The cervical smear test in the next millennium

AR Chang
Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong

This paper traces the cervical Papanicolaou smear test from the seminal work of George Papanicolaou undertaken more than 70 years ago, to the present use of computer technology to examine cervical smears. However, to successfully detect cervical cancer and precursor lesions, the standard of the specimens, as well as that of the screening laboratory, must be of the highest order so that false negative results are eliminated. Newer sampling devices, techniques for improving specimen quality, computerised laboratory technology, and the need for laboratory accreditation are also discussed. The Papanicolaou test is the most successful test invented for cancer prevention but despite this, up to two thirds of Hong Kong women have not had a test. There is a need for more public health education directed at women so that there is a greater awareness of the importance of disease prevention, with an emphasis on cancer prevention. The implementation of a cervical screening programme in the new millennium will ensure that women receive all the benefits that the Papanicolaou smear test can confer.

Hong Kong Med J 1999;5:294-302

Key words: Cervix neoplasms, prevention & control; Diagnosis, computer-assisted; Laboratories/standards; Vaginal smears/methods