Analysis of sampling methods for cervical cytology

Summary

A prospective, random allocation, single blind study was undertaken to compare the efficiency of the plastic versus the wooden Ayre spatula in cytological sampling from the cervix and the vagina. The cytobrush was also compared with a cotton swab for endocervical sampling. Each of the endocervical, ectocervical and vaginal specimens taken from 900 women were evaluated for the presence of endocervical columnar cells, metaplastic and squamous cells.

With the plastic spatula, the presence of endocervical columnar cells in the ectocervical sample was observed on more occasions (46–1 per cent) and there were more of the cells than when the wooden spatula was used (30·9 per cent; P < 0.001). Endocervical sampling with the cytobrush yielded the three cell types on more occasions than the cotton swab. The plastic spatula and the cytobrush yield more endocervical columnar cells on more occasions but entail a higher risk of bleeding, which prolongs the time required to interpret the cytological specimen.