Related Terms: Cervical smear; gynecologic cytology; Pap smear; Pap test; vaginal cytology; liquid based cytology.

Test Includes: Conventional smears with BD FocalPoint Slide Profiler System.

Availability: Mon–Fri 08:00–17:00; Pathologist on call at all times for consultation.

Special Instructions: Specify pertinent gynecologic and oncologic history, treatment, signs, symptoms, and risk factors.

Sample Collection: Label frosted end of slide with patient name.

  • Endocervical sampling — Cervical brush of endocervical canal. Use a tapered synthetic fiber brush (cytobrush) to sample endocervical cells. Rotate brush 90o to 180o in canal gently to limit bleeding. Apply material onto glass slide by rotating on surface. Do not scrub material on slide.
  • Ectocervical scrape — With wooden spatula, thoroughly scrape the entire ectocervix with emphasis on the squamocolumnar junction. If excess mucus or inflammatory exudate covers the mucosa, wipe it off gently using cotton tipped swab prior to sampling. Spread material evenly onto labeled glass slide and fix immediately by placing in 95% alcohol or using spray fixative. Both the endocervical and ectocervical specimen are placed on the same slide.
  • Place slides in holders when dry.

Analytic Time: 2–3 days.

Causes for Rejection: Improper/delayed fixation with air-drying artifact. Unlabeled slides. Obscuring blood, inflammation, or mucus. Scant cellular samples. Insufficient demographic or clinical information for processing.

Interpretation: Results interpreted by cytotechnologists or cytopathologists. Modified Bethesda System terminology.

Limitations: Allowing smears and brushings to dry before they are fixed may render them unsatisfactory for cytologic evaluation. The Pap smear is a screening procedure only. Annual screening increases and improves the reliability of the test and the rate of detection for premalignant lesions. Patients with signs and/or symptoms of gynecologic abnormalities may require diagnostic procedures despite negative cytologic findings.