Efficacy of the Cytobrush method in aged patients

To evaluate the efficacy of the Cytobrush method in aged patients, a comparative study between the Cytobrush smears and cotton swab smears from the uterine cervix was performed. Consecutive 319 cotton swab smears of the endocervix were attempted on aged patients (60-98 yr, average 77.5 yr) from 1987 to 1988 (A group). Subsequently 391 endocervical smears were attempted by the Cytobrush on aged patients (60-100 yr, average 76.9 yr) from 1988 to 1990 (B group). The Cytobrush method was more effective in the following two points: (1) The rate of insert-impossible case in B group (7.2%) was lower than A group (12.5%). (2) The rate of case containing endocervical columnar cells increased in B group (64.7%) compared with A group (47.7%). In contrast, benign epithelial fragments (BFs) were observed in 6.8% of A, in 28.4% of B group. In smears positive for squamous cancer, malignant epithelial fragments (MFs) were noted in 24.5% of A, and 55.1% of B group. Consequently, the differential diagnosis of MFs from BFs is of more importance on the Cytobrush smears of aged patients.