Cervical cytology

Worldwide, comprehensive, quality assured population screening by microscopic examination of cellular material obtained from the cervix has significantly reduced the incidence of and mortality from invasive cervical carcinoma. It has been estimated that cytology-based population screening has prevented up to 4500 deaths a year in England: it is a simple, safe and inexpensive method of detecting cervical premalignancy. Provided that the sample is correctly taken and is interpreted with skill and care, it will provide the general practitioner or gynaecologist with reliable information about the state of the cervix and enable them to reassure the woman about her risk of cervical neoplasia with a high degree of confidence.

INDICATIONS FOR A CERVICAL CYTOLOGY TEST

There are two indications for taking a cervical cytology sample:

1. • population screening for cervical precancer and early cervical cancer

2. • as part of the follow-up after treatment of cervical neoplasia.

Population screening

Worldwide, there are nearly half a million new cases of cervical carcinoma a year, of which over 75% occur in developing countries, where at best cervical screening is opportunistic and a cervical cytology test is only available on request. By contrast, in many developed countries, screening healthy women for preinvasive and early invasive cancer of the cervix is highly organised and well women are invited at regular intervals to attend for a cytology test.