Relation between sampling device and detection of abnormality in cervical smears: a meta-analysis of randomised and quasi-randomised studies

Buntinx, Frank; Brouwers, Marleen

doi:10.1136/bmj.313.7068.1285

Cited by 48 publications

(37 citation statements)

References 30 publications

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“…Em se tratando de evidências, uma revisão analisando 28 estudos randomizados, quase randomizados e pareados, com 85.000 pacientes, concluiu que o uso combinado da espátula de Ayre com a escova cervical obtém melhores resultados para o esfregaço do que seu uso isolado (17) .…”

Section: Discussionunclassified

Desempenho de enfermeiras na coleta de material cervico uterino para exame de Papanicolaou

2010

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RESUMO Objetivos:Verificar conhecimento e prática de enfermeiras na coleta de material cérvico-uterino, identificar disponibilidade de materiais para realização da coleta e conferir adequabilidade da lâmina. Métodos: Estudo transversal, de campo, realizado de agosto a outubro de 2006, com 21 enfermeiras. Conhecimento foi investigado por questionário; técnica de coleta e materiais foram pesquisados por observação; adequabilidade das lâminas foi verificada nos laudos laboratoriais. Resultados: Dezessete enfermeiras se auto-avaliaram seguras para realizar o exame; duas investigaram esvaziamento da bexiga; quatro explicaram o procedimento; nenhuma indagou uso de duchas, abstinência sexual e sangramento intermenstrual; duas não usaram espátula corretamente e duas consideraram desnecessária a coleta da endocérvice; duas coletas levaram tempo excessivo para fixação. Espéculos e pinças Cherron foram insuficientes; 63(100%) das lâminas estavam adequadas. Conclusão: Há déficit de conhecimento e de técnica, insuficiência de materiais, e apesar das falhas observadas na coleta, 100% dos laudos conferiram adequabilidade às lâminas. Descritores: Esfregaço vaginal; Neoplasias do colo do útero; Avaliação de desempenho; Conhecimentos, atitudes e prática em saúde ABSTRACT Objectives: Verify nurses' knowledge and practice to material uterine cervical, to identify availability of material of collection and to verify suitability of the smears. Methods: Transversal study, at service, was carried from August to October 2006, with 21 nurses. Knowledge was investigated through questionnaire; collection technique and material were researched through observation; suitability of the smears was verified in the lab reports. Results: Seventeen nurses evaluated themselves security to carry through the examination; two had asked about emptiness of bladder and four had explained procedure; none inquired using a shower, sexual abstinence and bleed intermenstrual; two had left to use of spatula correctly and two had considered unnecessary endocervix collection; two collections the time for fixation was excessive. Speculums and Cherron clamps had been insufficient; 63 (100%) blades were adjusted. Conclusion: It has been detected deficit of knowledge and technique, insufficiency of materials, and although the imperfections observed in the collection, 100% of the findings had conferred adequateness to the blades. Keywords: Vaginal smears; Uterine cervical neoplasms; Employee performance appraisal; Health knowledge, attitudes, practice RESUMEN Objetivos: Verificar conocimiento y práctica de enfermeras en colecta de material del cuello uterino, identificar disponibilidad de materiales para realización de coleta y averiguar adecuación de lámina. Metodos: Estudio transversal, de campo, realizado de agosto a octubre de 2006, con 21 enfermeras. Conocimiento fue investigado por cuestionario; técnica de colecta y materiales fueron investigados por observación; adecuación de láminas fue verificada en laudos laboratorillos. Resultados: Diecisiete enfermeras se ...

