conference in cape town. During the previous IMIG biennial meetings, thorough discussions have resulted in published guidelines for the pathologic diagnosis of MM. However, previous recommendations have stated that the diagnosis of MM should be based on histological material only.[12] Accumulating evidence now indicates that the cytological diagnosis of MM supported by ancillary techniques is as reliable as that based on histopathology, although the sensitivity with cytology may be somewhat lower.[345] Recognizing that noninvasive diagnostic modalities benefit both the patient and the health system, future recommendations should include cytology as an accepted method for the diagnosis of this malignancy.[67] The article describes the consensus of opinions of the authors on how cytology together with ancillary testing can be used to establish a reliable diagnosis of MM.

In January 2013, we will debut a new monthly format that represents the natural evolution of our journal from 6 issues to 12 issues per year. We will initiate this new schedule with another dynamite issue that highlights what Cancer Cytopathology strives to do with every issue: provide the best of cutting-edge research; highlight new paradigms of practice; and review important concepts, techniques, and diagnoses. Since Cancer Cytopathology launched in 1997, its focus has been to provide rapid and accurate peer review of the best current original research and timely commentaries and review articles. This commitment to our readers has allowed us to gain and maintain our standing as the premier journal in the discipline. Over the last 2 to 3 years, Cancer Cytopathology has continued to experience increased submissions of outstanding articles from acknowledged leaders in the field of cytopathology as well as from new authors, following a tradition of sound scientific research and publication. The success of this competitive selection process is reflected in our impact factor, which has continued to increase (from 2.773 in 2010 to 3.333 in 2011). This increase raises Cancer Cytopathology to the rank of 16 of 78 pathology journals and 65 of 194 oncology journals. To accommodate our authors and readers and to continue maintaining the excellence we strive to achieve with high-quality articles, increasing our frequency from 6 to 12 issues per year was the next logical step in our strategic plan. In addition to increasing the number of original articles we publish, our news and views feature, “CytoSource,” will continue to appear bimonthly in 2013. The increase in pages will also allow us to explore new ideas and concepts emerging in the disciplines of cytopathology and molecular biology and new ways of presenting that content outside the traditional article format. Our journal Web site continues to publish all articles online ahead of print an average of 8.5 weeks after acceptance and thus is the primary source for our latest content as well as online polls, free article access via Cancer Cytopathology Complimentary, “CytoSource,” and our annual newsletters, as well as access to tools for sharing content via e-mail, Facebook, and other social media. Our Web site also connects our readers to content highlights from the other American Cancer Society journals, Cancer and CA: A Cancer Journal for Clinicians. Cancer Cytopathology will continue to focus on content that caters to our readers' need for new, accurate, concise, and accessible information they can trust. Cancer Cytopathology seeks reviewers who are experts and scholars in their discipline and who will be expedient in their critical review of submissions, such that authors will continue to choose us as the preeminent journal to submit their research and reviews. One of the ways we believe Cancer Cytopathology will fulfill the above promise is with a restructuring of our Editorial Board. In addition to our 3 outstanding Associate Editors, we will have a new Editorial Advisory Board as well as a Review Board. As always, all our Editorial Board members represent the most prompt, active, and scholastic of reviewers. From this great group of individuals, we have selected expert reviewers in the fields of cytopathology and molecular biology to comprise the Editorial Advisory Board. These members will not only provide expertise in peer review and adjudication of articles, they will also present their input and feedback to the editors on emerging concepts and changing facets in cytopathology in addition to trends in molecular pathology that we want to communicate to our readership. As always, our Editorial Review Board members are an essential component of the success of the journal. These Board members are committed to providing timely, expert reviews that ensure excellent and current content for our readers. I hope you will share my enthusiasm as we enter this new growth phase for the journal. On behalf of the Associate Editors and the American Cancer Society journals program, I hope you continue to enjoy the various offerings that Cancer Cytopathology brings to you, our readers. We encourage you to visit our Web site, where we will be posting a call for papers in early 2013 for a special issue and highlighting some of the new content format that we hope you will enjoy. As always, we encourage your suggestions and input so that Cancer Cytopathology may continue to bring you the best available research, reviews, and updates in cytopathology!

The extension of automation to the diagnostic assessment of clinical materials raises issues of professional responsibility, on the part of both the medical professional and designer of the device. The International Academy of Cytology (IAC) and other professional cytology societies should develop a policy towards automation in the diagnostic assessment of clinical cytologic materials. The following summarizes the discussion of the initial position statement at the International Expert Conference on Diagnostic Cytology Towards the 21st Century, Hawaii, June 1997. 1. The professional in charge of a clinical cytopathology laboratory continues to bear the ultimate medical responsibility for diagnostic decisions made at the facility, whether automated devices are involved or not. 2. The introduction of automated procedures into clinical cytology should under no circumstances lead to a lowering of standards of performance. A prime objective of any guidelines should be to ensure that an automated procedure, in principle, does not expose any patient to new risks, nor should it increase already-existing, inherent risks. 3. Automated devices should provide capabilities for the medical professional to conduct periodic tests of the appropriate performance of the device. 4. Supervisory personnel should continue visual quality control screening of a certain percentage of slides dismissed at primary screening as within normal limits (WNL), even when automated procedures are employed in the laboratory. 5. Specifications for the design of primary screening devices for the detection of cervical cancer issued by the IAC in 1984 were reaffirmed. 6. The setting of numeric performance criteria is the proper charge of regulatory agencies, which also have the power of enforcement. 7. Human expert verification of results represents the "gold standard" at this time. Performance characteristics of computerized cytology devices should be determined by adherence to defined and well-considered protocols. Manufacturers should not claim a new standard of care; this is the responsibility of the medical community and professional groups. 8. Cytology professionals should support the development of procedures that bring about an improvement in diagnostic decision making. Advances in technology should be adopted if they can help solve problems in clinical cytology. The introduction of automated procedures into diagnostic decision making should take place strictly under the supervision and with the active participation and critical evaluation by the professional cytology community. Guidelines should be developed for the communication of technical information about the performance of automated screening devices by the IAC to governmental agencies and national societies. Also, guidelines are necessary for the official communication of IAC concerns to industry, medicolegal entities and the media. Procedures and guidelines for the evaluation of studies pertaining to the performance of automated devices, performance metrics and definitions for evaluation criteria should be established.

A brief review of the WHO reporting system for pancreaticobiliary cytopathology.