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Clinical Cytology in Croatia - Development



         A great clinicians´ interest in the application of the cytological tests in the diagnostics of numerous diseases and preceding pathological changes was incited in our country in the middle of 20th century by  rapid growth of cytodiagnostics. Up to then, clinicians of different specialities coped with cytological examinations alongside their basic profession, but the continually expanding application of cytodiagnostics in practice created the need for education of  independent experts of clinical cytology.  The doctors who were mainly involved with cytodiagnostics established an independent professional organisation in 1970 within the Croatian Medical Association (ZLH) under the following name: Section for Cytology and Cytodiagnostics of ZLH with the aim of achieving a functional and systematic cytological development. Its members were, through the former Association of Yugoslav Clinical Cytologists, included in the EFCS (European Federation of Cytology Societies). In 1991, after the Serbian aggression on Croatia, the Section withdrew from the Association. In 1992, on the cytologist congress in Prague,  the Section acquired the monitoring status within the EFCS and forwarded an application for  membership in the IAC (International Academy of Cytology). In 1993, at the Vienna meeting, our Society became a regular member of the EFCS, and the name Croatian Society for Clinical Cytology (Croatian Medical Association) was added to the group of some forty world cytological societies that are recorded in each issue of Acta Cytologica, the IAC magazine.

         Today the Society has 117 members, and all up-to-date presidents, secretaries and treasurers are named in the following table.


Year President Vice-President Executive Secretary Secretary Treasurer
1970.-1974. I. Črepinko   J. Ivić Ž. Bauer V. Pešut
1974.-1978. J. Ivić   Ž. Bauer-Znidarčić Z. Papić V. Pešut
1978.-1981. J. Ivić   Ž. Bauer-Znidarčić S. Audy-Jurković Z. Papić
1981.-1985. Ž. Bauer-Znidarčić   A. Batinica   B. Cimić Vukosavić
1985.-1989. T. Jeren   I. Kardum-Skelin   V. Mahovlić
1989.-1993. S. Audy-Jurković   I. Kardum-Skelin D. Markov V. Mahovlić
1993.-1997. S. Boljkovac M. Roglić S. Bastić S. Rastovski-Smojver D. Kani
1997.- 2001. S. Boljkovac M. Pajtler B. Molnar Stantić S. Judin M. Barišić


         Let us remind of the definition of clinical cytology and its development, both world-wide and in Croatia: Clinical Cytology is an interdisciplinary diagnostic branch of medicine which, based on the microscopic cell analysis of different biological samples, recognises physiological conditions, discovers and diagnoses benign, pre-malignant and malignant pathological processes.

          In gynecology, the first report on the application of cytology in cancer detection under the title “New Cancer Diagnosis” was given by G. N. Papanicolaou in 1928, and it was not welcomed by the clinicians, especially pathologists. Only after the publishing of the work entitled "Diagnosis of Uterine Cancer by Vaginal Smear" by G. N. Papanicolaou and H. F. Trauta, in 1943, the cytological merit in that area was recognised in America, and soon after that in the whole world.

In hematology, cytological tests were developed in Europe by clinicians at the beginning of the century. Soon afterwards, they expanded to other areas in the form of aspiratory and exfoliative cytodiagnostics.

          In Croatia, too, cytodiagnostics started to be developed by clinicians. It had its roots in hematology already in the 1930s and 40s, and Eric Hauptmann was particularly responsible  for the acceptance of cytological examinations by other branches.  Beata Brausil, M.D., PhD.,  whose  students (I. Črepinko, M. Dubravčić, Z. Grgić, H. Harambašić, D. Ivanov, J. Ivić, K. Ljubimir, V. Rajčić, A. Tiefenbach, Z. Škrabalo and others)  were the future cytology founders in certain medicine specialities, is considered to be the originator of  the Croatian clinical cytological laboratory specialization.

          At the end of the 1960s, the need for a systematic education of cytologists and cytotechnicians was recognised. Therefore, following the initiative of the pathologist Ante Zimola (picture) and hematologist Erik Hauptmann (picture), the post-graduate study of "Medical Cytology" was founded at the Medical School of the Zagreb University. In 1967, Inga Črepinko (picture) organised  additional training for health technicians in order to become cytotechnicians. Through the efforts of the very active clinical cytology  experts who were, at that time, gathered  in the Section for Cytology and Cytodiagnostics of ZLH, as well as due to the presentation of a comprehensive documentation and detailed elaboration of the curriculum, the specialization in "Medical Cytology" (later named "Clinical Cytology") for medical doctors was approved in 1974.

           During 1970, the Section for Cytology and Cytodiagnostics of ZLH was established so that Clinical Cytology could become an independent interdisciplinary diagnostical specialization, as well as to regulate the status of its expert practitioners.  For their Presidents and secretaries, the  society members have always elected persons with great experience in clinical cytology who had the will and ability to co-operate with clinicians, experts in other specialities, the Croatian health institutions, as well as with Medical School and various educational health institutions. Under their leadership, continuous work has been done in the form of professional and scientific activities, educational organisation, recording the data important for professional growth, and protection of interests of clinical cytology and cytologists. The most important activities connected to the last topic have been devoted to safeguarding the independence of the profession, better organisation of cytological services in health institutions in the form of independent organisational units, control of work quality, determining the terminology and standard specifications for cytological services in order to form real financial indicators, and safety at work.



(Inga Črepinko, Željka Znidarčić, Silvana Audy-Jurković. Clinical Cytology in Croatia - on the occasion of the 30th anniversary of the Croatian Society for Clinical Cytology of HLZ and the 25th anniversary of specialization in Clinical Cytology, Zagreb 2000)


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