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Section: Discussionunclassified

Desempenho de enfermeiras na coleta de material cervico uterino para exame de Papanicolaou

2010

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“…Vários trabalhos demonstraram que a associação da escova cytobrush com a espátula de Ayre tem bom desempenho para o diagnóstico citológico da neoplasia de colo uterino 3,[8][9][10] . Luzzatto e Boon 11 analisaram separadamente a contribuição das amostras endocervical e ectocervical de cada exame para a detecção das lesões pré-neoplásicas do colo uterino.…”

Section: Discussionunclassified

“…Vários dispositivos para colher material do canal cervical foram testados, sendo que os resultados mostraram que a utilização de técnicas que Zeferino et al Diagnóstico das neoplasias de colo incluem amostragem do canal cervical apresentaram melhor desempenho 3 . Pelos fatos acima expostos, a amostra do canal cervical é quase obrigatória, porém faltam informações objetivas do real papel da amostra do fundo de saco no diagnóstico citológico da neoplasia do colo uterino.…”

Section: Introductionunclassified

Desempenho das Amostras do Canal Cervical e do Fundo de Saco no Diagnóstico da Neoplasia do Colo Uterino

Zeferino¹,

Catharino²,

Araujo³

et al. 2000

Rev. Bras. Ginecol. Obstet.

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Resultados: os percentuais de exames alterados dos grupos 2 (2,6%) e 3 (2,4%), incluindo todas as lesões escamosas e glandulares, foram significativamente maiores que no grupo 1 (2%). Os percentuais de diagnóstico da lesão intra-epitelial escamosa de baixo grau (LIE-BG) não foram estatisticamente diferentes entre os três grupos (1,27; 1,25 e 1,07%). Por outro lado, os percentuais de diagnóstico da lesão intra-epitelial escamosa de alto grau (LIE-AG) foram significativamente maiores nos grupos 2 (0,81%) e 3 (0,77%) do que no grupo 1 (0,54%

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“…Seven studies suggested the potential benefits of improved sampling due to use of endocervical brush and better identification of precursor lesions, thereby reducing progression to adenocarcinoma. 8,13,21,[40][41][42][43] In Ontario, the endobrush was first recommended in 1989 through the publication of ''The Adequate Pap Smear,'' which detailed proper collection techniques. 44 Many clinicians had already adopted this format several years prior to the recommendations.…”

Section: Discussionmentioning

confidence: 99%

Decreasing incidence of cervical adenocarcinoma in Ontario: Is this related to improved endocervical Pap test sampling?

Howlett

Marrett

Innes

et al. 2006

Intl Journal of Cancer

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In many developed countries, the incidence of cervical cancer has decreased. These reductions have been specific to squamous cell carcinoma (SCC) and have not included adenocarcinoma (AC). Incidence of AC has increased steadily over the last 20 years. The intent of this article is to examine trends in cervical adenocarcinoma incidence in Ontario over a 20-year period in relation to screening practices. All cases of cervical cancer between 1981 and 2002 were extracted from the Ontario Cancer Registry (a population-based, provincial-wide database). Age-standardized incidence rates were calculated overall, by broad age groups and by morphological type (SCC and AC). Time trends were assessed using JoinPoint methodology. In Ontario, opportunistic cervical cancer screening has been accompanied by significantly decreased rates of SCC since at least 1981. Conversely, the incidence of AC rose by 3.1% per year (95% CI: 1.6%, 4.6%) between 1981 and 1995, and subsequently declined by 4.0% per year (95% CI: 27.4%, 20.5%). From the mid-to late-1990s, instructions were distributed to clinicians, reinforcing the importance of dual specimen collection (i.e. using both spatula and endocervical brush). At the same time, laboratories routinely provided physicians with kits that included both spatula and brush. The subsequent decline in AC incidence may be due, in part, to improved specimen collection. As well, the decline may be partly due to increased awareness of AC precursors among cytopathologists and clinicians, and/or improvements in laboratory training and quality assurance. ' 2006 Wiley-Liss, Inc.

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Relation between sampling device and detection of abnormality in cervical smears: a meta-analysis of randomised and quasi-randomised studies

Abstract: These results support the use of either the extended tip spatula, a combination of any spatula plus the Cytobrush or cotton swab, or the Cervex brush for cervical screening.

Cited by 48 publications

References 30 publications

Desempenho de enfermeiras na coleta de material cervico uterino para exame de Papanicolaou

Desempenho de enfermeiras na coleta de material cervico uterino para exame de Papanicolaou

Desempenho das Amostras do Canal Cervical e do Fundo de Saco no Diagnóstico da Neoplasia do Colo Uterino

Decreasing incidence of cervical adenocarcinoma in Ontario: Is this related to improved endocervical Pap test sampling?

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