Detection of cervical cancer by irrigation smear and cervical scraping.

Since it was first shown (Papanicolaou and Traut, 1941) that the cytological examination of vaginal secretions could reveal unsuspected gynaecological cancer, various techniques for obtaining suitable cellular preparations have been suggested. Davis (1962) introduced the irrigation smear, using a disposable plastic pipette (cytopipette) containing a cell-preserving fluid. The fluid is ejected into the upper vagina and irrigates the cervix and fornices. It is then aspirated, carrying with it a sample of the cell population. The pipette containing the cell suspension is then sent to the laboratory for processing. Davis introduced this method, not as a substitute for existing techniques (Ayre scrape and Papanicolaou aspiration smear), but as a method by which women could themselves obtain the specimens. It has been claimed that the irrigation smear is as effective diagnostically as the cervical scrape (Bredahl, Koch, and Stakemann, 1965). This laboratory is operating, with the support of the Ministry of Health, a pilot population screening scheme for the detection of cervical cancer (the evolution of this project was described by Smith, Muskett, and Easson in 1965). We started in 1964 a matched series of tests (at the request of the Ministry of Health) to evaluate the comparative merits of the Ayre smear and the Davis cytopipette in the detection of cervical malignancy. We now report the results in a series of 905 women examined by both methods.