The diagnosis of genital malignancy by vaginal smears

Six thousand, seven hundred fifty-three smears on 1,709 patients have been studied. The smears were obtained, stained, and classified by the methods of Papanicolaou and Traut. One hundred fourteen patients with genital malignancy were diagnosed by smears out of a group of 124 diagnosed by pathology; a percentage error of 8.1.False positive diagnoses were made in 34 of 1,585 patients; a percentage error of 2.1.Nine patients have been presented who illustrate the diagnosis of genital carcinoma by the vaginal smear method. These include squamous celled carcinoma of the cervix, 5; squamous celled carcinoma of the vulva, 1; sarcoma of the uterus, 1; and chorionepithelioma, 1. Those patients having squamous celled carcinoma of the cervix show that the diagnosis of malignancy sometimes may be made earlier by smears than by the biopsy method.Primary adenocarcinoma of the oviduct was revealed in the vaginal smears of one patient.One patient with adenocarcinoma of the endometrium in which smears were negative even when they were obtained from the tumor surface is reported to show a weakness of the smear method.Salient features, good and bad, of the vaginal smear method in the diagnosis of genital cancer have been presented.It is thought that this procedure will become routine in the complete physical examination of women, but that treatment for malignancy should not be instituted prior to pathologic tissue confirmation.