The Use of the Cervical Spread in Cancer Detection
JAMES S. KRIEGER, M.D.
Department of Obstetrics and Gynecology
LAWRENCE J. McCORMACK, M.D.
Department of Pathology
With the technical assistance of Doris Belovich, B.S.
THE cervical spread, stained by the Papanicolaou method, is so useful that it is in danger of being looked upon as an infallible diagnostic aid — both by physicians and by patients. Some surgeons have performed hysterectomy on the sole basis of a cytologic diagnosis of cervical cancer; and patients themselves have become so imbued with the fear of cancer that the mere mention of their having an atypical or a positive “cancer spread” persuades them that immediate drastic treatment alone will avoid the consequences of the dread disease. The cervical spread has great diagnostic value only if the physician is fully aware of its specific limitations.
It is the purpose of this report to indicate some of the sources of possible error in making a cytologic diagnosis, to describe an effective cervical spread technic, and to summarize our results from its use.
Sources of Error
Cytologic study, like other laboratory studies, is subject to technical and human error. The judgment and actions of several persons are involved. They are: (1) the patient, (2) the examining physician, (3) the cytotechnician, and (4) the pathologist.
The fastidious patient usually will take a douche in preparation for a pelvic examination, not realizing that cells of diagnostic value may be washed away or destroyed. Normal findings after a douche could be false. Every woman who makes an appointment for a pelvic or a general examination should be advised to refrain from douching for from 48 to 72 hours before the examination.
The examining physician . . .