Cervical screening

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7089.1277 (Published 26 April 1997) Cite this as: BMJ 1997;314:1277

Rate of diagnosis of cytological abnormalities is best end point

  1. Sophia Williamson, Senior registrar in histopathologya,
  2. Viney Wadehra, Consultant cytopathologistb
  1. a Freeman Hospital, Newcastle upon Tyne NE7 7DN
  2. b Newcastle General Hospital, Newcastle upon Tyne NE4 OBE
  3. c Heaton Moor Medical Centre, Stockport SK4 4NX
  4. d Southampton University Hospitals NHS Trust, Southampton General Hospital, Southampton SO16 6YD

    Editor—Frank Buntinx and Marleen Brouwers report a meta-analysis examining randomised and quasi-randomised studies of 85 000 patients to assess the relation between the detection of abnormality in cervical smears and the sampling device used.1 They recommend the use of an extended tip spatula, a spatula with a brush or cotton swab, or a Cervex brush. We have performed a retrospective analysis of 126 608 smears submitted to our laboratory by general practitioners and family planning clinics.2 We compared the rate of detection of cytological abnormalities associated with the three most popular devices: the spatula alone (predominantly Aylesbury spatulas), the Cervex brush, and a combination of a spatula and brush. Table 1 shows the results (presented with the permission of the editor of Cytopathology). The results obtained with the Cervex brush were different from those obtained with the other techniques: the brush produced a higher proportion of satisfactory smears but a lower rate of diagnosis of cytological abnormality.

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    Table 1

    Quality of smears obtained and abnormalities diagnosed with three sampling devices. Figures are numbers (percentages)

    In his editorial Peter Sasieni comments that the diagnosis of abnormalities in cervical smears is not an ideal indicator of the usefulness of …

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