Cervical cytology. Increased sensitivity with a second cervical smear.

Two consecutive Papanicolaou smears were obtained in 3524 patients during a single clinic visit. The first smear consisted of a combined cervical scrape and vaginal pool sample (Fast smear) while the second smear contained only a cervical scrape. Of the 93 patients with abnormal cytology, 71 (76%) patients were identified by the first smear and 74 (80%) by the second smear. The interpretation of the two smears correlated in 51 patients (54.8%). Of the remaining 42 patients, the cytologic findings were more advanced in the second smear in 19 cases, and in 23 cases the reverse was true. There were 19 instances in which the cytologic findings were suspicious or positive. In 8 (42.1%) of these 19, one of the two smears contained either negative (7) or atypical (1) cytologic findings. The histologic diagnosis corresponded to the more advanced cytologic findings in all cases. The addition of the second cervical smear increased the detection rate of suspicious of positive cytology by 26.3%.