Comparison of Pap Smear Quality with Anatomical Spatula and Convenience (Spatula-Cytobrush) Methods: A Single Blind Clinical Trial


Objectives: The Papanicolaou smear is a standard test for cervical cancer screening; however, the mostimportant challenge is high false negative results. Several factors contribute to this problem and one the mostimportant is inappropriate sampling. The aim of this study was to compare the quality of smears obtained byeither an anatomical spatula or a spatula-cyto brush.
Methods: One hundred married women participated inthis single blind clinical trial. After all participants were interviewed, two samples were obtained from each: onewith a spatula-cytobrush and another with an anatomical spatula. Slides were prepared and assessed by twopathologists for kappa coefficient analysis.
Results: Cell adequacy was 96.1 % in anatomical spatula methodand 91.2 % in spatula-cyto brush method (p= 0.016). The rates for endocervical cells and metaplasia cells were70.6%and 24.5%, respectively, with the anatomical spatula method and 69.6% and 24.5% using a spatulacytobrush(p<0.001). No one reported pain and the amount of bleeding was 38.2% in both methods (p>0.05).In addition, there were no statistically significant differences regarding infection and inflammatory reactions(p>0.05).
Conclusion: Based on the findings of this study, the results of sampling with anatomical spatula weremore acceptable and better than those of spatula-cytobrush sampling.