title: Use effectiveness of the Cytobrush in the primary care setting.
abstract: BACKGROUND
  Numerous studies indicate that Papanicolaou smears contain better cellular material when the technique for collecting the sample employs the Zelsmyn Cytobrush. Few studies, however, have examined its ability to increase the percentage of abnormal Papanicolaou smear results in actual clinical practice.
  
  
  METHODS
  This study looked at 7999 Papanicolaou smears done by 46 primary care physicians to determine the percentage of abnormal results during two different periods. The Cytobrush technique was then implemented; and after 6029 Papanicolaou smears, the percentage of smears with abnormal findings was recalculated.
  
  
  RESULTS
  The proportion of Papanicolaou smears demonstrating significantly abnormal cells remained constant during the three observation periods: 1.81 percent during the first period, 1.96 percent during the second period (before the Cytobrush technique was implemented), and 1.96 percent during the third period (after the Cytobrush technique was implemented).
  
  
  CONCLUSIONS
  It seems logical that Papanicolaou smears containing better cellular material from the squamocolumnar junction would increase the yield of Papanicolaou smears with cancerous and precancerous cells. Our study, however, did not confirm this supposition. While evaluation of Papanicolaou smear technique based on quantity and quality of cellular material is important, we believe the effectiveness of any technique must be evaluated from another perspective--the actual practice setting.
authors.affiliation: Department of Family Medicine, Scott & White Clinic, Temple, TX.
authors.forename: D B
authors.initials: DB
authors.lastname: Cauthen
authors.forename: M
authors.initials: M
authors.lastname: Cullison
authors.forename: B
authors.initials: B
authors.lastname: Symm
authors.forename: R F
authors.initials: RF
authors.lastname: Peterson
mesh_terms: D002985:Clinical Protocols / Q000592:standards; D003584:Cytological Techniques / Q000295:instrumentation*; D005069:Evaluation Studies as Topic; D005194:Family Practice / Q000592:standards*; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D012680:Sensitivity and Specificity; D013781:Texas / Q000453:epidemiology; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D014626:Vaginal Smears / Q000295:instrumentation*