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1. Introduction and an overview of the evolution of the Pap smear to cervical cancer screening as it is today

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These chapters of the website were primarily designed for
Cytotechnologists and Pathologists (trainee and practicing)
who regularly examine cervical cytological preparations
The chapters are also designed for
General practitioners
Nurse practitioners
All these professional groups could benefit from the chapters that explain the effectiveness and limitations of cervical cancer screening as well as the sensitivity, specificity and predictive values of the various modalities involved in an increasingly multidisciplinary process


Summary of Chapters

The central theme of this section of the website is cervical cytopathology, which includes:

  • Guidelines for collecting cellular samples, comparison between conventional and liquid-based cytology, processing samples in the laboratory and automation 
  • Criteria for adequacy and terminology, normal cytology and benign/reactive changes, cytological abnormalities of precancerous lesions and cancer, and recommendations for management 
  • Pitfalls in cytological diagnosis 
  • Quality control, quality assurance and quality standards 

Chapters on background information include chapters on

  • Anatomy, histology and function of the cervix 
  • Epidemiology and aetiology 
  • Pathogenesis of cervical cancer and its precursors 
  • Principles of screening and measurement of its accuracy 
  • Effect of screening on incidence and mortality 
  • The role of HPV tests in cervical screening and the effect of vaccination

The final chapter will describe the place of cytology, colposcopy findings, HPV status and biopsies in a multidisciplinary setting 

Chapter 1 provides a histological overview up to the present day and refers to the chapters listed above.  References and sources of images in Chapter 1 are provided in the relevant chapters.


Although these chapters primarily deal with cervical cytology, the central focus is the woman, whose precancerous lesions must be diagnosed accurately and removed safely to prevent unnecessary anxiety or damage to her cervix while reducing the risk of progression to invasive carcinoma