Cytology, Screening Thin Layer Cervical-Vaginal Pap Test With Guided Screening


Sunquest Code:PITLSCoPath Code:PITLS2
Epic Code:LAB5900Epic Name:Pap Imaged thin layer prep screening (Surepath, Focal Point with Guided Screening)
Synonyms:Cervical Smear; Pap Smear; Papanicolaou Smear; Thin Prep Pap; Thin Layer Pap; SurePath Pap; Autocyte; Screening Pap; Vulvar Cytology; Endocervical Cytology; PITLD
Methodology:Preferred methodology SurePath Pap test. Thin Layer: Processing utilizing SurePrep or Thin Prep processing devices, staining and microscopic evaluation.
CPT Code:----------CPTCODES HERE----------
Test Includes:Pathologist consultation fee is added if potentially abnormal. Note: Molecular testing for HPV DNA is possible when using thin layer, liquid collection methodology if reflex is requested by the physician.
Turnaround Time:Performed Mon-Fri, 0800-1500; results are reported within one week.
Special Instructions:
Provide pertinent clinical history.



Screening Paps are covered by Medicare:

May be used for routine 3-year interval cervical cancer screening test in all woman ≥21 years. For 5-year interval testing (co-testing) in women 30-65 years, order with Human Papillomavirus (HPV).

  1. Early onset sexual activity (under 16 years of age).
  2. Multiple sexual partners (five or more in a lifetime).
  3. History of a sexually transmitted disease (including HIV)
  4. Fewer than three negative Pap tests within the past seven years.
  5. Daughters of women who took DES (diethylstilbestrol) during pregnancy.
  6. Women of childbearing age who have had a Pap test indicating the presence of cervical cancer or other abnormality within the past three years.
   


Collection Instructions

Specimen:Cervical sample, endocervical sample or vaginal sample
Collection Instructions:
  Thin Layer/SurePath:
  • Label the vial of SurePath preservative. SurePath vial must contain at least 2 patient identifiers: Patient name, date of birth, medical record number.
  • Obtain sample under direct vision. Do not lubricate the speculum with medical jelly.
  •  Using a Rover's Cervex brush, place the brush on cervix and rotate clockwise five rotations. Disconnect the brush tip into the preservative vial. Cap the vial and send to the Cytology Laboratory with completed request form. (Cervical scraper and endocervical brush combo is also available from the Cytology Lab, 612-273-4143.) All collection devices should be placed in the vial when sending.
  HPV Testing:
  • If HPV testing is requested, an HPV test should be ordered.
  • Refer to the Molecular Diagnostics HPV test.
 
Patient Preparation:Obtain smear under direct vision. Do not lubricate the speculum with medical jelly. Instruct the patient not to douche, have intercourse or use vaginal medication for 3 days prior to pelvic examination. If the patient is menstruating on the day of examination, reschedule procedure for Pap smear during the midcycle.
Causes for Rejection:Specimens not collected in a SurPath Pap Test Colleciton Kit, or specimens submittted in an expired collection kit. Fixation in formalin, request form or vial mislabeled or not labeled. Age, LMP, date of smear and pertinent clinical information on request form are mandated by the Clinical Laboratory Improvement Act of 1988.


Processing and Shipping

Specimen Processing:Store slides or vials at room temperature.
Shipping Instructions:Ship slides or vials at room temperature in a sealed leak-resistant bag.
Test Performed at or Referral Lab Cytology  (UMMC-East Bank, Fairview Ridges - FRH, Fairview Southdale - FSH, UMMC/UMMCH-West Bank)


Interpretive

Reference Range:Results are reported as negative to positive for intra-epithelial lesion or malignancy. Cytologically apparent infectious disease is indicated.
Results reported using Bethesda Pap test nomenclature and as negative to positive for pre-malignant or malignant abnormalities.


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