Cervix Sampling Card (Papscreen Victoria)

ervix Sampling Card

This resource is a guide for practitioners to assist them in identifying visual cervical appearances.

The images shown here are some examples of cervices you may see when taking a Pap test.

It is recommended that any visual cervical abnormality be referred for further investigation even if the Pap test is reported as normal.

Nulliparous1

Eversion/ectropion2

Multiparous

Atrophy

IUD

Nabothian follicles

Polyp

Stenosis

Post treatment2

Mucopurulent discharge3

Cervical wart

Cancer2

If you are uncertain about the appearance of the cervix, we recommend you seek a second opinion.

Thank you to all practitioners who provided cervical images for this resource.

Funded by PapScreen Victoria, the Victorian component of the National Cervical Screening Program.

Produced by PapScreen Victoria and VCS Pathology.

1 Reproduced with permission from: Wolfendale, Margaret, 1995. Taking Cervical Smears. British Society for Clinical Cytology: page 12.

2 Reproduced with permission from: Burghardt, Erich, 1984. Colposcopy Cervical Pathology Textbook and Atlas. Georg Thiem Verlag. Germany: pages 162 & 174.

3 Reproduced with permission from: Cartier, RenĂŠ, 1984. Practical Colposcopy. Laboratoire Cartier. Switzerland: page 168.

ervix Sampling Card

A guide to taking a high-quality Pap test

To order a free copy of Taking a Pap test: instructional DVD contact VCS Pathology on (03) 9250 0300.

Alternatively, watch the video online at www.mshc.org.au.

Go to Health Professionals, then Videos.

Recommended techniques and instruments to be used when taking a Pap test For pre-menopausal women Cervical sampler broom: rotate 3–5 times or Cervex-Brush® Combi: insert central part of the brush into os and rotate clockwise twice or Spatula: rotate once or twice, taking care to keep contact with the ecto-cervix plus Endocervical brush: insert ensuring that you can see the lower row of the bristles and make a quarter rotation

Sampling instruments

For peri and post-menopausal women

Techniques

Cervical sampler broom: rotate 3–5 times plus Endocervical brush: insert ensuring that you can see the lower row of the bristles and make a quarter rotation or Cervex-Brush® Combi: insert central part of the brush into os and rotate clockwise twice or Spatula: rotate once or twice, taking care to keep contact with the ecto-cervix plus Endocervical brush: insert ensuring that you can see the lower row of the bristles and make a quarter rotation.

Cervical sampler broom & Cervex-Brush® Combi

Endocervical brush Cervical sampler broom Cervex-Brush® Combi Hybrid Capture® Brush

Spatula & Endocervical brush

Hybrid Capture® Brush

Making the Pap slide: After taking the sample/s they must be placed promptly onto the slide. Wipe both sides of the spatula, cervical sampler broom or Cervex-Brush® Combi onto the slide. If you have taken an endocervical brush sample, roll this gently onto the remaining half (see diagrams).

If you wish to discuss sampling techniques, ring VCS Pathology and ask to speak to a Liaison Physician.

Fix the slide within 5 seconds, spraying from a distance of around 20cms. The cells expand if they are not fixed quickly and any degree of dysplasia might be underestimated.

For more information about Pap tests, HPV testing or cervical cancer visit www.papscreen.org.au or call the Cancer Council Helpline on 13 11 20.

Liquid-based cytology: Use plastic sampling instruments and agitate them in the liquid medium to release cells. Dispose of the instruments, do not leave them in the fluid.

© February 2013 Cancer Council Victoria

Spatula

Watch the instructional DVD Taking a Pap test to see the correct technique for making and fixing the slide.

Testing for HPV using Hybrid Capture® Brush After taking the Pap test, insert the brush into the cervical os (ensuring you can see the lower bristles). Rotate it 3 times counter-clockwise, withdraw it and snap it off into the tube. HPV testing can also be done on liquid-based samples. Check with your lab.

Special notes Eversion: take care to sample the squamo-columnar junction. This is the junction where the columnar epithelium of the endocervical canal meets the squamous epithelium of the vagina. It is the area where cell changes occur.

Pregnancy: do not use the endocervical brush or Cervex-Brush® Combi.

Disclaimer This resource is a guide for practitioners only. Neither PapScreen Victoria nor any other persons associated with the preparation of this resource accept any liability whatsoever from consequences arising from the use of this resource.