A comparison of the three most common Papanicolaou smear collection techniques

To evaluate three common instruments for sampling the endocervical canal: the Q-tip applicator, the Cytobrush, and the Cervex brush.

Clinical, cytologic, and histologic data were collected from patients enrolled in the colposcopy clinic at the National Naval Medical Center. Subjects were assigned to one of three techniques: a combination of spatula and swab, a combination of spatula and Cytobrush, and the Cervex brush alone.

There was no significant difference in the ease of use or the amount of patient discomfort among the three methods, although the Cytobrush caused an increase in mild cervical bleeding. The Cytobrush yielded the greatest number of endocervical cells. The swab produced the lowest number of endocervical cells and the greatest cellular distortion. The ability to identify patients with biopsy-proven dysplasia was comparable for each of the three methods.

The Cytobrush was the best device for sampling the endocervical canal, but it was no more sensitive in detecting cervical dysplasia.