From simple technology to complex arena: classification of Pap smears, 1917-90.

This article explores historical constructions of Pap smear classification systems from 1917 to 1990. Using a social worlds/arenas analysis, we examine the perspectives and properties of all the major actors (both human and nonhuman) in the Pap smear arena, including implicated actors. Analytical emphasis is on interpretive struggles among different actors in this arena and centers on the consequences of such conflicts for global classificatory systems and on the global classificatory criteria. We describe some of the local clinical "work-arounds" designed to resolve problems of classification standards in practice. In drawing theoretical conclusions, comparison is made between Pap smear classification systems and two other systems.

[1]  G. Papanicolaou,et al.  The existence of a typical oestrous cycle in the guinea‐pig—with a study of its histological and physiological changes , 1917 .

[2]  A. Clarke,et al.  The Many Faces of RU486: Tales of Situated Knowledges and Technological Contestations , 1993, Science, technology & human values.

[3]  G. Canguilhem,et al.  On the Normal and the Pathological , 1978 .

[4]  D. Stemerding.  How to make oneself nature's spokesman? A latourian account of classification in eighteenth- and early nineteenth-century natural history , 1993 .

[5]  D. Le.  A further comment on the contributions of Aurel Babes to cytology and pathology. , 1967 .

[6]  Improving accuracy in gynecologic cytology. Results of the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology. , 1993, Archives of pathology & laboratory medicine.

[7]  J. Wright.  The development of the frozen section technique, the evolution of surgical biopsy, and the origins of surgical pathology. , 1985, Bulletin of the history of medicine.

[8]  E. Holtzman,et al.  The Cancer Mission: Social Contexts of Biomedical Research , 1980 .

[9]  S Wacholder,et al.  Epidemiologic evidence showing that human papillomavirus infection causes most cervical intraepithelial neoplasia. , 1993, Journal of the National Cancer Institute.

[10]  K. Ringen,et al.  Health policy: gaps in access, delivery, and utilization of the Pap smear in the United States. , 1987, Milbank Quarterly.

[11]  L. Koss.  The Papanicolaou test for cervical cancer detection. A triumph and a tragedy. , 1989, JAMA.

[12]  M. Hård.  Beyond Harmony and Consensus: A Social Conflict Approach to Technology , 1993 .

[13]  A. Hertig,et al.  A debate: what is cancer in situ of the cervix? Is it the preinvasive form of true carcinoma? , 1952, American journal of obstetrics and gynecology.

[14]  Mike Michael,et al.  Actor-Networks and Ambivalence: General Practitioners in the UK Cervical Screening Programme , 1993 .

[15]  M. Callon.  Some Elements of a Sociology of Translation: Domestication of the Scallops and the Fishermen of St Brieuc Bay , 1984 .

[16]  M. Foucault,et al.  The birth of the clinic : an archaeology of medical perception , 1974 .

[17]  N. Oudshoorn.  On the Making of Sex Hormones: Research Materials and the Production of Knowledge , 1990, Social studies of science.

[18]  R. Scott,et al.  The detection of cancer of the uterine cervix by cytological study. , 1951, American journal of obstetrics and gynecology.

[19]  A. I. Spriggs,et al.  History of clinical cytology : a selection of documents , 1983 .

[20]  The Bethesda System for cervical/vaginal cytologic diagnoses: a note of caution. , 1990, Obstetrics and gynecology.

[21]  L G Kessler,et al.  Cervical cancer screening: who is not screened and why? , 1991, American journal of public health.

[22]  W. Ross.  Crusade: The official history of the American Cancer Society , 1987 .

[23]  R. Nickerson,et al.  Epidemiologic evidence for the spectrum of change from dysplasia through carcinoma in situ to invasive cancer , 1968, Cancer.

[24]  R. Numbers,et al.  The dread disease : cancer and modern American culture , 1989 .

[25]  M. Kirsch‐Volders,et al.  Detection of premalignant stages in cervical smears with a biotinylated probe for chromosome 1. , 1994, Cancer genetics and cytogenetics.

[26]  J W REAGAN,et al.  The cellular morphology of carcinoma in situ and dysplasia or atypical hyperplasia of the uterine cervix , 1953, Cancer.

[27]  Brown Cl,et al.  The 1988 Bethesda System for reporting cervical/vaginal cytologic diagnoses. , 1990, Acta cytologica.

[28]  R. Richart,et al.  Alterations in chromosomes and DNA content in gynecologic neoplasms. , 1969, American journal of obstetrics and gynecology.

[29]  R. Richart.  Influence of diagnostic and therapeutic procedures on the distribution of cervical intraepithelial neoplasia , 1966, Cancer.

[30]  P. Valente.  Update on the Bethesda System for reporting cervical/vaginal diagnoses. , 1994, Cancer treatment and research.

[31]  D. R. Gordon.  Tenacious Assumptions in Western Medicine , 1988 .

[32]  J. Mandelblatt,et al.  Breast and Cervical Cancer Screening of Poor, Elderly, Black Women: Clinical Results and Implications , 1993 .

[33]  Geoffrey C. Bowker,et al.  Situations vs. standards in long-term, wide-scale decision-making: the case of the International Classification of Diseases , 1991, Proceedings of the Twenty-Fourth Annual Hawaii International Conference on System Sciences.

[34]  T. Wright,et al.  Controversies in the management of low‐grade cervical intraepithelial neoplasia , 1993, Cancer.

[35]  L. Suchman.  Do categories have politics? The language/action perspective reconsidered , 1993 .

[36]  W. Chanen.  The ON Saga — The Biological and Clinical Significance of Cervical Intraepithelial Neoplasia * , 1990 .

[37]  Yobs Ar,et al.  Laboratory reliability of the Papanicolaou smear. , 1985 .

[38]  T. Posner.  What's in a smear? Cervical screening, medical signs and metaphors , 1991 .

[39]  R. G. Wright,et al.  The Pap Smear Revisited , 1987, The Australian & New Zealand journal of obstetrics & gynaecology.

[40]  David L. Hull,et al.  How Classification Works Nelson Goodman Among the Social Sciences , 1995 .

[41]  T. Gieryn,et al.  Boundaries of Science , 1995 .

[42]  G. Papanicolaou.  Cytologic diagnosis of uterine cancer by examination of vaginal and uterine secretions. , 1949, American journal of clinical pathology.

[43]  Joan H. Fujimura,et al.  The Right Tools for the Job: At Work in Twentieth-Century Life Sciences , 1992 .

[44]  G. Reader.  Medical Work in America: Essays on Health Care , 1989 .

[45]  R. Westrum.  The Social Construction of Technological Systems , 1989 .

[46]  George N. Papanicolaou Herbert F. Traut,et al.  Diagnosis of uterine cancer by the vaginal smear , 1943 .

[47]  B. Latour.  Science in action : how to follow scientists and engineers through society , 1989 .

[48]  Susan Leigh Star,et al.  Institutional Ecology, `Translations' and Boundary Objects: Amateurs and Professionals in Berkeley's Museum of Vertebrate Zoology, 1907-39 , 1989 .

[49]  A. RuizValdes.  Carcinoma in situ of the uterine cervix , 1955 .

[50]  S. Brunton.  Nonpharmacologic management of hypertension. , 1991, The Western journal of medicine.

[51]  J. Ploem,et al.  Interobserver variability in the cytological diagnosis of 1500 Papanicolaou stained cervical monolayer specimens. , 1990, Pathology, research and practice.

[52]  M. Hamonic,et al.  DYSPLASIA OF THE UTERINE CERVIX , 1956, Annals of the New York Academy of Sciences.