Screening a cervical smear at the microscope · Contested (since 1998)

In 1998 the FDA approved the AutoPap system, later sold as the FocalPoint Slide Profiler, for primary screening of cervical smears, ranking each slide by its likelihood of being abnormal.

Before this, every slide was read by a cytotechnologist at a microscope, and the volume of that reading was the bottleneck of the whole programme. The approved use allows a laboratory to sign out up to a quarter of low risk slides, those the instrument places in its no further review class, as negative with no person ever looking at them. The rest are still read, with the machine choosing which fields the eye is shown first, and anything abnormal goes to a cytopathologist. Reading has been rationed by machine rather than replaced, which is why this stays contested. The colposcopy and the conversation that follow an abnormal result belong to a clinician.