Evaluating of citological quality in three diferent spatula for PAP testing

Abstract

Objective: Identify the spatula that achieves the lowest percentage of "less tan optimal" PAP smears.

Methodology: Cross-sectional study, with an intentional and proportionally stratified simple, consisting of 761 women between 25 and 64 years of age, in the public health centers of the Northern Metropolitan Health Service. Midwives took the PAP sample from each women using one of the three spatulas: Ayre, a plastic spatula and the combination Citobrush-Ayre (C+A). (Fig 1, 2, 3). The PAP samples were classified as "satisfactory" or "less tan optimal" according to the Bethesda System. Results: The highest percentage of "less tan optimal" samples, (17.4%), was found in women between 25 and 34 years of age, and the minimum (0.8%) in women from 55 to 64 years. This result was statistically significant (pvalue <0.000 Chi2). Comparing the "cytological quality" of each spatula, significant differences were also found (p value < 0.014). The combination (C+A) and the plastic spatula had lower percentages of "less than optimal" samples (9.8% and 10%, respectively) compared with the Ayre spatula (17.3%). Conclusion: The combination (C+A) achieved the lowest percentage of "less than optimal" samples, and the best "cytological quality." The combination (C+A) was a factor favoring "cytological quality." The best "cytological quality" is associated with older age groups with all spatulas used in this study.