Current status of cytology laboratories in anatomic pathology departments.

Details of cytology work in 103 US histology laboratories (histolabs) and in 200 from 18 other countries are presented. Data from 1345 additional US cytology practices surveyed from 1985 to 2004 are also included. The average annual workload in 130 histolabs from the United States and 12 other countries combined is 32 200 cases. The average annual workload in 173 histolabs from Spain and 5 Hispano-American countries is 20 000 cytology cases, a workload that is significantly lower (P < .0005) than that in US laboratories. Gynecologic cases, with an average of 1.2 slides each, represent 79% of all cytology accessions in all laboratories. The average annual workload per cytotechnologist (CT) is 6600 cases; this number is not significantly different between countries (P > .10 to P > .75) and is significantly correlated (P < .0008) with the laboratories' total workloads. In the United States, the average annual productivity per CT is 6700 cases with 1.8 slides each, for a daily screening of 55 to 60 slides. The annual benchmark is from 7900 to 8700 cases, equivalent to 14 300 to 15 000 slides per each full-time CT position. The benchmark per cytology aide is 17 000 to 20 000 cases. The number of CTs per histolab is significantly correlated (P < .0002) with its workload. In the United States, there is an average of 4 CTs and 2.7 cytology aides per laboratory, and the cytology tasks completed by the histology staff average 4.1 hours daily. The average turnaround time for cytology cases in the United States is approximately 6 calendar days, with 90% of all cases signed out between 7 and 8 calendar days. In addition to the productivity benchmarks, the pathology leadership must address the ergonomic conditions of the work when filling a new CT position because muscular discomfort caused by the microscopy work is a common occurrence.