Optimal collection technique and devices for a quality pap smear

Area of Science:

• Gynecologic Oncology
• Cytopathology
• Diagnostic Cytology

Background:

• Papanicolaou (Pap) smear technique is crucial for cervical cancer screening.
• Suboptimal collection devices persist, impacting conventional and liquid-based Pap smear quality.
• This study evaluates conventional Pap smear collection device performance and sequence impact.

Purpose of the Study:

• To assess the performance of current conventional Pap smear collection devices.
• To determine if the sequence of sample collection influences Pap smear quality.
• To identify factors affecting the quality of conventional Pap smears.

Main Methods:

• Prospective, blinded cohort study involving 128 clinicians across two cytology labs.
• Analysis of conventional Pap smears collected over one year.
• Logistic regression used to analyze quality indicators and device performance.

Main Results:

• Collection sequence did not affect conventional Pap smear quality indicators.
• The Cervex-brush (broom) was linked to absent endocervical cells (OR=3.12), unsatisfactory results (OR=1.68), and inflammation (OR=2.01).
• Cytobrush combined with a spatula was superior; broom alone performed poorly. Infection presence correlated with absent endocervical cells (OR=3.09).

Conclusions:

• A combined Cytobrush (endocervix) and spatula (ectocervix) approach yields the highest quality Pap smears.
• Collection sequence is not a significant factor for conventional Pap smear quality.
• Broom devices demonstrate poor performance, and infection negatively impacts sample quality.