26601 Cytology, Pap, Liquid Prep w/HPV if ASCUS + HPV Genotyping Reflex

​The cervicovaginal smear is a test for the detection of premalignant, cellular changes, which are precursors to carcinoma of the cervix.  The conventional pap smear, when used as part of a regular screening program has been credited with reducing the incidence of cervical cancer worldwide.  
The Thin-Prep pap test has been approved by the U.S. Food and Drug Administration as a replacement for the conventional pap smear and is endorsed by the College of American Pathologists as a method to improve the accuracy of pap examinations. The Thin Prep pap test improves detection of low-grade and more severe lesions.  By improving detection, disease can be identified at an earlier stage when it is more easily and cost-effectively treated. 

​Obtain an adequate sampling from the ectocervix using a plastic spatula. Immediately rinse the spatula into the ThinPrep PreservCyt Solution vial by swirling the spatula vigorously in the vial 10 times. Discard the spatula. Obtain an adequate sampling from the endocervix using an endocervical brush device. Insert the brush into the cervix until only the bottom-most fibers are exposed. Slowly rotate 1/4 to 1/2 turn in one direction. DO NOT OVER-ROTATE. Immediately rinse the brush in the PreservCyt Solution by rotating the device in the solution 10 times while pushing against the PreservCyt vial wall. Swirl the brush vigorously to further release material. Discard the brush. Tighten the cap so that the torque line on the cap passes the torque line on the vial.

Record the patient name and ID number on the vial and the patient information and medical history on the cytology requisition enter this information when the order is placed.

HPV Orders:  If ThinPrep Pap and HPV if ASCUS is requested in the original order, the PreservCyt ThinPrep vial will be processed as a pap first and then the HPV test will be tested by the Molecular Pathology Department if the Pap Interpretation is:  Atypical Squamous Cells of Undetermined Significance (ASC-US). 
NOTE: Self-collected pap tests are not FDA approved and will be rejected by the laboratory.

​See HUMAN PAPILLOMAVIRUS (HPV) AND HPV GENOTYPING

Frozen Specimen

Self-collected specimen

​Lubricants may increase the risk of contaminating and obscuring the cellular sample. When collecting a specimen, warm water is suggested to lubricate and warm the speculum. If a lubricant must be utilized, a sparing application to the outer portion of the speculum, with avoidance of the tip, is recommended. The following lubricant brands are acceptable to use with the PreServCyt Solution: Surgilube, CerviLube or Pap Test Lubricating Jelly.​

​For additional HPV information, see the Human Papillomavirus (HPV).

For additional HPV Genotyping information, see HPV-Human Papillomavirus Genotyping 16,18/45(NAM).

Include specimen source, p​ertinent patient history and clinical information along with the appropriate ICD-10 code on the electronic order or test requisition form. 

For Collection Techniques/Instructions see:

• Endocervical Brush/Spatula Collection Guide
• Cervical Broom Collection Guide
  

For list of a compatible lubricants and lubricant usage see:

• ThinPrep Pap Test Lubricant Compatibility List
• Lubricant Usage During Pap Collection Letter

For Appropriate ThinPrep Vial Labeling see:

• ThinPrep Vial Labeling Instructions

 
Additional References:

Cervical Broom Collection Guide

Endocervical Brush-Spatula Collection Guide

Lubricant Usage During Pap Collection Letter

ThinPrep Pap Test Lubricant Compatibility List

ThinPrep Vial Labeling Instructions