[Who performs gynecological cytology and how?]

Area of Science:

• Gynecologic oncology
• Public health screening programs
• Diagnostic pathology

Context:

• Germany's established free annual gynecological cancer screening for women 20+ since 1971.
• Upcoming changes by the Federal Joint Committee (GBA) for women over 30.
• Current cytological classification based on Munich Nomenclature (MN III) since 2015.

Purpose:

• To outline the proposed shift in Germany's cervical cancer screening strategy.
• To detail the new options for women over 30: annual cytology vs. 5-year HPV testing.
• To describe the triage process for HPV-positive cases.

Summary:

• German women aged 30+ will have a choice between annual cervical smear (cytology) or primary HPV testing every 5 years.
• Human papillomavirus (HPV) positive results will necessitate a follow-up cytological examination.
• The number of pathologists has increased, while testing volume remains stable, with a trend towards larger laboratories.

Impact:

• Potential for improved cervical cancer detection rates and patient outcomes.
• Adaptation of screening protocols to incorporate primary HPV testing.
• Changes in laboratory practices and workforce dynamics within cytology services.