• The accuracy of diagnostic tests for carcinoma of the cervix was studied in a series of 5,617 women in whom cancer had not been previously diagnosed or treated. Each patient, in addition to a gynecologic history, abdominal and pelvic examinations, and cervical palpation and inspection, had multiple punch biopsies and cervical and vaginal smears.
Of the 310 proved cases of cervical cancer in this series, 222 were correctly diagnosed by the initial smear. Analysis of the data for false-positive, false-negative, and dubious or conflicting reports leads to the conclusion that the greatest value of the cervical smear lies in the detection of early cervical lesions and that it should be used as a screening technique for the detection of lesions in the grossly unremarkable cervix.
The cervical smear and biopsy are complementary adjuncts in the detection of cancer. Definitive diagnosis is never justified on the basis of one smear. Multiple biopsies are frequently necessary for complete clinical evaluation of the case before instituting definitive therapy.