The work of cytotechnologists has aided in a 50-percent drop in rates of cervical cancer over the past three decades. That change plus the evolution of technology and the introduction of a vaccine to prevent this cancer are leading to a shift in their focus.

Cytotechnologists have traditionally spent most of their work days screening Pap smears for signs of cervical cancer, which is caused by the human pappilomavirus (HPV), a common sexually acquired disease. A year ago, the American College of Obstetricians and Gynecologists (ACOG), recommended that women younger than 30 undergo cervical cancer screening once every two years instead of annually, and that those 30 and older be re-screened every three years.

Computerized and automated screening machines that perform pre-screenings have reduced cytotechnologists' workloads, and the HPV vaccine promises to do the same.

Change already underway

Pap smears still take up a great deal of cytotechnologists' time, but that is already changing, according to Michael Henry, M.D., medical director of the Cytotechnology School at the Mayo School of Health Sciences in Rochester (mayo.edu). It's the only school in Minnesota that trains these laboratory sleuths. Cytotechnologists must have a bachelor's degree and certification by the Board of Certification of the American Society for Clinical Pathology (ascp.org).

"We are seeing a transition now from cytotechnologists being predominantly GYN/cytology/Pap smear screeners to being much more involved in other types of diagnostics, including molecular studies," Henry said. "Cytotechnologists are very, very good at doing those sorts of things... They have the ability to look and find the needle in the haystack and to be able to identify it and classify it as abnormal."

The addition of molecular tests represents an exciting change, according to Sarah Lunde, a technical specialist in cytology at Methodist Hospital in St. Louis Park, part of Park Nicollet Health Services (parknicollet.com). Lunde said she and her colleagues have begun performing fluorescence in situ hybridization (FISH) tests to examine breast tissue specimens from cancer patients.

Patient welfare takes precedence

Lunde said that although interaction with patients is minimal, their welfare is of utmost importance. "What I always say is, treat every Pap smear like it was your mother's or sister's or daughter's," Lunde said. "How would you want that Pap smear screened?"

The job market for cytotechnologists is tight now, but that may change with an economic revival, Henry said. Starting salaries average $55,000 in the Midwest.

"It requires a definite level of dedication to be able to look at these types of specimens day in and day out," Henry added.