History of the Australian Society of Cytology
Cytology laboratories and screening programs for the early detection of cervical cancer began to emerge in Australia in the middle to late 1950s. The concept that cancer could be diagnosed by examining exfoliated cells was viewed with scepticism by many, including anatomical pathologists. In Australia, as in North America, it was the gynaecological fraternity who were the first to realise the potential of the technique in saving lives of women. It was often the pathologists from Women’s Hospitals and sometimes gynaecologists themselves who became the promoters of cytology in Australia and journeyed to the centres of learning in North America and the United Kingdom to be educated in this emerging field.
Dr Gladstone Osborn was (in 1948) the first to leave Australian shores to work with Dr Papanicolaou at Cornell University Medical School. Dr Osborn was a strong proponent of correlating cytologic changes with the histologic diagnosis and, as a result, in 1953 his text Applied Cytology was the first Cytology book published by an Australian author. Others to pursue their interest in this new discipline overseas were Dr Mary Heseltine (NSW) in 1955, Dr Hans Bettinger (Vic) in 1956, Dr Bruce Gutteridge (Qld) in 1956, Dr Ruth Osmond (SA) in 1958, Dr Ted Macarthur (ACT) in 1959 and Dr Elaine Waters (WA) in 1960.
It was, however, Dr Hans Bettinger’s visit to Dr George Wied in Chicago in 1956, which had the most influence in Cytology becoming a new diagnostic tool in Pathology. As Director of the Royal Women’s Hospital in Melbourne, he invited Dr Wied to Melbourne to instruct a select group of Pathologists and technicians in the diagnosis of cervical cancer by “Pap” smear. Two Australian Society of Cytology Honorary Life Members (Dr Bob Barter and Miss Patricia Archer) were graduates of this course and passed on this unique teaching experience to those who followed. Dr Barter was instrumental in setting up the first tertiary cytology teaching facility in Australia for the training of screeners as a resource for the emerging cervical screening programs and Pat Archer was similarly involved with Dr Drake in setting up the teaching facility at Prince Henry’s Hospital, Melbourne in 1962. By the mid-1960s, most pathologists had returned to their respective states in Australia to establish cytology laboratories. Population screening programs were introduced with financial aid being sought from governments.
There, however, was very little communication between states or individual laboratories and there were no coordinated training programs for pathologists or cytotechnologists. Cytologists followed their discipline in virtual isolation compared to their colleagues in other disciplines. Dr Michael Drake, on returning to Melbourne after an intensive training course in cytology with Dr John Frost in Baltimore USA, realised the urgent need for these issues to be addressed. In 1966 he was the prime motivator in establishing the Victorian Society of Cytology. This Society did not become active until 1968 and by this time plans were being formulated for a national society.
Dr Drake was the main instigator and worked hard to coordinate laboratories and cytologists around Australia. A national interim committee was formed in Sydney in 1969 to ascertain the need for a national body and to develop a constitution.
The inaugural meeting of the Australian Society of Cytology was held at 4:00pm on 26 August 1970 in the Arts Building, University of Western Australia, and the constitution, developed by Dr Ben Wadham, was accepted. Elected office bearers were: President, Dr Michael Drake; Vice President, Dr Robert Barter; Honorary Secretary and Treasurer, Dr Denys Fortune. State representatives were: Dr Alf Gatenby (NSW), Dr James Kirkland (SA), Dr Peter Foote (Qld) and Dr Cam A Duncan (Tas). There were 50 inaugural members of the Society.
The aims as set out in the Constitution were to provide a forum for the exchange of ideas; to foster an interest in training; to achieve uniformity in interpretation and reporting; to advance knowledge; to encourage research; to liaise with similar bodies and to represent the special interests of the Society. Over the next few years, the larger states formed branches in accordance with the constitution and in later year, branches were formed in the Australian Capital Territory, Tasmania and Northern Territory.
