UPDATE ON THE PAPANICOLAOU SMEAR - NEW ISSUES FOR THE 1990S

The Papanicolaou (Pap) smear is a complex examination that has undergo ne refinement in recent years. It is now widely accepted that a false- negative rate of perhaps 10 to 20% is inevitable for a variety of reas ons. The diagnosis of ''atypical cells of undetermined significance'' is not a benign diagnosis and is often followed by a more severe lesio n on follow-up. The Pap smear appears to be an inefficient method for detecting glandular neoplasms, and clinical features remain the most i mportant diagnostic clue. A Pap smear and cervical biopsy should corre late in 75% or more of cases. In cases of noncorrelation, a positive P ap smear diagnosis is supported in the vast majority of cases.