CA: A Cancer Journal for Clinicians, Vol 10, 182-193, Copyright
© 1960 by American Cancer Society
Exfoliative Cytology of the Uterine Cervix and Vagina
Leopold G. Koss M.D.1
1 The Memorial Hospital for Cancer and Allied Diseases, New York, N. Y.
Our present general knowledge pertaining to the early stages of cancers of the cervix and the vagina may be summarized as follows:
1. By application of cytology to the detection of cervix cancer in the in situ stage, it is within the reach of the medical profession to reduce very significantly the mortality rate due to this disease.
2. All, or nearly all, of the carcinomas of the cervix arc preceded by the stage of carcinoma in situ.
3. In situ carcinonia may remain stationary for periods varying from one to 10 years or longer. If adequately treated, the prognosis is excellent.
4. The evidence presently available suggests that not all in situ cancers invariably develop into invasive cervix carcinoma within the lifespan of the patient.
5. The presence of in situ carcinoma in limited biopsy material calls for further investigation of the cervix to rule out the concomitant presence of invasive cervix cancer.
6. If invasion has been ruled out, in situ carcinoma ceases to be a surgical emergency. It can be treated electively and without urgency.
7. In the presence of cytologic findings which suggest epidermoid or squamous carcinoma, a thorough search should be instituted for carcinoma of the vagina or the vulva, if the lesion cannot be localized within the cervix.
8. Metastatic cancers from sites other than the genital tract may occasionally be the cause of positive genital smears.
