Wednesday, November 07, 2007 6:12:20 PM
The following is from an old report I found.
The cervical smear is effective in detecting the precursor lesions of cervical cancer. With appropriate treatment invasive carcinoma maybe prevented. A major cause of a non-diagnostic smear is poor sampling. A new sampling device, the Cervex-Brush, has been touted as being capable of producing a superior specimen compared with the modified Ayre's spatula, which is the most widely used cervical sampler in Hong Kong. When evaluated on 500 women, the Cervex-Brush was found to produce a good quality sample as judged by the presence of endocervical and/or metaplastic cells, lack of blood, and the thickness of the cell sample. In the drive to ensure that cervical smears are of the highest quality, the Cervex-Brush is worthy of further evaluation for routine use. Although it is significantly more expensive, the extra costs could be offset by the substantial savings that can accrue from having a smaller number of substandard samples and the need to repeat smears.
With the cost of medical care escalating at an alarming rate, two factors are of paramount importance in any health expenditure—cost effectiveness and cost containment. Therefore, should the Cervex-Brush, which is substantially more expensive, be used instead of the modified Ayre's spatula? Each Cervex-Brush costs approximately HK$1.80 to $2.50, depending on the supplier, while the wooden spatula costs from 5 to 25 cents, depending on the country of manufacture. Even with mass production techniques and bulk purchasing, the price of the Cervex-Brush is unlikely to approach the modest price of the wooden Ayre's spatula. However, there can be substantial savings if the number of inadequate smears that lack EECs or MCs can be reduced. Having to repeat a smear because of a previously inadequate sample not only requires a woman to be present for a further examination but also involves further nursing, medical, and staff laboratory time and effort. In addition, there are added stresses for the patient and more importantly, an inadequate sample may mean an undetected lesion and the development of a cancer in the future.
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