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Cytopathology in focus: Three special reports capture a field in transition

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Kaitlin E. Sundling, MD, PhD
Jennifer Brainard, MD

January 2019—In the September/October 2018 issue of the Journal of the American Society of Cytopathology are three special reports from the American Society of Cytopathology/American Society for Clinical Pathology workgroup on current practices and future perspectives for the field of cytotechnology.

In the first, Roberson and colleagues at the University of Alabama and the American Society for Clinical Pathology present a comparison of the results of the ASCP Board of Certification 2015 survey with the previous 2009 survey.1 As anticipated with the new extended screening intervals for Pap tests, cytotechnologists reported a decrease in Pap volumes. Interestingly, they report performing other morphology-based tasks at a greater level, including cytology-histology correlation, interpretation of cell blocks, and interpretation of histologic stains. Although a small proportion of cytotechnologists reported involvement in selection and preparation of cytology specimens for molecular oncology testing, these did not yet achieve the authors’ majority threshold for emerging roles.1

Next, Friedlander and colleagues report complementary results from a combination of focus groups and a Rand Delphi study.2 A Delphi study aims to predict future trends based on expert opinions. The focus group reported a mismatch between cytotechnologists’ education and laboratory needs. The Delphi study identified emerging roles for cytotechnologists in fine-needle aspiration, rapid on-site evaluation, fluorescence in situ hybridization, immunohistochemistry, and molecular testing.2

In the third special report, Friedlander and colleagues focus on educational needs related to the practice changes discussed in the first two articles.3 Educational needs reported by survey respondents included cell block methods, FNA adequacy assessment, IHC, and molecular diagnostics. With these needs in mind, the workgroup developed the Advanced Cytopathology Education (ACE) in-person conference and the online educational platform ACE University.3

This trio of articles nicely captures the current transitional state of the field of cytotechnology, as declining Pap tests give way to emerging roles for cytotechnologists both within cytology and beyond. These articles provide an excellent overview of key areas to watch as the future of the cytotechnology profession

  1. Roberson J, Ali AM, Clark J, Eltoum I, Ritter D, Soles R. Changing practice patterns for cytotechnologists: a comparative analysis of data from the 2009 and 2015 ASCP BOC Practice Analysis Surveys. J Am Soc Cytopathol. 2018;7(5):232–239.
  2. Friedlander MA, Pineault LS, Roberson J, Wendel Spiczka A. Perspectives on expanded scope of practice in cytotechnology. J Am Soc Cytopathol. 2018;7(5):240–249.
  3. Friedlander MA, Pineault LS, Donnelly A, Giroux S, Naik K. Voices from the field: supporting the educational needs of cytotechnologists. J Am Soc Cytopathol. 2018;7(5):250–260.

Dr. Sundling is faculty director of the cytotechnology program, clinical instructor, and cytopathologist, University of Wisconsin School of Medicine and Public Health, Madison. Dr. Brainard is a staff pathologist and cytopathology section head, Cleveland Clinic. Dr. Sundling is a member and Dr. Brainard is vice chair of the CAP Cytopathology Committee.


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