August 9, 2017 / 8:05 PM / 3 years ago

Can new tool make cervical biopsy more efficient, less painful?

Women undergoing cervical biopsies might have lower odds of repeat tests with a rotating fabric brush than a sharp instrument because the soft device may capture more cells for analysis, a recent study suggests.

Furthermore, biopsies with the softer tool may be less painful, researchers say.

Cervical biopsies sometimes fail to collect enough cells from the cervix to accurately test for cancer, in which case another biopsy is needed.

For the new study, researchers compared data on 9,234 biopsy specimens collected with an older, sharp hooked device that scrapes cells from inside the cervix to data from 774 specimens obtained with a newer, fabric alternative. With the sharp instruments, 4.2 percent of the specimens didn’t have enough cells to adequately test for cervical cancer, compared with 0.6 percent of specimens collected with the fabric brush.

“The fabric-based device takes a biopsy that is larger which allows pathologists to have a better chance of finding abnormal cells,” lead study author Dr. Justin Diedrich of the University of California, Riverside, said by email.

As reported in the Journal of Lower Genital Tract Disease, Diedrich and colleagues examined data on lab results before and after 81 doctors and nurses switched from using sharp instruments to a fabric alternative.

This included biopsies done in 2010 and 2011 using an older, sharp device known as a Kevorkian curette as well as biopsies done in from 2011 to 2013 using an alternative fabric brush instrument made by Histologics LLC, a tissue-sampling company that provided funding for the study.

The fabric hook has material, similar to the rough side of Velcro, that scrapes for tissue samples. This option may be less painful for women than conventional sharp instruments, the study authors write.

The study wasn’t a controlled experiment designed to prove whether the fabric-based alternative is safer, more effective or more comfortable than sharp instruments. Researchers also didn’t examine outcomes for women after they got the biopsy results to see how many of them actually required repeat biopsies.

“This paper cannot make a comparison of accuracy between the two different methods,” said Dr. Christina Chu, a gynecologic oncology specialist at Fox Chase Cancer Center in Philadelphia who wasn’t involved in the study.

Because the fabric brush is a single-use device, while the sharp instrument can be used repeatedly, costs are different, Chu said by email. While the Kevorkian sharp curette costs $40 to $50, it can be sterilized and used hundreds of times, compared to a $3.75 cost for every single-use fabric brush.

Getting vaccinated for human papilloma virus (HPV), which causes cervical cancer, and getting Pap tests to screen for tumors can help prevent malignancies from developing and improve the odds of catching cancer early if it does develop.

The U.S. Centers for Disease Control and Prevention recommends that children get two doses of the HPV vaccine at least six months apart when they are 11 to 12 years old. Teens and young adults who get their first shot at ages 15 through 26 years should get three doses of the HPV vaccine.

The United States Preventive Services Task Force recommends a Pap test every three years for women aged 21 to 29, and every five years from ages 30 to 65.

SOURCE: Journal of Lower Genital Tract Disease, online July 25, 2017.

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