Non-gynae cytology was practised in tandem with the cervical screening, but was not deemed as important until better treatment regimes and more accurate diagnostic tools were developed. The introduction of FNA in the early 70s also promoted non-gynae cytology.
Private cytology laboratories, often set up and owned by pathologists, operated in parallel with public laboratories and continue to do so although many have now merged with publicly-listed companies.
One of the main focuses of the Society has been to establish and maintain a national examination for cytotechnologists and to provide an environment for further education. Dr Drake persuaded the International Academy of Cytology to visit Australia in 1973 and the first Australian CT(IAC) Examination was held in Melbourne after the IAC Tutorial. In 1974 the Society established an examination subcommittee and eleven candidates sat for the first national exam in 1975. The Board of Examiners was set up in 1993 and Mary Harney was the first Chief Examiner.
A Board of Education was established in 1997/98 under the chair of Dr Darrel Whitaker to foster continuing education for cytotechnologists. A continuing education for cytotechnologists (CEC) scheme was designed in conjunction with the Board of Education for use by non-medically qualified persons to provide encouragement and a means by which cytologists could keep up to date. Mark Stevens was the inaugural CEC Registrar. Since 2006, a National Training Syllabus has been available online.
Another aim of the Society was to establish an official journal in which news of the Society and its activities could be promulgated. Cytoletter began as a humble 2-3 foolscap page newsletter and was first published in 1978. Dr Alf Gatenby, Mrs Joy Ford and Miss Jillyan Hill formed one of the first editorial boards. Other editors who have nurtured and evolved this journal to its current status have been Dr Julienne Grace, Ms Myf Fraser, Richard Rose and Grant Scott, Noel Loughman and Paul Harmata, Dr Phil Baird and Todd Walker, Gillian Phillips, Jenny Ross and, currently, Tony Henwood.
Originally, the national Executive Committees remained in Melbourne with the President and Vice President being elected from the branches. Councillors were elected from each state. From 1979 onwards, the Executive Committee has moved from state to state with President and Vice President alternating during the term of office. The New South Wales Executive was elected in 1979, Western Australia from 1985-1989, then returning to Victoria from 1989-93 when Dr Bill Murray oversaw the rewriting of the constitution. The Executive passed to South Australia in September 1993 when a permanent National Office was set up in Adelaide and Bev James was appointed. The Executive continued to rotate every four years through Queensland, then NSW, then Western Australia, then Victoria, SA, NSW and is now back to Queensland.
In the mid-90s Grant King set up a website for the ASC and became the inaugural Webmaster.
Dr Julienne Grace and Joy Ford established the first QAP program under the auspices of the RCPA. Dr Gordon Wright, Paul Shield and Jo Finnimore then instigated changes which evolved into Cytology Laboratory QAP and Cervical Screening Performance Measures.
The Society has had a close association with the IAC since 1973, Dr Drake became IAC President in 1990 and an IAC Congress was held in Melbourne in 1992 and, more recently, A/Prof Andrew Field has become the IAC President and another IAC Congress was held in Sydney in 2019. Two members of the Australian Society have been honoured with IAC Cytotechnologist of the Year Awards – Dr Darrel Whitaker and Miss Patricia Archer. Dr Michael Drake received the Maurice Goldblatt Award in 1990 and Dr Svante Orell in 2008. Dr Gabriele Medley is one of five cytopathologists worldwide to have received the Kazumasa Masubuchi Lifetime Achievement in Clinical Cytology Award.
In 2016 the CTASC Examination was split into Gynaecological/Non-Gynaecological for the first time.
The Renewed Cervical Screening Program…
NPAAC guidelines “Requirements for Laboratories Reporting Tests for the National Cervical Screening Program” – S1.4 Cytology staff employed for examining gynaecological LBC must hold a CTASC which includes a gynaecological cytology component. C1.4(ii) Trainees progressing towards a CTASC within 4 years may report LBC under supervision.
ACCMLSW now known as CMLS – certification launched in 2020. CEC scheme accepted as evidence.