Cervical Pap smears are designed primarily to detect cervical dysplasia, the precursor lesion of cervical carcinoma. We recommend the combined use of a spatula and brush; the combined method is superior for detecting lesions in the cervical canal that cannot be reached with the spatula alone.
In the conventional method, the physician or physician’s assistant smears the collected material on a slide, which is then fixed in alcohol. This slide is sent to the laboratory for staining and interpretation. (In the newer method, the collected material is transferred to a liquid fixative, which is then processed and stained in the laboratory.)
The cervical Pap smear is an excellent screening test, but like any screening test, it is not perfect. One way to improve its accuracy is to perform Pap smears annually; the majority of patients who develop invasive cancer of the cervix have not had Pap smears, or have had them performed sporadically.
METHOD OF COLLECTION
Use the Pap smear kit that has been provided to you by Calpath lab. This kit contains a spatula, an endocervical brush, a glass slide and a pouch of alcohol fixative. The instructions for collecting the smear are on the inside of the package supplied to you, but they will be repeated here.
- Prompt fixation is important, and it is necessary, therefore, to prepare the fixative before collecting the specimen. Tear open the fixative pouch or uncap the fixative spray bottle prior to collecting the specimen.
- Take the cervical smear by rotating the notched end of the spatula 360 degrees around the cervix, with the os at the center point. Hold this sample aside until the endocervical sample has been collected.
- Take the endocervical sample by gently inserting the endocervical brush into the os and rotating it one half turn. Gently remove the brush. Note: the endocervical brush should not be used in pregnant patients.
- Prepare the smear by evenly spreading the material collected on the wooden spatula over two-thirds of the glass slide, and do this without using excessive pressure. Then quickly spread the endocervical sample over the remaining one third of the slide by rolling the endocervical brush on the slide.
- Immediately fix the smear by flooding the slide with the cytology fixative provided in the kit, or spray with a spray fixative.
- Label the slide with the patient’s name.
- Place the slide in the cardboard slide container provided with the Calpath Pap smear kit.
- Federal regulations require that you provide the laboratory with the following information: patient’s date of birth, LMP, previous Pap history, and relevant clinical information. In addition, Medicare patients have to sign an “Advance Beneficiary Notice” form; the completed ABN form should be attached to the Calpath requisition form.
- Complete the Calpath requisition form per the instructions.
After collecting the specimen, please do the following:
- Place the specimen in the Calpath specimen bag.
- Place the requisition form in the side slot of the Calpath specimen bag.
- Call Calpath for a pickup or place the Calpath specimen bag in the location where our courier usually picks up your daily specimens.