L Lo1, J Jordan. 1. University of Western Ontario.
Abstract
OBJECTIVE: To compare two sampling techniques in their ability to obtain endocervical and metaplastic cells from the Papanicolaou smear. DESIGN: Prospective clinical trial comparing the criterion standard of a wooden spatula to a cytology brush. SETTING: Community-based family medicine clinic in London, Ont. PATIENTS: Consecutive sample of 102 women aged 15 to 58 years requiring a Pap smear between October 1992 and October 1993 who presented to the office of their family physician and were assessed by one resident or one faculty physician. INTERVENTIONS: A Pap smear was obtained from each participant using first the wooden spatula and then the cytology brush. MAIN OUTCOME MEASURES: The number of Pap smears done in the study population that contained endocervical or metaplastic cells. RESULTS: Endocervical cell yield was significantly greater using the cytology brush (93.1%) than using the spatula (61.8%) (P < 0.001). There was no significant difference in metaplastic cell yield between the cytology brush (71.6%) and the spatula (63.7%). At least one of these cell types was identified on 95.1% of cytology brush samples and on 79.4% of spatula samples (P < 0.001). The resident and faculty physician were not significantly different in their rate of detecting endocervical or metaplastic cells. CONCLUSIONS: Adding a cytology brush sample to the Pap smear resulted in a significant increase in the rate of Pap smears that detected cells. The cytology brush was significantly better than the spatula for detecting endocervical cells (P < 0.001), but not significantly better for detecting metaplastic cells.
OBJECTIVE: To compare two sampling techniques in their ability to obtain endocervical and metaplastic cells from the Papanicolaou smear. DESIGN: Prospective clinical trial comparing the criterion standard of a wooden spatula to a cytology brush. SETTING: Community-based family medicine clinic in London, Ont. PATIENTS: Consecutive sample of 102 women aged 15 to 58 years requiring a Pap smear between October 1992 and October 1993 who presented to the office of their family physician and were assessed by one resident or one faculty physician. INTERVENTIONS: A Pap smear was obtained from each participant using first the wooden spatula and then the cytology brush. MAIN OUTCOME MEASURES: The number of Pap smears done in the study population that contained endocervical or metaplastic cells. RESULTS: Endocervical cell yield was significantly greater using the cytology brush (93.1%) than using the spatula (61.8%) (P < 0.001). There was no significant difference in metaplastic cell yield between the cytology brush (71.6%) and the spatula (63.7%). At least one of these cell types was identified on 95.1% of cytology brush samples and on 79.4% of spatula samples (P < 0.001). The resident and faculty physician were not significantly different in their rate of detecting endocervical or metaplastic cells. CONCLUSIONS: Adding a cytology brush sample to the Pap smear resulted in a significant increase in the rate of Pap smears that detected cells. The cytology brush was significantly better than the spatula for detecting endocervical cells (P < 0.001), but not significantly better for detecting metaplastic cells.
Authors: A B Miller; G Anderson; J Brisson; J Laidlaw; N Le Pitre; P Malcolmson; P Mirwaldt; G Stuart; W Sullivan Journal: CMAJ Date: 1991-11-15 Impact factor: 8.262