Appraisal of sampling methods in Cervical cancer screening: In specual reference to comparison between Cervex brush and cotton swab

Objective: An attempt was made to compare the detection of cervical abnormalities between the use of a cotton swab and a Cervex brush in mass cancer screening. Study Design: Of 15, 664 women who participated in a cervical cancer screening program in 2002, 8, 366 women underwent Cervex brush sampling and 7, 298 underwent cotton swab screening to compare the detectability of dysplasia and cancer in situ. Results for 2002 were also compared to those from 1998 to 2001. The proportion of unsatisfactory smears to all smears taken by 25 gynecologists was evaluated. Results: The detectability of cervical abnormalities including low grade squamous intraepithelial lesion (LSIL) and high grade squamous intraepithelial lesion (HSIL) was higher in the use of the Cervex brush than with the cotton swab. The sensitivity for women 49 years of age or younger was significantly high with the Cervex brush. A proportion of inappropriate smears to all smears was 3 times higher in cotton swab sampling than Cervix brush sampling. The proportion of inappropriate smears varied among doctors taking smears. Conclusion: The use of the Cervex brush was significantly more efficient in detecting cervical abnormalities. Variations in detectability were also significantly smaller among gynecologists, indicating the feasibility of the Cervex brush as a sampling device.