A Report of Current Practices and Trends in New York State

A survey was conducted among 130 New York State (NYS) registered cytology laboratories to better understand current and future changes in the practice of cytology, changes in the cytotechnologist (CT) scope of practice, and the future need for CTs. A 51.5% (67/130) response rate was obtained. Trends for gynecologic case volume varied across facility types. Nongynecologic volume is growing primarily in hospitals and large medical center laboratories and private laboratories; the fine-needle aspiration volume is growing in hospital and large medical center laboratories. One third of responding laboratories anticipate a continued demand for CTs within the next 3 years owing to impending retirements. Few laboratories also report the gradual adoption of molecular testing with CTs directly involved. Because 60% (3/5) of NYS CT training programs have closed since 2008, the 2 remaining programs are a valuable key staffing resource for CTs. Continued viability of these programs is essential to provide the necessary training and staffing of NYS laboratories for cytopathology practice. Cytotechnologists (CTs) are laboratory professionals who perform high-complexity testing that traditionally includes microscopic screening and interpretation of gynecologic, nongynecologic, and fine-needle aspiration (FNA) specimens. CTs are highly educated “physician extenders” specifically trained in analyzing cellular morphologic features and their relationship to disease processes. In recent years, there is evidence that some CTs are assuming additional nontraditional responsibilities, including interpretation of molecular tests such as fluorescence in situ hybridization (FISH), laser capture microscopy, tissue banking, archiving digital image files, and provision of immediate adequacy assessment of FNA biopsy specimens. 1-3 Some CTs also assume active roles in laboratory management, hospital administration and leadership, quality assurance, patient safety and risk reduction, commercial ventures, education, and research. 2,4 There is anxiety and speculation, however, that CTs may not be needed in the future owing to screening with automated and image-assisted Papanicolaou (Pap) test devices, human papillomavirus (HPV) DNA testing, changes to cervical cancer