Changing Digital and Telecytology Practices post COVID-19 Comparing ASC survey results from 2016 to 2023

Introduction During the COVID-19 pandemic, the need for digital pathology tools became more urgent. However, there needs to be more knowledge of the use in cytology. We aimed to evaluate current digital cytology practices and attitudes and compare the results with a pre-COVID-19 American Society of Cytopathology (ASC) survey. Materials and Methods Fourteen survey questions assessing current attitudes toward digital cytology were developed from a 2016 ASC Digital Pathology Survey questions. Ten new survey questions were also created to evaluate telecytology use. The survey was e-mailed to ASC members over six weeks in 2023. Results 123 individuals responded (116 in 2016). Attitudes toward digital cytology were unchanged; most participants stated digital cytology is beneficial (87% 2023 vs. 90% 2016). The percentage of individuals using digital cytology was unchanged (56% in 2016 and 2023). However, telecytology for rapid on-site assessment (ROSE) is now considered the best application (55% 2023 vs. 31% 2016). 43 institutions reported using digital and telecytology tools; 40% made implementations after 2020; most did not feel that COVID-19 affected digital cytology (56%). Telecytology for ROSE is the most common application now (78%) compared to education (30%) in 2016. Limitations for implementing digital imaging in cytology included inability to focus (38%) and expense (33%). Conclusions General attitudes toward digital tools by the cytology community have essentially remained the same between 2016 and now. However, telecytology for ROSE is increasingly being used, which supports a need for validation and competency guidelines.