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Plastic Spatula with Narrow Long Tip is Better than Ayre’s Spatula for Pap Test
 Author : Pervinder Kaur ,MD Resident in Obstetrics-Gynecology Kasturba Medical College, Manipal
Pralhad Kushtagi, MD DNB FICOG Professor in Obstetrics-Gynecology Kasturba Medical College, Mangalore
Lakshmi Rao, MD Professor in Pathology Kasturba Medical College, Manipal
Cancer of the uterine cervix continues to be a leading cause of morbidity and mortality among women worldwide. Of the new cases reported, three fourth of them occur in developing countries. It is the most common neoplasm among Indian women accounting for 20-50% of all cancers and 80-85% of female genital cancers. 1 Although adoption of screening program with exfoliative cytology has resulted in a large decline in incidence of cervical cancer and mortality due to it in developing countries, it remains a significant problem in developing countries either because of ineffective or no screening.

Approximately two thirds of the false negative results are caused by sampling error, and the rest are caused by detection errors. An attempt was made to see whether the cytological pickup improves with the use of long tipped spatula.

Clinic attending 1000 women aged between 30-70 years and consenting to participate in the study were recruited. Celibate women, those having vaginal bleeding or lesion on the cervix were excluded.

Cervical smear for Pap test was obtained using the traditional Ayre’s spatula in 500 cases and with Szalay’s spatula in 500 cases. Szalay’s spatula is made of plastic and has an elongated narrow tip. Re-screening was planned in 2-3 weeks for crossover. From Ayre’s spatula group 163 women returned and had repeat smear from Szalay’s spatula; and 187 women of initial Szalay’s spatula group had repeat smear using Ayre’s spatula. A single person (1st author) obtained all the smears; and a single person (LR).