title: Plastic spatula with narrow long tip provides higher satisfactory smears for Pap test.
abstract: BACKGROUND
  Ayre spatula for cervical smear collection is being used despite the suggestion that different modified spatulas provide more satisfactory sampling.
  
  
  OBJECTIVE
  To see whether the cytological pickup improves with the use of long tipped spatula.
  
  
  METHODS
  Rurally based University Hospital; crossover study.
  
  
  METHODS
  Pap smear using Ayre spatula in 500 and with plastic narrow long tip (Szalay) spatula in 500 clinic attending women was taken and analyzed. Crossover smears were taken with modified spatula in 163 and using Ayre spatula in 187 women after 2 weeks of initial smears. The same pathologist made cytological reporting for all smears and was unaware of the type of spatula used.
  
  
  RESULTS
  Smears from Ayre spatula had significantly higher reports of inadequate smears (94 of 500 vs. 68 of 500 for Ayre and Szalay, respectively; P = 0.032) and it remained so even after crossover (94 of 187 vs. 70 of 163 for Ayre and Szalay, respectively; P = 0.2). Cellular quality appeared better with smears taken using Szalay spatula, but the overall abnormal smear detection rate remained similar with either collection tool (χ(2) = 1.5; P = 0.2).
  
  
  CONCLUSIONS
  Proportion of satisfactory smears is higher when long tip plastic spatula is used for collection of sample.
authors.affiliation: Department of Obstetrics and Gynecology, Kasturba Medical College, A Constituent College of Manipal University, Manipal, Karnataka, India.
authors.forename: Pervinder
authors.initials: P
authors.lastname: Kaur
authors.forename: Pralhad
authors.initials: P
authors.lastname: Kushtagi
keywords: Ayre spatula; Pap test; cervical cancer screening; narrow long tip spatula; satisfactory smear