Comparing two sampling techniques for endocervical cell recovery on Papanicolaou smears

The importance of endocervical cells in a Pap smear is well-recognized. A Pap smear lacking endocervical cells is considered inadequate and necessitates a repeat test. Clinicians continue to search for techniques that will ensure consistently adequate samples. In this study, Pap smears were obtained for 200 subjects, alternating use of a saline-moistened cotton-tipped applicator with the Zelsmyr Cytobrush for endocervical cell collection. Endocervical cells were present in all 100 Cytobrush smears, compared with 91 of the cotton-tipped applicator smears. The difference is significant (p less than 0.005). The nine smears that lacked endocervical cells were repeated, using the Cytobrush; all nine repeat smears contained endocervical cells. Although the sample used in this study was small, results indicate that the Cytobrush is more effective in obtaining endocervical cells than the cotton-tipped applicator. Use of the Cytobrush is recommended in the interest of reducing the number of false negative reports.