Currently, the vast majority of Pap smears are obtained using a wooden Ayre spatula, which is associated with suboptimal sampling of the endocervix and a higher rate of inadequate smears compared with use of the cytobroom. [9,10]
Specifically, our objective was to determine whether training with the Ayre spatula (step 1) or introduction of the cytobroom (step 2) resulted in greater improvements in Pap smear adequacy rates.
Step 2 included a 1-day on-site training in the use of the cytobroom. No additional mentorship was provided during step 2.
After step 2, during which the cytobroom was introduced, results were reported for 212 of 219 Pap smears.
We found that both training on the Ayre spatula and introduction of the cytobroom resulted in statistically significant improvements in adequacy rates.
We are not aware of any prior studies comparing training with the introduction of the cytobroom to improve Pap smear adequacy rates in SA.