Measure on Pap Smear Standards Advances

Responding to concerns about the accuracy of Pap smears used in the early detection of cervical cancer, the Assembly on Thursday overwhelmingly passed a bill to toughen standards for laboratories and the technicians who evaluate the tests.

“This is a matter of life or death for women,” said Assemblywoman Sally Tanner (D-Baldwin Park), author of the measure, which passed 55 to 9.

The bill, which now goes to the Senate, places a limit on the number of Pap test slides a technician can review during any eight-hour day and requires both labs and technicians to be tested regularly for accuracy.

A similar measure was passed by the Legislature last year but vetoed by Gov. George Deukmejian. The governor complained of what he called “a major intervention into the private sector by government” without evidence that California women are being hurt because of unreliable Pap tests.

But Tanner and other supporters of the legislation argued that there now is ample evidence that a serious problem exists.

Tanner cited the case of one of the biggest clinical laboratories in the country, Central Pathology Services Medical Group in Tarzana. The lab was shut down by state health officials last month after inspectors found that 21% of Pap tests in a sample of 1,103 had been diagnosed in error, according to a spokesman for the Department of Health Services. Most alarming was the finding that 143 of those slides--13% of the total--were incorrectly diagnosed as showing no sign of cancer.

State officials complained that Central Pathology technicians were examining more than 100 slides a day each--too many to be accurate.

Annual Load

The lab annually handled nearly 700,000 tests that had been sent by physicians from California and other parts of the country.

Pap smears--named for Dr. George Papanicolaou, who developed the procedure--can detect 90% of cervical cancers at a stage when they still can be effectively treated. A standard physician’s reference book credits the test with reducing deaths from cervical cancer by 50%.

But physicians depend on the accuracy of pathology labs to prepare and evaluate slides made from cells scraped from a woman’s cervix and vagina.

Under the Tanner bill, the technicians, called cytotechnologists, would be licensed and regularly tested by the state. And laboratories would have to recheck a sampling of slides regularly.