Cancer Cytology: History (May 1948 - Present)

The Cancer Cytology Unit at the North Carolina State Laboratory of Public Health is the first public health laboratory in the United States to enter the cytology field and stay in continuous operation.

In 1947, Dr. John Hamilton, director of the State Laboratory of Hygiene, read the publication, The Diagnostic Value of the Vaginal Smear in the Diagnosis of Uterine Cancer by Dr. George N. Papanicolaou and HF Traut. He decided to help fund a new Cytology Laboratory at Duke Hospital to evaluate if this new procedure could be used in public health.

Dr. Hamilton selected Mr. Earl Emory, a parasitologist at the State Laboratory of Hygiene, to study at the newly created Cytology Laboratory at Duke Hospital. Mr. Emory began his study in May, 1948 with Dr. John H. Kernodle and Dr. W. Kenneth Cuyler at Duke Hospital. He returned to the State Laboratory of Hygiene to begin establishing the Cytology Laboratory. In June, 1949, Mr. Emory had the opportunity to study with Dr. George N. Papanicolaou, founder of the Pap smear and cervical cytology, at his lab at Cornell Medical School in New York. After returning to North Carolina, the Cancer Cytology Unit began to perform testing and expand its services in public health.

Interesting Facts about the Unit

• In early 1960, the chief of the Chronic Disease Section, Dr. Frank Milam and Mr. Emory were able to secure federal funds to establish a training program for cytotechnologists at Bowman Gray Medical School in Winston-Salem, NC. The program was so popular, the federal government set up a 10-year program to fund schools in hospitals across the United States. At the end of the 10 years, the federal funds elapsed and the enrollment fell, but not before 2,950 cytotechologists had been trained and registered. (The American Society of Cytology Bulletin, Volume XXIX, Number 2, 1992.
• In 1969, the Cancer Cytology Unit assisted the West Virginia State Laboratory of Public Health in starting a cytology program in their state.
• In May, 1970, the unit processed and cytodiagnosed its one-millionth Pap smear.
• Mr. Emory worked with the National Center of Disease Control in Atlanta, Georgia to help them develop a cytology evaluation program in 1970.

Today, the Cancer Cytology Unit is still in the forefront of the profession. Gyn Cytology smears are processed using a liquid based cytology preparation, ThinPrep®. In 2008, Human Papilloma Virus (HPV) testing was added to the test menu; this molecular test provides additional diagnostic information for public health patients in North Carolina.

Changes through the Years

Five Years Ago	Now
Conventional Pap Smears	ThinPrep® Slides with Imaging
No additional testing	HPV testing
Abnormal slides mailed to pathologists for review	Pathologist on staff to review abnormals
Turn-around time: 8-12 days	Turn-around time: 3-5 days

SLPH Cancer Cytology Information

• Overview
• History
• Descriptions
• F.A.Q.s
• Online Resources