The effect of cervical cleaning with a big cotton swab on Pap smear samples quality

Cervical cancer is one of the most frequent female cancers which is usually diagnosed late. Papanicolaou test is an important screening tool for early diagnosis, but it has false-negative results. In this study, the effect of cervical discharge cleaning with a big cotton swab before taking the smear on diagnostic efficacy of this test were evaluated. This study is a randomized clinical trial which was conducted from September 2007 until December 2010 among 500 women who came to Tehran Bouali hospital gynecology clinic and had indication for Papanicolaou test. These women were divided into two groups as case and control by random allocation. In case group, before taking the smear, cervical discharge was cleaned by a big cotton swab. In control group, the smear was taken in traditional way with spatula. At last, the quantity (presence of 8000-12000 squamous cells), quality (presence or absence of endocervical cells) and amount of inflammatory exudates in the smears (highà coverage of >75% of smear, moderateà coverage of 50-75% of smear, lowà coverage of <50% of smear with inflammatory exudate) were compared between two groups using Mann-witney, chi-square, Fisher-exact test and t-student test. Quantity, quality and the amount of inflammatory exudates in the smears were the same in these two groups. According to the results of this study, cleaning cervical discharge by a big cotton swab prior to taking sample for Papanicolaou test did not increase the diagnostic efficacy of this test.