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  3. Adequacy of cervical cytology sampling with the Cervex brush and the Aylesbury spatula: a population based randomised controlled trial
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Adequacy of cervical cytology sampling with the Cervex brush and the Aylesbury spatula: a population based randomised controlled trial

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7059.721 (Published 21 September 1996) Cite this as: BMJ 1996;313:721
  1. Paola Dey, lecturer in public healtha,
  2. Stuart Collins, statisticiana,
  3. Minaxi Desai, consultant cytopathologistb,
  4. Ciaran Woodman, professor of public health and cancer epidemiologya
  1. a Centre for Cancer Epidemiology, University of Manchester, Manchester M20 4QL,
  2. b Department of Cytopathology, Christie Hospital NHS Trust, Manchester M20 4QL
  1. Correspondence to: Dr Paola Dey, Centre for Cancer Epidemiology, Christie Hospital NHS Trust, Manchester M20 4QL.
  • Accepted 11 July 1996

Abstract

Objective: To compare the adequacy of cervical cytology sampling with two sampling instruments commonly used in primary care—namely, the Aylesbury spatula and the Cervex brush.

Design: Pair matched, population based randomised controlled trial.

Setting: 86 general practices and family planning clinics in Greater Manchester.

Subjects: 15 882 cervical smears taken from women aged 20-64 years as part of the national cervical screening programme.

Interventions: Participating centres were allocated to sample with either the Cervex brush or the Aylesbury spatula.

Main outcome measure: Inadequate smear rate.

Results: 5.4% and 5.5% (433/8086 and 426/7796) of smears taken with the Cervex brush and the Aylesbury spatula respectively were reported as inadequate (odds ratio 0.95; 95% confidence interval 0.74 to 1.22).

Conclusion: The Cervex brush offers no advantage over the Aylesbury spatula in reducing inadequate smear rates in the primary care setting.

Key messages

  • Cervical sampling instruments have rarely been formally evaluated in population based settings

  • Group randomisation is useful when evaluating community based interventions but requires modified statistical techniques

  • The Cervex brush offers no advantage over the Aylesbury spatula in reducing rates of inadequate smears when used in primary care

Footnotes

  • Funding The R L Gardner Cancer Research Fund (North Manchester).

  • Conflict of interest None.

  • Accepted 11 July 1996
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