This document provides guidelines for collecting Pap smear samples. It defines a Pap smear as a screening procedure for cervical cancer that tests for precancerous or cancerous cells on the cervix. The guidelines specify the equipment needed for collection, including a speculum, brush, and slides. It outlines policies for screening based on age and risk factors. The procedure involves examining the cervix with a speculum, collecting cell samples from the cervix and smearing them on slides, which are then sent for laboratory evaluation.

2. PURPOSE
❖Provides guidelines for OB Gyne doctors for
collection of PAP SMEAR
❖Prevent errors in collection of PAP SMEAR

3. DEFINITION
A Pap smear, also called a Pap test, is a
screening procedure for cervical cancer. It
tests for the presence of precancerous or
cancerous cells on your cervix.

4. EQUIPMENTS
▪ Cytology request
▪ Vaginal Speculum
▪ Cervical Brush
▪ Spatula
▪ Glass Slide
▪ Fixative Solution

5. POLICY
❖ Screen sexually active women for precancerous lesions of the cervix.
❖ Ensure Pap Smear properly collected ,labeled & documented
❖ Pap smear to be started 3 years after vaginal intercourse,no earlier
than age 21
❖ Women aged 21 -29 years ,should be test every 3years .
❖ Beginning at age 30 ,the preferred way to screen with Pap Test
combined with HPV test every 5 years. This is called co testing and
should continue until age 65.
❖ Women who are high risk of cervical cancer because of suppressed
immune system ,for ex from HIV infection ,organ transplant ,or long
term steroid use.
❖ Women who had a total hysterectomy ( removal of uterus and
cervix ) should stop screening unless hysterectomy was done as a
treatment for cervical pre cancer .
❖ Women who have been vaccinated against HPV should still follow
these guidelines

6. PROCEDURE
⮚ Women should have pAP Smear when she is not menstruating,best
time at least 5 days after the end of menstrual period.
⮚ For about 2 days before testing ,woman should avoid douching or using
spermicidal foams ,creams or jellies or vaginal medicines except
directed by physician . These may wash away or hide abnormal cervical
cells
⮚ No intercourse during 48h prior the test
⮚

7. PROCEDURE
▪ The women placed on examination table ,clinician will examine outside of the patients genital and rectal areas
,including urethra to assure they look normal
▪ The Doctor insert speculum into the vagina so the wall of the vagina and cervix can be seen clearly
▪ Cotton swab is sometimes used to clear away mucus that might interfere with an optimal sample
▪ Endocervical sample to be taken by inserting the cervical brush into the opening of the cervix and twirled around to
collect a sample of cells
▪ Endocervical samples also collected as part of the PAP smear .These cells are collected from a scraping the area
surrounding ,but not entering the cervical os
▪ Both endocervical and ectocervical samples gently smeared on a glass slide, and a fixative ( preservative) is used to
prepare cells on the slide for laboratory evaluation (conventional method ) with liquid based methods the specimen is
place in to a liquid fixative solution
▪ A bimanual exam usually follows the collection of the two samples for the PAP smear
▪ Sample will be labeled ,patient name ,date and file number
▪ Doctors will advise patient to get appointment after 2 weeks for follow up of result
▪ Under the Bethesda System ,pap smear samples that have no cell abnormalities are reported as negative for
intraepithelial lesion or malignancy .