The risk factors and error factors in cytological service of the Republic of Kazakhstan
Cytopathology is the study of cells for the purpose of diagnostics and monitoring of diseases through the identification of primary, recurrent and metastatic tumors and their predecessors. This simple, rapid method of preoperative diagnostics contributes to early detection of tumors and supports the oncologists in determining the treatment tactics and conducting dynamic observation. The procedure of obtaining the biomaterial for examination is easy and minimally invasive. Only cytology allows defining and monitoring of early stages of cancer and precancerous conditions. The quality and method of sampling allow defining the nature of growth, the size, and prevalence of the process, the information value of the biopsy. As a result, it reduces the time for examination, eliminates unreasonable procedures, excludes the anxiety of the patient’s, and speeds up the start of treatment. Often, only cytological examination can give the grounds for specialized treatment. Multidisciplinary integration with molecular biology, medical genetics, and etc. creates demand for optimization of information obtained in a non-invasive way using cytological samples. The modernization carried out in Kazakhstani cancer centers has led to the amalgamation of cytological and histological laboratories. At that, the incompetence and misunderstanding of the meaning of preoperative verification by the heads of some laboratories levels down the status of cytology thus creating conditions for destructive professiogenesis. The effectiveness of cytological examination depends on good practice and motivation, proper management, competence, information value of biomaterial, standardization of procedures, and etc. Diagnostic errors can lead to undesirable consequences. Kazakh Institute of Oncology and radiology (KazlOR) acts as a coordinator in improving the quality of oncological care in the Republic of Kazakhstan (RK), along with the prevention and early diagnostics issues. The adequacy of the obtained biomaterial sample is a well-known key factor which guarantees the quality of cytological examination. In clinical units, high information value of biomaterial under study is ensured by adherence to protocols and standard operating procedures regarding sampling. The growing need for minimally invasive diagnostic methods requires a review of the content and methodology of specialization of cytologists. The cytologist performing a fine-needle aspiration biopsy shall possess dynamic thinking, sociability, and empathy plus to his/her professionalism. Modern standards shall govern practical issues of diagnostic cytology, the issues related to advanced training of cytopa-thologists in accordance with the current requirements. The transition of the RK health care system to insurance medicine increases the level of mutual responsibility at all levels of diagnostics and the requirements for quality of provided services. A constructive and progressive approach to the development of cytological art in the RK is required.