Chapter 9 – “Advancements of cytology in cervical cancer” in “ The Resistance of Cervical Cancer to Chemotherapy and its Reversal”.

Cervical cancer (CC) remains high-risk with increased incidence observed even in global countries. Early detection using papanicolaou (pap) smear test remains the most widely utilized screening method and has contributed to reducing the mortality of CC cases. Recent advancements in diagnostic tools have significantly provided deeper insights into enhancing understanding of the cytological approaches towards the CC diagnostic and therapeutic levels. This chapter aims to comprehensively document cytological and histological changes, including alterations in the membrane, cytoplasmic and nuclear compartments, and evaluate their utility as diagnostic and prognostic markers. Special emphasis is placed on human papillomavirus immunotyping and its predictive value in disease progression. The integration of advanced diagnostic technologies such as fluorescence in situ hybridization, next-generation sequencing, artificial intelligence- assisted screening, and three-dimensional culture systems, including spheroids and organoids, for modeling CC resistance mechanisms is discussed in the context of improved detection and therapeutic development of CC. Furthermore, the application of various cytological and diagnostic approaches may enhance the precision of CC management and support personalized therapeutic strategies.