A Study of the Self Smear Method as a Screening Device for Uterine Cancer

ABSTRACT

The accuracy of Kato's self smear Kit was studied in screening a relatively unselected population group for cervical cancer. Routine cervicovaginal smears taken periodically would be the ideal method but would be unrealistic in view of the physician's time involved when considered on a large population scale. Three hundred patients were randomly selected at the Out Patient Clinic of Yonsei Medical Center and 26 cases grossly of cervical cancer were included in this group. We have here summarized the results briefly as follows. 1. Among 300 women examined in our OPD, 256 (85.3%) were classified as Pap. Class I or II, 9(0.3%) as a 'Defferred' group (Class II, Repeat), 18(6%) as Class III and 17(5.7%) as Class IV or V. 2. Fifteen of the total cases had insufficient material for evaluation (poor quality) and the major causes of the poor smears were vaginal douche within 24 hours, technical problems and cell degeneration. 3. The rate of agreement between the Self Smear Kit and cervicovaginal smear was as follows: a. The rate of complete agreement was 93.2% (280/300) b. The rate of complete or partial agreement was 96.7% (290/300). 4. The diagnostic accuracy of the Self Smear Kit was as follows: a. If we assumed the 'Deferred' group to be detection failures for uterine cancer, the diagnostic accuracy would be 82.4%. b. If we assumed the 'Deferred' group to be detection successes, the diagnostic accuracy would be 94.1%. 5. The quality of self smears was superior when taken by an aid nurse rather than by the patient herself. 6. Optimal time for good preservation with the Self Smear Kit prior to pap. stain under the following temperatures was proven experimentally to be as follows; a. At 5 degrees C: 3 days after smear b. At 15 degrees C: 3 days after smear c. At 30 degrees C: 2 days after smear