K. M. Sunanda1, K. Srinivas2
ABSTRACT: INTRODUCTION: Worldwide, According to statistics every year 8,000,000 new cases of cancer are diagnosed and about 5,000,000 people die from the disease. The early diagnosis will play a great role in reducing the mortality and morbidity. India being a developing country, an early and low cost screening procedure with good detection rate will play great a role in reducing the mortality and morbidity. Cytology is the time tested procedure in this screening modality. AIM: The purpose of the study is to compare smear quality and endo-cervical cells recovery of three Papanicolau smear collecting devices and to determine which method produces the highest quality smear. MATERIALS AND METHODS: It is a prospective study for a period of 18 months conducted at Vanivilas hospital and Bowring and lady Curzon hospitals attached to Bangalore Medical College. 300 women were chosen among perimenopausal, pregnant, and postmenopausal both symptomatic and asymptomatic women attending the OPD, were randomized to be tested with one of the 3 methods of PAP smear examination each group with 100 patients. Smears were reported by Bethesda method, compared for adequacy, inflammatory pattern, infection, presence of endocervical cells etc. Analysis was done with chi square test. RESULTS: 55% were in the age group of 20-25 years. 43% presented with leucorrhoea. 36% cases had healthy cervix and 27% showed cervical erosion. Adequacy was best with cytobrush and spatula. Comparison of adequacy showed a significant p value with cytobrush and spatula. 13% smears showed trichomoniasis. Ayre’s spatula alone was not an ideal method as endocervical cell presence is least with this. CONCLUSION: Use of cytobrush + Ayre spatula in routine pap smear screening is effective in obtaining adequate smears when compared to smears taken with cotton swab + Ayre spatula or spatula alone. Keeping in mind that ours is a developing country with financial problems, cotton swab along wuthAyre spatula may be recommended for improving percentage of adequate smears. However to reduce the percentage of false negative smears cytobrush along with Ayre spatula should be used.
