Cytotechnologists examine cellular samples under a microscope to determine the presence of disease. They are involved in the diagnosis of cancer, precancerous lesions, benign tumors, and infections from a wide variety of body sites.
Cytotechnologists work under the direction of a physician called a pathologist, a medical doctor who specializes in the study of diseases and determines the nature and cause of the problem. Most patients never meet the pathologist or the cytotechnologist who evaluates their samples. Yet the treatment of their illness may depend on the work of the pathologist-cytotechnologist team.
Cytotechnologists evaluate or screen specimens looking for the presence of abnormal cells. Abnormal cells may be cancerous, precancerous, or show other disease processes. Cytotechnologists mark the abnormal cells and make a preliminary diagnosis. A pathologist then reviews the abnormal cells and makes a final diagnosis. As a result of cytologic findings, physicians are often able to diagnose and treat cancer before symptoms occur or before it can be detected by other methods.
Cytotechnologists study cell specimens collected by a patient’s physician, surgeon, radiologist, pathologist, or other medical professional. Cell specimens may come from reproductive organs, the mouth, the lungs, stomach, esophagus, or from any body cavity. Physicians or other medical professionals collect cellular samples by scraping or brushing areas of the body to collect cells. Body fluids such as urine may contain cells, which cytotechnologists may concentrate for examination. To get samples from lumps or sites deep in the body, a physician may insert a very thin needle and collect cell specimens.
Each patient sample is assigned a unique identification number as soon as it arrives at the laboratory. Patient and specimen data is entered into a computer. The Pap Test, a sample taken from the cervix, the bottom portion of the uterus (womb), is the most common type of specimen submitted to a cytology laboratory. The goal of the Pap Test is to provide early detection of precancerous and cancerous lesions of the cervix when treatment is most effective. The results of all previous specimens for each patient are stored in the computer and are reviewed when each new cytology test is evaluated by the cytotechnologists.
After receiving a physician’s order for laboratory tests, cytotechnologists prepare samples for examination under a microscope. In some labs, they may supervise other workers who prepare the specimens. They use several different techniques when processing specimens. In most cases, they place samples on glass microscope slides, and stain them to highlight the structures of the cells. Then they seal the cells on the slides with a mounting medium and a glass cover slip.
Cytotechnologists know how cells respond to disease processes, to the environment, and to different kinds of therapy. They look for abnormalities in cell structure or size. They look for changes in the cytoplasm and the nucleus, an outer part and inner core, of the cell. They may find healthy cells, cells from precancerous lesions, or cells with changes consistent with cancer. Other specimens may show the presence of a noncancerous tumor or an infection.
In most cases, cytotechnologists issue the final reports on normal specimens. If they find abnormal cells, they work with a pathologist to identify cell changes and to determine the significance of those changes. The pathologist issues the final reports on abnormal specimens and on all non gynecologic specimens.
Work varies with laboratory size and setting. In some laboratories, cytotechnologists may evaluate only certain kinds of specimens. In other labs, they deal with all kinds of specimens. Those who serve as supervisors may write laboratory procedure manuals, hire and counsel employees, order supplies, and oversee quality control and patient follow-up programs.
Most cytotechnologists work in clean, well-lighted, temperature-controlled laboratories. The work is not particularly physical. Cytotechnologists may stand, bend, and reach while preparing specimens. Most of the time, however, cytotechnologists evaluate slides while sitting at a microscope. Prolonged work at the microscope involves repetitive hand motions. This may cause a repetitive stress injury, like carpal tunnel syndrome.
Cytotechnologists may work with infectious specimens that require careful handling, proper methods of infection control, and sterilization. They do not often work directly with patients. The demand for fast and accurate work may be stressful. Sometimes unpleasant odors are present in a specimen prep laboratory.
Most cytotechnologists work in hospitals, university medical centers, or in private laboratories. They may work in public health facilities or in business and industry. They may also work in state, federal, or military laboratories. Some teach at universities, colleges, schools, or hospitals. Others work on research projects in public or private laboratories.
Hours and Earnings
Cytotechnologists usually work five days a week, eight hours a day. Large, busy independent labs or hospital facilities may operate around the clock every day of the year. Many large laboratories offer flexible hours and shifts to accommodate the employees’ needs.
The most recent salary survey, conducted by the American Society for Cytotechnology (ASCT) shows that respondent cytotechnologists earned an average salary of approximately $68,000 a year. Average earnings ranged from a high of $143,000 to a low of $44,900. Wages vary depending on geographic location, employer, level of education, job position and years of experience.
Fringe benefits often include paid holidays and vacations, health care coverage, dental insurance, and tuition reimbursement for continuing education.
Education and Training
To start a career in this profession, students need a bachelor’s degree with a major in biology, medical technology, or the life sciences. They also need to complete an accredited cytotechnology program to receive instruction and clinical training in the field. Students may transfer to a cytotechnology program in their junior or senior year of college or after they have earned a bachelor’s degree, according to the requirements of the school. Students should make sure the program they are taking is accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) in collaboration with the American Society of Cytopathology (ASC).
Course requirements vary among schools. However, most schools require at least twenty eight semester hours of biological science/chemistry, and a mathematics/statistics courses. The biology courses may include general biology, cell biology, anatomy, bacteriology, embryology, genetics, histology, parasitology, physiology, and zoology.
Cytotechnology programs include lectures, laboratory demonstrations, seminars, practical microscopic study, diagnosis, and clinical education experiences. Course work includes clinical and diagnostic interpretation, anatomy, embryology, endocrinology, microbiology, histology, physiology, and cytochemistry of each organ system accessible to examination by cytologic methods. Other studies cover principles of management and supervision, quality control methods, specimen preparation, research techniques, and health and safety regulations. As molecular diagnostics becomes increasingly important in the field of pathology, programs are incorporating instruction in immunohistochemistry, cytogenetics, in situ hybridization, polymerase chain reaction, and flow cytometry.
There are accredited cytotechnology programs throughout the United States and Puerto Rico.
High school students who want to be cytotechnologists should take biology, chemistry, health, computer science, and mathematics. Studies that teach written and verbal skills are also important.
Certification, which is recommended, shows that the cytotechnologist has mastered both the academic and clinical components of the field. Cytotechnologists who complete an accredited bachelor’s degree program are eligible to take the certification examination administered by the Board of Certification (BOC) of the American Society for Clinical Pathology (ASCP). Those who pass the exam may use the initials CT (ASCP) after their name. Additionally, cytotechnologists may be required to obtain a license in order to work in some states. Cytotechnologists must be certified before they can receive a license.
As molecular diagnostics become increasingly important in the field of pathology, cytotechnologists may want to further expand their skills with additional training in molecular pathology. Additional certification can be obtained through the ASCP.
Association Contact Information
American Society of Cytopathology
100 West 10th Street, Suite 605
Wilmington, DE 19801
Phone: (302) 543-6583
Web site: www.cytopathology.org