Practice of Cytopathology in Korea: A 40-Year Evolution Through Standardization, Digital Transformation, and Global Partnership

Abstract

Over four decades, Korea has advanced from a limited cytology service to a global model of digital and AI-integrated cytopathology. Since the founding of the Korean Society for Cytopathology (KSC) in 1986, a nationwide framework has been established-encompassing standardized practices, systematic education for specialists and cytotechnologists, and nationwide cervical screening through the National Cancer Control Program. A mandatory Quality Assurance Program (QAP) launched in 2005 ensured consistent diagnostic quality, achieving an unsatisfactory Pap test rate below 0.2% and cytology-histology discrepancy under 0.6% among over 10 million annual examinations. The 2021 STANBAI project digitized two decades of QAP slides into a standardized whole-slide image (WSI) archive, driving the development of multiple AI models. In parallel, the CytoAcademy web/mobile platform enabled interactive WSI-based education and global participation by over 200 institutions. Korea has also shared this model internationally through on-site and virtual programs in low-resource countries. By integrating national QA, digital infrastructure, AI innovation, and global training, Korea has built a future-ready cytopathology ecosystem-enhancing diagnostic precision and offering a scalable blueprint for global implementation.