Author: Marlin Rosa, M.D. (see Authors page)

Revised: 23 April 2017, last major update September 2010

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PubMed Search: Cervix cytology [tile]
Table of Contents
Definition / general
Cite this page: Cytology. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/cervixcytologycytologygeneral.html. Accessed October 20th, 2018.
Definition / general
  • The most successful application of clinical cytology is diagnosing cervical abnormalities before they develop into invasive cervical carcinoma
  • Used for screening and follow up of cervical carcinoma, particularly squamous carcinoma
  • Cytology smears are sensitive to abnormalities, although there is variable interpretation on any particular smear
  • The most important factor is to detect an abnormality and to start an appropriate management plan
  • Specimen should be obtained and prepared by trained individuals
  • False negative tests are often due to poor quality specimens and inadequate sampling (Mod Pathol 1992;5:337) or interpretation/ screening errors
  • Endocervical sampling should be performed to confirm that the entire transition zone was sampled, although many studies show no association between the absence of endocervical cells / transition zone and a higher risk of squamous lesions on subsequent smears (Am J Clin Path 2001;115:851, Acta Cytol 1986;30:258, Cancer 2001;93:237, Lancet 1991;337:265)
  • For endometrial carcinoma, pap smear is only 50% sensitive; 60% with cervical scrapings, 75% with vaginal pool material; thus, pap smears are not appropriate for screening endometrial abnormalities (Cytopathology 2009;20:380)
  • Liquid based cytology performed by cytocentrifugation is reported to be efficient and inexpensive (CytoJournal 2005;2:15); is associated with higher rates of LSIL and lower ratios of atypical squamous cells/LSIL (Arch Pathol Lab Med 2004;128:1224, Arch Pathol Lab Med 2003;127:200)