Comparison of Pap Smear Quality With Anatomical Spatula Method and the Common Method (Spatula‐ Cytobrush): A Single Blind Clinical Trial

Background: Cervical cancer is the third most common cancer in women in theworld. Papanicolaou smear is known as a standard test for cervical cancerscreening; however, the most important challenge is high rates of false negativeresults. The aim of this study was to compare the quality of smears obtained byanatomical spatula and spatula-cytobrush. The most important factor in falsenegative result is inappropriate tool of sampling.Methods: One hundred married women participated in this single blind clinicaltrial. All participants were interviewed; two samples were obtained from everyparticipant: one with spatula-cytobrush and another one with anatomical spatula.All slides were encoded and were assessed by two pathologists. Then, data wereanalyzed by means of kappa coefficient.Results: Cell adequacy was 96.1 % in anatomical spatula method and 91.2 % inspatula-cytobrush method (p= 0.016). The rates for endocervical cells andmetaplasia cells in anatomical spatula method were 70.6% and 24.5%respectively and these amounts were 69.6% and 24.5% respectively in thespatula-cytobrush method (p <0.001). No one reported any pain and the amountof bleeding was 38.2% in both methods (P>0.05). Regarding infection andinflammatory reactions there was no statistically significant difference between twomethods (p>0.05).Conclusion: Based on our findings in this study, results of sampling with anatomicalspatula method were more acceptable and better than those with spatulacytobrushsampling.