The accuracy and reliability of Pap smear testing is a major public health concern. As the most important tool in prevention of cervical cancer, an accurate Pap smear is vital to promoting women's health. Charged by HHS to develop cytology laboratory standards and a national cytology proficiency test (PT) as a part of the CDC CLIA responsibility, the Division of Laboratory Systems in the Public Health Practice Program Office at CDC has undertaken a broad effort to improve quality of cervical cytology performance.

Activities:

• A plan to implement national cytology PT has been initiated based on recommendations from a CDC-conducted national meeting and from the Clinical Laboratory Improvement Advisory Committee. The regulatory modifications necessary to fully implement the plan are under development.
• A major cytology research study, comparing Pap smear screening performance in the actual work environment, rescreening, and cytology proficiency testing (PT) using glass slides to answer the question of whether cytology PT (both glass slide and computer-based testing) measures actual performance has been pilot-tested. The full study is being conducted.
• Cooperative agreements with the American Society of Clinical Pathology, New England Medical Center, and Thomas Jefferson University have demonstrated that computer-based cytology PT programs are not only feasible, but also seem to be acceptable to cytotechnologists as measures of their ability to identify abnormal cells in Pap smears.
• The first phase of development of a prototype computer-based cytology slide imaging system (CytoView™) , which will permit an assessment of both the cell location and identification skills of cytotechnologists using a computer, is nearing completion.
• It is important that cytology personnel have opportunities to improve their skills in the interpretation of Pap smears in a learning environment. Glass slide self-study sets provide practice in the Bethesda System; they are available from the National Laboratory Training Network(NLTN). In addition, two interactive computer-based training programs, Bethesda System and Dysplasia, are in development and will be released through the NLTN shortly.