Collection devices for obtaining cervical cytology samples

Extended tip spatulas (Aylesbury device) of various designs appear to be better for collecting endocervical cells than the commonly used Ayre spatula. The most effective combination appears to be the cytobrush and an extended tip spatula. Health workers will require training in the form of a one-day workshop to implement this intervention.

RHL Commentary by Jurandyr M. Andrade, Rui A. Ferriani

EVIDENCE SUMMARY

The review identified randomized trials investigating the performance of sixteen cervical smear collection devices. All the devices capable of collecting endocervical smears were superior to the Ayre spatula in terms of smear quality. The devices that collect a higher proportion of endocervical cells have a better chance of detecting abnormal cytology, particularly in the presence of severe dyskaryosis.

Most of the adequately controlled trials have been included. The study by Germain et al.(1) for example, was not included. The selected trials were carefully analysed.

The full RHL commentary also includes sections on:

Relevance
- Magnitude of the problem
- Feasibility of the intervention
- Applicability of the results of the Cochrane Review
- Implementation of the intervention
- Research
References

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This document should be cited as: Jurandyr M. Andrade, Rui A. Ferriani. Cervical smear collection devices: how effective are they at detecting endocervical cells and dyskaryosis?: RHL commentary (last revised: 17 December 2000). The WHO Reproductive Health Library, No 9, Update Software Ltd, Oxford, 2006. www.rhlibrary.com