Papanicolaou smears: to swab or not to swab

To determine whether cleaning the cervix with a cotton swab affects the quality of the conventional Papanicolaou smear.

Prospective, single-blinded randomized case-control study.

Two academic family medicine teaching units and 1 community family practice site.

Female patients, 18 to 65 years of age, who presented for a routine Pap smear in the family practice setting were randomized into the Swab Group (n = 300) or the No Swab Group (n = 316).

Before the Pap smear, the cervix of patients in the Swab Group was wiped with a cotton swab until visibly free of mucus. In the No Swab Group, the cervix was not cleaned with a cotton swab before the Pap smear.

The quality of the conventional Pap smear was determined by the presence or absence of endocervical cells noted on the pathology report.

There was no major difference in the quality of the Pap smear in terms of the adequacy of endocervical cells between the Swab and No Swab Group.

Cleaning the cervix with a cotton swab does not appear to affect the quality of the conventional Pap smear in terms of adequacy of endocervical cells. This implies that the practice of wiping or not wiping the mucus from the cervix before taking the Pap smear can be employed at the discretion of the clinician.