title: Death of the Papanicolaou smear? A tale of three reasons.
abstract: The Papanicolaou smear is arguably the most cost-effective cancer screening test ever devised. Yet future availability of this low-cost test is seriously threatened by increasing litigation, huge awards, and the implied linkage between "error" and "negligence." The expectation of a 0 error standard, even for a screening test, is central in the current medical-legal climate. Three reasons for this escalating problem will be explored, as follows: (1) substandard laboratories; (2) misunderstanding of the Papanicolaou smear by the media, the public, the legal profession, and physicians, compounded by the "greed factor"; (3) an "acceptable error rate" in quality laboratories for Papanicolaou smear screening. I will explore the future of the Papanicolaou smear and will make specific recommendations for all obstetricians-gynecologists.
authors.affiliation: University of Mississippi Medical School, Mississippi Baptist Medical Center, Jackson, USA.
authors.forename: R C
authors.initials: RC
authors.lastname: Boronow
mesh_terms: D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007753:Laboratories; D065006:Papanicolaou Test; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis; D014626:Vaginal Smears