Between September 1984 to November 1992, 19,062 cases of cervical smears were taken from women, of which 12,248 cases964.3%) were from those who visited Health Care Center in Taejon for routine check, while 6,814 cases(35.7%) were taken from the
patients who come to the local OBGYN clinic in rural area in Chungnam Province. The 36.1% of total cases had been taken in 1991 and 1992, indicating the growing interest to routine cervical smear among the women of this region.
For internal quality assurance, I have taken special care in sampling, staining, screening, reporting and reviewing. Especially for sampling, cardboad-spatula-spray method had been used for smear and fixing. The responsibility of the clinician
lies
not
only in simply obtaining a Papanicolaou smear but also in the seletion of the sampling device and the cytology lab, as well as in the education of the patients in properly preparing for the smear to be taken. Combining of Papanicolaou
classification and
Bethesda system for reporting cervical vaginal cytologic diagnosis was developed internally for clinician.
The distribution of cytopathological report was 57.2% Class I:39.8%, Class II:1.3%, Class II III; 1.3%, Class III;0.4% Class IV. Amolng those cases beyond Class III of 318 cases(1.7% of total cases), 163 were form OBGYN Clinic, 145cases Health
Care
Center. After the follow up biopsides for 247 cases over Class III, 8 cases were confirmed as invasive cervical cancer, all from OBGYN clinic, while none of those from Health Care Center were thus confirmed. This means routine check without any
symptom
is nessesary for early detection of cancer. 10% of all negative smears (Class I. II) were rescreened randomly for quality assurance. Over all, sensitivity of 97.2% (error was 2.8%) resulted in report, which may be evidence of high degree of
internal
quality assurance.
It is very likely that not only for cervical cancer but for the early detection of all kinds of cancer, quantitative cytology will be prevalent in the near future. For this expected development, many screeners and cytopathologists will shortly be
in
demand who are qualified both in terms of professional and ethical responsibilities. And also for the regular check up, review and the maintenance fo the report, the life time health monitoring program is needed to be developed using computer
based
monitoring system.
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