title: Cervical cytology: a randomized comparison of four sampling methods.
abstract: OBJECTIVE
  The purpose of this study was to compare smear quality and endocervical cell recovery of four cervical smear sampling devices.
  
  
  METHODS
  Two thousand fifteen patients undergoing routine cervical smears at the University of Tennessee Obstetrics and Gynecology clinics were randomly assigned to a cotton swab-spatula, Cytobrush-spatula, Cervex-Brush, or Bayne Pap Brush. The cytopathology laboratory, blind to method, used specific criteria to grade smears as being optimal, adequate, marginal, or inadequate. Statistical analysis was by the chi 2 and analysis of variance tests.
  
  
  RESULTS
  No statistical differences occurred among the groups for nonpregnant patients. For pregnant patients smear quality was improved with both Cytobrush-spatula and Bayne Pap Brush versus cotton swab-spatula (p = 0.0301 and 0.0004, respectively); cotton swab-spatula had fewer endocervical cells than the Cytobrush-spatula (p = 0.0001), Cervex-Brush (p = 0.0288), and Bayne Pap Brush (p = 0.0081).
  
  
  CONCLUSIONS
  The cotton swab-spatula and Cytobrush-spatula appear to be the most effective screening methods for nonpregnant and pregnant patients, respectively.
authors.affiliation: Department of Obstetrics and Gynecology, University of Tennessee, Memphis 38103.
authors.forename: M L
authors.initials: ML
authors.lastname: McCord
authors.forename: T G
authors.initials: TG
authors.lastname: Stovall
authors.forename: J L
authors.initials: JL
authors.lastname: Meric
authors.forename: R L
authors.initials: RL
authors.lastname: Summitt
authors.forename: S A
authors.initials: SA
authors.lastname: Coleman
mesh_terms: D001706:Biopsy; D002584:Cervix Uteri / Q000166:cytology* / Q000473:pathology; D003127:Colposcopy; D004867:Equipment Design; D005260:Female; D006801:Humans; D011247:Pregnancy; D011897:Random Allocation; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis; D014626:Vaginal Smears / Q000295:instrumentation / Q000379:methods*