AUTOMATED SCREENING OF CERVICAL CYTOLOGY SPECIMENS

After more than four decades of research into automation of the proces s of screening Papanicolaou (Pap) smears, attempts to develop commerci ally viable automated screening machines have increased in recent year s. These developments have been made possible in part because of the i mproving price-to-performance ratios in computers and other electronic s. Although the Pap smear has been responsible for a very significant decrease in mortality of cervical cancer over the past 40 years, conce rn has arisen over false-negative cases, with their effects on patient s, and the associated legal liability, particularly in the United Stat es. In addition, shortages of cytotechnologists, which have been exace rbated by new regulations limiting the number of slides that may be ex amined per day, have caused concern about handling the workload, which will probably increase as more individuals gain access to preventive health care. Automated screening machines can potentially allow detect ion of abnormal cases that are missed with conventional screening, alt hough they may substantially increase the cost of Pap smears. The use of automated screening machines represents a change in the way cervica l cytology specimens are processed, and with some machines, a signific ant change in the operation of the cytology laboratory. Current method s for processing and evaluating Pap smears have not changed significan tly for the past four decades. This review discusses some of the princ iples of operation and practical aspects of automated screening machin es. (C) 1996 by W.B. Saunders Company