Does a zero error standard exist for the Papanicolaou smear? A pathologist's perspective.

A review of the error rate of cervicovaginal cytology in light of the increasing litigation over alleged misread Pap smears is presented. Public expectation for the eradication of death from carcinoma of the cervix has not been realized. The gap between that expectation and test performance of the Pap smear is examined historically and in light of current regulations that impact on cytology laboratories. It is imperative to educate the public as to the value and limitations of screening for cervical cancer by the Pap smear and to develop reasonable practitioner standards for the performance of the test. The current climate of increasing litigation over alleged false-negative Pap smears has the potential to reduce the use and availability of this test which is still considered the most effective cancer screening test devised.