title: Comparison of pap smear quality with anatomical spatula method and the common method (spatula-cytobrush): a single blind clinical trial.
abstract: BACKGROUND
  Cervical cancer is the third most common cancer in women in the world. Papanicolaou smear is known as a standard test for cervical cancer screening; however, the most important challenge is high rates of false negative results. The aim of this study was to compare the quality of smears obtained by anatomical spatula and spatula-cytobrush. The most important factor in false negative result is inappropriate tool of sampling.
  
  
  METHODS
  One hundred married women participated in this single blind clinical trial. All participants were interviewed; two samples were obtained from every participant: one with spatula-cytobrush and another one with anatomical spatula. All slides were encoded and were assessed by two pathologists. Then, data were analyzed by means of kappa coefficient.
  
  
  RESULTS
  Cell adequacy was 96.1 % in anatomical spatula method and 91.2 % in spatula-cytobrush method (p= 0.016). The rates for endocervical cells and metaplasia cells in anatomical spatula method were 70.6% and 24.5% respectively and these amounts were 69.6% and 24.5% respectively in the spatula-cytobrush method (p <0.001). No one reported any pain and the amount of bleeding was 38.2% in both methods (P>0.05). Regarding infection and inflammatory reactions there was no statistically significant difference between two methods (p>0.05).
  
  
  CONCLUSIONS
  Based on our findings in this study, results of sampling with anatomical spatula method were more acceptable and better than those with spatula-cytobrush sampling.
authors.affiliation: Dept. of Midwifery, Fatemeh College of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Soleimani
authors.affiliation: Dept. of Midwifery, Fatemeh College of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Kh
authors.initials: Kh
authors.lastname: Abdali
authors.affiliation: Dept. of Sexology, School of Public Health, Curtin University, Western Australia.
authors.forename: M
authors.initials: M
authors.lastname: Khajehei
authors.affiliation: Dept. of Epidemiology, Health and Nutrition Faculty, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: H R
authors.initials: HR
authors.lastname: Tabatabaee
authors.affiliation: Medical Faculty, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: P V
authors.initials: PV
authors.lastname: Komar
authors.affiliation: Medical Faculty, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: N
authors.initials: N
authors.lastname: Riaz Montazer
keywords: Cervical neoplasm; Clinical trial; Papanicolaou smear