Exfoliative cytology in the detection of cervical cancer in Uganda

ABSTRACT

Walshe in 1851 observed fragments of malignant tissue in sputum; and duggeon and Patrick examined scrapings of tissues for malignant cells. In 1928; Papanicolaou used a similar wet fixation technique for diagnosing cancer of the female genital tract; although his classic paper with Traut was not published until 1943. Exfoliative cytology can now be applied to the study of sputum; stomach washings; pleural; ascitic and cerebrospinal fluids; aspirates; breast secretion and rectal and colonic specimens but it is in the cervix uteri that it is still of maximum value and most frequently used. Cervical cytology may be investigated to determine the hormonal status of the patient and thus serve as a guide to therapy. A second use is as an adjunct to other conventional diagnostic aids where there is an somiasis or tuberculosis. A third and more important use is in the detection of cancer in the population at large. It is this latter application that holds the greatest possibilities; has excited the greatest interest and is the subject of this paper. A group of women who would not otherwise be suspected of having cancer may be identified at a stage before the malignant process has become invasive; when it has an excellent prognosis and when it is treatable by limited surgery which is not mutilating; leaving the patient free incertain cases to have further children