The success of this contemporary Pap smear method relies on strict adherence to proper sample collection and submission technique as outlined below. The FDA has approved sample collection using a plastic spatula, with or without brush, or a broom-like device. Based on our experience, the spatula is strongly recommended.

1. Label the PreservCyt® vial with the patient’s full name (first and last) and date of birth.  Specimens not properly labeled must be rejected.
2. Obtain an adequate sample using either a cytobrush/spatula or broom-like device.
   1. Cytobrush/spatula:
      1. Scrape cervix with spatula, attempting to scrape the entire squamo-columnar junction (transformation zone). Place the plastic spatula in the vial of PreservCyt® solution.
      2. Obtain an endocervical sample with a brush by gently inserting the brush into the endocervical canal and rotating one to two full turns.
      3. Scrape the collection devices against each other within the solution.  Use the brush as a scraper and similarly use the plastic spatula to scrape the brush while twirling the brush within the solution.  Be certain that both sides of the plastic spatula are free of any visible sample.  If only the plastic spatula is used, it must be vigorously rinsed in the vial of solution by scraping the spatula along the inside wall of the vial.  The collection device(s) should be free of any remaining visible sample prior to disposal.
   2. Broom-like device: Insert the central bristles into the cervical canal deep enough to allow the shorter bristles to fully contact the ectocervix.  While maintaining gentle pressure in the direction of the cervix, rotate the brush 5 times in either direction.  Rinse the broom into a vial of PreservCyt® solution by pushing the brush into the bottom of the vial 10 times, forcing the bristles to bend apart to release the cervical material.  As a final step, twirl the brush between the thumb and forefinger vigorously to further release cellular material. Discard the collection device.
3. Tighten the PreservCyt® vial cap so the torque line on the cap passes the torque line on the vial.

(Refer to the One-Slide Technique section for a diagram.)

1. Write the patient's full name (first and last) and date of birth in pencil on the frosted/ white end of the glass slide. Specimens not properly labeled must be rejected.
2. Scrape cervix, attempting to scrape the entire squamo-columnar junction (transformation zone). Retain sample on scraper.
3. Obtain an endocervical sample with a brush by gently inserting the brush into the endocervical canal, and rotating one full turn (360°).
4. Smear both the cervical and endocervical sample on one slide:
   1. First, gently smear the endocervial brush sample by firmly rotating (not rubbing) the brush back and forth several times (at least twice in each direction) on one half of the slide.
   2. Second, gently smear the cervical scrape sample by spreading the sample from both sides of the scraper.
5. Immediately flood the smear with the spray/liquid fixative.

1. Label the SurePath™ vial with the patient’s full name (first and last) and date of birth. Specimens not properly labeled must be rejected.
2. Obtain an adequate sample using either a cytobrush/spatula or broom-like device with detachable head.
   1. Cytobrush/spatula:
      1. Scrape cervix with spatula, attempting to scrape the entire squamo-columnar junction (transformation zone). Using the thumb and forefinger of gloved hand(s), disconnect the head of the device from the handle. Do not touch the head of the device. Drop the detachable head into the SurePath™ vial. Discard the handle of the spatula. Place the cap on the vial but do not tighten.
      2. Insert the brush into the cervix until only the bottom-most bristles are exposed at the os. Slowly rotate ¼ to ½ turn in one direction. Using the thumb and forefinger of gloved hand(s), disconnect the head of the device from the handle. Do not touch the head of the device. Drop the detachable head into the same SurePath™ vial. Discard the handle of the cytobrush. Place the cap on the vial and tighten.
   2. Broom-like device: Insert the central bristles of the broom into the endocervical canal. Use gentle pressure in the direction of the cervix until the lateral bristles bend against the ectocervix. Maintaining gentle pressure, rotate the broom in a clockwise direction five times. Using the thumb and forefinger of gloved hand(s), disconnect the head of the device from the handle. Do not touch the head of the device. Drop the detachable head into the SurePath™ vial. Discard the handle of the broom. Place the cap on the vial and tighten.
3. Tighten the SurePath™ vial cap so the torque line on the cap passes the torque line on the vial.