SPUTUM CYTOLOGY - A LIMITED ROLE

Aims-To determine the cost and sensitivity of sputum cytology in routi ne use and to determine when sputum cytology is most appropriate. Meth ods-A retrospective study, based on all sputum cytology requests recei ved in five histopathology/cytopathology laboratories in Yorkshire fro m 1 January to 31 December 1993. Cytology findings were correlated wit h histological diagnosis or clinical outcome, and related to the speci ality of the referring clinician. Results-Laboratory practice and perf ormance was similar in all five centres. The average laboratory cost o f sputum cytology was pound 26.93. The mean absolute sensitivity was 3 6% and the specificity was 99.6%. The majority of specimens was submit ted by general physicians or geriatricians. The largest proportion of positive specimens were submitted by chest physicians. Conclusions-Oft en sputum cytology is used inappropriately as a screening investigatio n on, or soon after, admission. In addition, it is used inappropriatel y before bronchoscopy. Sputum cytology should be limited to individual s in whom a histological diagnosis is desired, but in whom bronchoscop y is inappropriate or unsuccessful.