Milwaukee deaths reignite critical issues in cervical cancer screening

Abstract

GHOSTS FROM the pre—CLIA 88 era have come back to haunt technologists, physicians, and patients who rely on the sensitivity of the Papanicolaou (Pap) test for detecting cervical cancer. Last month's news reports that a cytology laboratory was charged in Milwaukee, Wis, with reckless homicide in connection with misread Pap smears has left the cytopathology community with a disturbing sense of déjà vu. "This [Milwaukee] case is similar to several other stories that first started to appear in 1987," explains Stanley L. Inhorn, MD, medical director of the Wisconsin State Laboratory of Hygiene and professor of pathology and laboratory medicine at the University of Wisconsin Medical School in Madison. "What they focus on is not that people missed the [diagnosis], but that the laboratory practice was one in which cytotechnologists were being encouraged, if not coerced, into reading large numbers of Paps, quotas were being set, and they were paying