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.
1Reproduced with permission from: Wolfendale, Margaret, 1995. Taking Cervical Smears. British Society for Clinical Cytology: page 12.
2Reproduced with permission from: Burghardt, Erich, 1984. Colposcopy Cervical Pathology Textbook and Atlas. Georg Thiem Verlag. Germany: pages 162 & 174.
3Reproduced with permission from: Cartier, René, 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.