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 Vanchai Vatanasapt

EVIDENCE SUMMARY

The review attempts to find a suitable method of cervical cancer screening by comparing the advantages and the drawbacks of the currently available Pap (Papanicolau) smear devices.

The device used in the collection of the Pap smear is important. The review shows that the commonly used wooden spatula (Ayres spatula) to obtain cells from cervix is not the best device for collecting an adequate smear and to identify abnormal cells. The longer-tipped and narrower headed wooden spatula called the Aylesbury device is found to be better for this purpose.

The search and review of the articles have been extensive. Meta-analysis of all the data has been done properly and the results are presented clearly.

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: Vanchai Vatanasapt. Cervical smear collection devices: how effective are they at detecting endocervical cells and dyskaryosis?: RHL commentary (last revised: 15 November 2002). The WHO Reproductive Health Library, No 9, Update Software Ltd, Oxford, 2006. www.rhlibrary.com