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September 2001
saw the 40th annual meeting of the British Society for Clinical
Cytology. The meeting was hosted by the Leeds Teaching Hospitals/
Harrowgate Healthcare and held in the lovely town of Harrogate at
the very impressive Majestic Hotel.
On arrival we
were greeted by Dr Andrew Boon and his fellow workers who sought
to make us feel very welcome and presented us with a bone china
mug as a souvenir of our visit. I still have the mug presented to
delegates at the 25th annual meeting of the BSCC held at Durham
University. At that time the commemorative mug was made of pottery.
I am not sure if the change from pottery to bone china marks the
change of status of cytology or merely a different part of the country.
The trade show
was very good reflecting the magnificence of its setting in the
huge lounge of the hotel where doors led out on to a veranda and
lawns that must have seen many an elegant ball gown and were now
host to a lively bunch of enthusiastic cytology personnel. Slide
seminars were held in the elegant reading and drawing rooms. We
sat beneath beautiful chandeliers and screened smears prepared by
liquid based techniques and attempted to improve our knowledge of
LBC with the help of Nick Dudding. The group I shared this experience
with, I hope, all left feeling as I did that it had been well worth
making the effort to attend.
Lectures held
in the modern spa suites were all of the excellent standard we have
come to expect from the annual meeting. Topics ranged on Monday
from HPV testing and its practical use as part of the recall program
within cytology to organization and staffing of future laboratories.
Preferred papers included the 'Leicestershire Audit' that hit the
headlines in the summer of 2001 and few of us had not already heard
of. It was however useful to hear details from the staff themselves
rather than the interpretation of the press. I feel the lesson learnt
is an old one known by cytology staff but still not understood by
the general public. Cytological interpretation is not easy.
To the old chestnut
of definitions of dyskaryosis - BSCC versus Bethesda - may the best
'term' win.
Tuesday was
mainly a 'specialist' day with a symposium on Head and Neck FNA,
and the guest lecture on Salivary gland FNA'. However one set of
preferred papers between 11 and 12 o'clock were gynaecological and
included the fascinatingly entitled 'A review of Post-Trachelectomy
Ishmic smear cytology'. This lecture discussed the treatment of
young women with cervical cancer and the conservation of the uterus
to allow fertility to remain. The tumour is resected and vagina
and uterus reunited forming an isthmic-vaginal anastomosis from
which brush samples are taken at cytology follow up. Although few
of these operations are contemplated, they will be undertaken at
centres of expertise, and patients are likely to be referred from
all over the country. 43 were performed between 1994 and 2000 at
St Bartholomew's Hospital. Long-term follow-up will revert to their
local hospital. It does seem wise to know that such techniques are
being practiced and the type of cells one can expect to see. Hopefully
this lecture plus illustration will appear in an addition of cytopathology.
Many of us will never have cause to need it but best to be prepared.
So another year
has passed, an important landmark for cytology. Its ruby anniversary,
40 years from first taking a few hesitant steps in a handful of
laboratories around the country. Employing a few consultants often
travelling between several hospitals where the newly created cytology
departments were staffed by enthusiastic 'med lab technicians' interested
in microscope work and willing to learn something new. Now we have
cytology established in most hospitals. The departments expect to
employ possibly 2 or more consultants with a staff of Biomedical
scientists and cytoscreeners. There is a training programme and
examinations. We have quality control and a National Health Service
Cytology Screening Programme.
Between now
and its golden anniversary what will happen in the next 10 years.
Hopefully steps forward to improve the service for both staff and
patients. Maybe a technique that will help to remove the anxiety
shared by both. Maybe it will be LBC followed by some sort of automation.
We wait to see. All I know is that I will be retired by then and
despite many 'scares' that Cytology is not going to survive 40 years
on, it is still going strong and all being well will continue to
do so.
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