The Pap smear test, a highly effective, relatively inexpensive screening test for cervical cancer, has been a mainstay in routine gynecologic care for more than six decades.

But because a single abnormal cell may be hiding among the 50,000 to 300,000 cells collected on a typical Pap smear, finding suspicious cells can be "like looking for a needle in a haystack," says Southeast Missouri Hospital pathologist Paul H. Cordes, M.D.

A new screening process now available at Southeast’s Clinical Laboratory helps assure women that their Pap tests are getting clearer screenings that provide clearer diagnoses.
Southeast’s AutoPap System and PrepStain liquid based Pap processor made by TriPath Imaging, Inc., "are a huge improvement," Cordes says. "Having this system available here is another major step in the improvement of women’s health care."

Normally, cytologists and pathologists still evaluate all Pap smear samples. However, with this technology, a computer pre-examines the slide, grades each sample and assigns a ranking number indicating which samples are most likely to contain abnormal cells. The technologist or pathologist then spends more time examining those samples. "The advantage of this technology is that the computer may find pre-cancerous or cancerous cells that the human eye may miss," Cordes explains.

These cervical samples, taken from the same patient, illustrate the striking difference between conventional and liquid based Pap smears. A conventional sample, top, is clouded with obscuring material and cells are hidden by excessive cell clumping, Above, the same sample, using SurePath. Obscuring material is eliminated, allowing for diagnosis with no questions or concerns.

Southeast’s Lab is one of only about 100 U.S. labs to offer physicians and women this cutting edge technology. While most hospital labs send Pap tests to referencing labs in distant cities, Southeast is the only hospital lab in the region to perform all Pap smear evaluations in-house, says Cytology Supervisor Dean Wendel, CT(ASCP).
Doing all the testing at Southeast, Cordes explains, allows for "better continuity of care and fewer patient call-backs because of unsatisfactory samples. And the report goes back to the physician more quickly."

Southeast’s lab receives about 20,000 Pap smears a year from physicians throughout the region. Almost 90 percent are liquid-based SurePath samples, Wendel says, which also allows for better interpretation. "Conventional Pap smears deposit only a fraction of the collected epithelial cells on slides," he says. "The majority of cells – up to 80 percent – are discarded." This new way of collecting cervical cells involves placing the sampling device directly into a liquid preservative, thus ensuring a full 100 percent of the cells collected get to the lab. The PrepStain instrument then processes the material onto a glass slide for evaluation.