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September 4, 1948

DIAGNOSIS OF PRECLINICAL CANCER OF THE CERVIX: Cervical Cone Knife: Its Use in Patients with a Positive Vaginal Smear

Author Affiliations

Montreal, Canada

From the Cancer Research Division, Gyne-cytology Laboratory, Royal Victoria Hospital, McGill University, Montreal.

JAMA. 1948;138(1):11-13. doi:10.1001/jama.1948.02900010013004

Recent advances in methods of cancer detection by Papanicolaou's1 vaginal smear and the subsequent development of the "surface-biopsy"2 cell-scraping method offer a valuable method of uterine cancer control through early diagnosis. A danger exists, however, that the method might fall into disrepute if hysterectomy were widely practiced on the basis of a cytologic diagnosis alone. Especially could this become true if inexperienced and inadequately trained cytologists were to influence the surgeon's judgment unduly. It therefore seems indicated that every effort to confirm a positive cell diagnosis by biopsy be made before subjecting the patient to radical treatment.

The sensitive "surface biopsy" method, when applied routinely, is bringing to light more and more cases of preclinical cervical cancer. This poses a genuine problem for the surgeon or gynecologist in attempting to confirm the cell diagnosis by cervical biopsy. The work of Novak,3 Schiller,4 Pund and Auerbach5