Comparison of pap smear quality with anatomical spatula method and the common method [spatula- cytobrush]: a single blind clinical trial

Cervical cancer is the third most common cancer in women in the world. Papanicolaou smear is known as a standard test for cervical cancer screening; however, the most important challenge is high rates of false negative results. The aim of this study was to compare the quality of smears obtained by anatomical spatula and spatula-cytobrush. The most important factor in false negative result is inappropriate tool of sampling. One hundred married women participated in this single blind clinical trial. All participants were interviewed; two samples were obtained from every participant: one with spatula-cytobrush and another one with anatomical spatula. All slides were encoded and were assessed by two pathologists. Then, data were analyzed by means of kappa coefficient. Cell adequacy was 96.1% in anatomical spatula method and 91.2% in spatula-cytobrush method [p= 0.016]. The rates for endocervical cells and metaplasia cells in anatomical spatula method were 70.6% and 24.5% respectively and these amounts were 69.6% and 24.5% respectively in the spatula-cytobrush method [p <0.001]. No one reported any pain and the amount of bleeding was 38.2% in both methods [P>0.05]. Regarding infection and inflammatory reactions there was no statistically significant difference between two methods [p>0.05]. Based on our findings in this study, results of sampling with anatomical spatula method were more acceptable and better than those with spatula-cytobrush sampling