The top photo shows the new device. The bottom photo is the ‘old’ standard device. [Images from J. Diedrich, UC Riverside
Women who have an abnormal pap smear results usually have to have a colposcopy to closely examine the cervix, vagina and vulva. The traditional device used for that is a small metal instrument that can cause pain for the patient and does not give consistent reliable results.
“Whenever someone has an abnormal pap smear, she should speak with her doctor about what the management options are,” said Justin T. Diedrich, a clinical faculty member in the school of medicine at the University of California at Riverside, in a press release.
Cervical cancer begins in the lining of the cervix. Pap tests are screening tests and aren’t used for diagnostics. If the test results come back negative, a physician may want to perform more testing, according to the American Cancer Society.
The American Cancer Society estimates that 12,820 new cases of invasive cervical cancer will be diagnosed in 2017 while 4,210 women will die from it.
Diedrich and colleagues at the University of California at Riverside tested Histologics’s fabric-based endocervical curettage, which features a fabric hook, much like the rough side of Velcro. It samples cells and avoids the use of the standard metal scraping device. The fabric hook is able to biopsy, trap and store tissues for transport to a lab.
“We found that the new fabric devices had significantly fewer ‘inadequate’ specimens – meaning, patients did not need to return for repeat biopsies,” said Diedrich, who is also an assistant clinical professor of obstetrics/gynecology and family planning. “This new device means that patients will get better results with fewer patients needing repeat biopsies, which can increase patient satisfaction.”
Histologics paid for the institutional review board process but had no say in the analysis, manuscript or results of the University of California at Riverside research .
The researchers sampled a group of 81 physician and nurse colposcopists used the new fabric-based endocervical curettage for two years after having used the metal one for a year and a half. The researchers also examined the pathology lab results from the fabric-based device and the metal-based device.
“Minimally-invasive office procedures for evaluating the outside of cervix have been around for at least 10 years, but this is the first product to evaluate the inside of the cervix with such ease,” said Diedrich.
Metal devices do not gather enough cells to make a proper diagnosis, according to the researchers. The device is also typically sharp and can be painful which results in physicians not scraping as hard for patient comfort.
“The new device, on the other hand, is not sharp and removes the appropriate amount of cells while minimizing discomfort,” Diedrich said. “Because the biopsy gets more tissue, it is able to find more precancerous cells. This could be the difference between intervening early before someone develops cancer and waiting until it has grown larger.”
The fabric hook device flexes downward when pressure is applied to tissues and the hook tip is exposed to the tissue face when it is rotated on the tissue surface. It also eliminates the need for a physician to handle the specimen, reducing the risk of contamination.
“Innovation can make medicine work better and more efficiently,” Diedrich said. “In this case, innovation is making colposcopy less painful, gets a larger biopsy and improves the detection of abnormal cells.”
This research was published in the Journal of Lower Genital Tract Disease.
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