title: Comparison of Pap smear quality with anatomical spatula and convenience (spatula-cytobrush) methods: a single blind clinical trial.
abstract: OBJECTIVE
  The Papanicolaou smear is a standard test for cervical cancer screening; however, the most important challenge is high false negative results. Several factors contribute to this problem and one the most important is inappropriate sampling. The aim of this study was to compare the quality of smears obtained by either an anatomical spatula or a spatula-cyto brush.
  
  
  METHODS
  One hundred married women participated in this single blind clinical trial. After all participants were interviewed, two samples were obtained from each: one with a spatula-cytobrush and another with an anatomical spatula. Slides were prepared and assessed by two pathologists for kappa coefficient analysis.
  
  
  RESULTS
  Cell adequacy was 96.1 % in anatomical spatula method and 91.2 % in spatula-cyto brush method (p= 0.016). The rates for endocervical cells and metaplasia cells were 70.6%and 24.5%, respectively, with the anatomical spatula method and 69.6% and 24.5% using a spatula-cytobrush (p<0.001). No one reported pain and the amount of bleeding was 38.2% in both methods (p>0.05). In addition, there were no statistically significant differences regarding infection and inflammatory reactions (p>0.05).
  
  
  CONCLUSIONS
  Based on the findings of this study, the results of sampling with anatomical spatula were more acceptable and better than those of spatula-cytobrush sampling.
authors.affiliation: Department of Midwifery, Fatemeh College of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran. abdali_kh@yahoo.com
authors.forename: Khadijeh
authors.initials: K
authors.lastname: Abdali
authors.forename: Marzieh
authors.initials: M
authors.lastname: Soleimani
authors.forename: Marjan
authors.initials: M
authors.lastname: Khajehei
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Tabatabaee
authors.forename: Perikala V
authors.initials: PV
authors.lastname: Komar
authors.forename: Nader Riaz
authors.initials: NR
authors.lastname: Montazer
mesh_terms: D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000473:pathology*; D003584:Cytological Techniques / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D016037:Single-Blind Method; D013525:Surgical Instruments; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D014626:Vaginal Smears / Q000295:instrumentation* / Q000379:methods; D055815:Young Adult