Collection Technique (for Conventional Pap Smear)

Obtaining Cellular Sample When using a spatula/Combi brush to collect sample, the long thin end is inserted in the endocervical canal and the broad arm of spatula is rotated 3600 over ectocervix in clockwise or anticlockwise direction 4-5 times (Fig. 16.1). It should be applied with some degree of firmness and rotated around the full circumference of the cervix. For “broom-type” sampler, it should be rotated 5 times in a clockwise direction with the central longer bristles in the canal. Slight bleeding is to be expected and will not interfere with interpretation. However, forceful scraping may lead to trauma and excessive bleeding and blood will interfere with interpretation. Particular care should be taken in young women with cervical erosion as they tend to bleed easily. Similarly, a small amount of mucus does not affect interpretation. However, if a large plug of mucus obscures the external os, it can be removed gently with a swab prior to sample collection.


If spatula alone is used for endocervix and an endocervical brush sample is taken separately, this should follow the spatula sample as it may cause slight bleeding. The brush is gently inserted into the endocervix and rotated gently one-half to one full turn.