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


Sunquest Code:PITLDCoPath Code:PITLD2
Epic Code:LAB1000Epic Name:Pap Imaged Thin Layer Diagnostic
Synonyms:Diagnostic Pap; Cervical Smear; Pap Smear; Papanicolaou Smear; SurePath Pap; Autocyte; Thin Layer Pap; Thin Prep Pap; Endocervical Cytology; Vulvar Cytology
Methodology:Preferred methodology SurePath Pap Test. Thin Layer: Processing utilizing SurePrep or Thin Prep processing devices, staining and microscopic evaluation.
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 order is requested by the physician.
Turnaround Time:Performed Mon-Fri, 0800-1500; results are reported within one week.
Special Instructions:Provide pertinent medical history.
  • May be used for routine 3 year interval cervical cancer screening test in all women ≥ 21 years. For 5 year interval testing, (co-testing) in women 30-65 years, order with Human Ppillomavirus (HPV).


Screening Paps are covered by Medicare:
  • Once every 2 years in absence of complaint or identified risk factor.


Diagnostic Paps are covered by Medicare:
  • Once annually if patient is considered high risk per Medicare criteria.
  1. Early onset sexual activity (under 16 years of age).
  2. Multiple sexual partners (five or more in a lifetime).
  3. History of sexually transmitted disease (including HIV)
  4. Fewer than three negative Pap tests within the past seven years.
  5. Daughters of women who took DES (diethylstibestrol) during pregnancy.
  6. Women of child-bearing 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 Smear
Container:SurePath collection vial
Collection Instructions:
Thin Layer/SurePath:
  • Label the vial of SurePath preservative fluid. 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:Instruct the patient not to douche, have intercourse, or use a vaginal medication for 3 days prior to pelvic examination, If the patient is menstruating on the day of examination, reschedule procedure for Pap test during the mid-cycle.
Causes for Rejection:Fixation in formalin, request form or vial mislabeled or not labeled.


Processing and Shipping

Specimen Processing:Store at room temperature.
Shipping Instructions:Ship vials at room temperature in a sealed leak-resistant bag.
Test Performed at or Referral Lab Cytology  (Range, UMMC-East 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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