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July 19, 1965


JAMA. 1965;193(3):221-222. doi:10.1001/jama.1965.03090030043012

The incidence of intraepithelial cancer is directly related to the development of an aggressive cytology program in any city or county. The gradual shift of cervical cancer from the invasive to the noninvasive stage means greater problems in histopathological diagnosis. Friedell has indicated the need for a specific terminology and an understanding of transitional changes and difficulties in defining what constitutes carcinoma-in-situ. Although he stressed the need for adequate pathological material, he did not dwell on the advantages of multiple biopsies with a square-jawed punch and cervical curettage as contrasted to sharp-knife conization. Multiple biopsies can be done as an office procedure with minimum personnel and equipment; they yield high diagnostic accuracy and few complications. Many gynecologists favor conization because of the completeness of the specimen and because this procedure has therapeutic as well as diagnostic value in most instances.

With the spectrum of pathological findings in stage O cervical