Evaluation of smears obtained by cervical scraping and an endocervical swab in the diagnosis of neoplastic disease of the uterine cervix

Abstract

A study of the supplementary value of an endocervical swab smear in addition to cervical scraping in the cytological diagnosis of cervical neoplasias is presented. The two sampling techniques were applied to a population with a high prevalence of neoplastic cervical disease. The endocervical swab smear was a useful adjunct in the detection of mild and moderate dysplasia, and a combination of the two sampling methods decreased the false negative rate in the diagnosis of intraepithelial, as well as invasive neoplasia. In the sphere of specific cytological diagnosis cervical scraping was found to be the more accurate method for diagnosing severe dysplasia and carcinoma in situ, while endocervical swab smears were more useful in diagnosing mild and moderate dysplasia. Differences between the results obtained in our study and comparable studies are discussed. It is concluded that the endocervical swab smear is a valuable adjunct to cervical scraping in the diagnosis of malignant cervical disease. It should not, however, be used as the only sampling method as it produces a higher proportion of unsatisfactory smears, and also because the severity of the epithelial lesion is more likely to be underestimated.