Evaluation of the Papanicolaou-stained cytological smear as a screening technique for asymptomatic gonorrhoea.

To assess the Papanicolaou smear as a screening test for asymptomatic gonorrhoea 311 women who had had simultaneous Papanicolaou smears and cervical cultures performed were studied. Of the 151 women who were culture-positive only 27 (18%) had a positive result by Papanicolaou smear. The presence of either endocervical or metaplastic cells did not increase the frequency with which gonococci were recognised. The eight cytotechnologists spent at least 30 minutes for each case looking for diplococci; the variability between observers was high. The possibility of using an already widely accepted diagnostic technique, such as the cytological smear, as a means of screening for gonococci is very attractive. Unfortunately in this study the excessive time taken to examine the slides, the poor correlation of observers' findings, and a low sensitivity for finding diplococci made the Papanicolaou smear an impractical method for detecting gonorrhoea in asymptomatic women.