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Pap Test, Conventional Pap Smear

Pap smear, PAP TEST (CONVENTIONAL), PAPC

Test Codes

EPIC: LAB6752

Department

Cytology

Instructions

• The Pap Test is a screening test for cervical cancer with inherent false negative results. Clinical judgment and follow-up of unexplained signs and symptoms are paramount.
• For optimal interpretation a Pap smear should be collected near the middle of the menstrual cycle. A patient should be counseled to refrain from intercourse, douching, using tampons, or using intravaginal medication for at least 48 hours before the examination to decrease the possibility that the number of exfoliated cells will be diminished or obscured by personal lubricants or spermicides. In addition, the patient should avoid scheduling her appointment during heavy menstrual bleeding.
• The Cytology Laboratory can provide slides, collection devices, and spray fixative for specimen collection:

• Dearborn: 313-436-2369
• Farmington Hills: 947-521-8249
• Grosse Pointe: 313-473-1801
• Royal Oak: 248-898-9035
• Taylor: 313-295-5365
• Trenton: 734-671-3868
• Troy: 248-964-9050
• Wayne: 734-467-4275
• Outreach: 800-511-0488

Specimen Collection Criteria

• Label the slide carrier with the EPIC specimen label with the patient's full name, date of birth, hospital number, source of specimen, and date of test.
• Specimen may be procured with a cervi-spatula and brush OR a broom like device. The sampling instrument and sampling technique used depends on the individual anatomy and the location of the transformation zone. An optimal cervical specimen includes sampling the squamous and columnar epithelium especially the transformation zone where the majority of cervical neoplasia arises.
• When using a spatula, rotate it 360 degrees around the circumference of the cervical os and ectocervix. Rotate the spatula clockwise so that the collected material is retained on the upper horizontal surface as the spatula is removed. Smear the spatula sample across the glass slide longitudinally and spray fix immediately. Make sure the spray fixative is held at least 3 inches from the specimen smear for adequate fixation.
• If a brush is used, insert the cervical brush into the cervical os with gentle pressure and rotate 90 to 180 degrees to minimize bleeding. Roll the brush across the plain glass slide with a single smooth stroke motion by twirling the handle and spray fix immediately.
• Air dry the spray fixed slide and place in a glass slide carrier. (Slide must be dry prior to placing it in the glass slide carrier).
• In house cytology specimens should be ordered in EPIC order entry. In the “additional orders” field input “PAP TEST (CONVENTIONAL)” and fill in all appropriate fields. Label specimen container and requisitions with EPIC specimen labels. Place an EPIC specimen label on the requisition.
• All Cytology specimens must be accompanied by a requisition and must include the patient name, hospital and visit number, date of birth, date of specimen collection, pertinent patient history, physician name and source of specimen.

Physician Office/Draw Specimen Preparation

Maintain the slide at room temperature (20-26°C or 68-78.8°F) prior to transport to the Laboratory. Place slide in appropriate slide container for transport.

Preparation for Courier Transport

Transport: Slide container at room temperature (20-26°C or 68-78.8°F).

Rejection Criteria

• Improper labeling of specimen container, slide, or requisition.
• Specimen not accompanied by requisition.
• Requisitions not accompanied by a specimen.
• Improper collection of specimen (such as improper fixation).
• Slide adhered to cardboard slide carrier due to being put into carrier while wet.
• Glass coverslip placed on top of specimen on slide and dried together
• Any specimen received without all the required information will result in a delay of processing until all information can be verified. (Date of service, date of birth, last menstrual period, etc.) 

Inpatient Specimen Preparation

Farmington Hills

• Deliver the specimen directly to the Cytology Laboratory (2nd floor, East) Monday – Friday, 7:00 am – 4:00 pm.
• When the Cytology Laboratory is closed, specimens may be delivered to Laboratory Central Processing.

Grosse Pointe

• Deliver the specimen directly to the Clinical Pathology Specimen Prcessing area (lower level).

Royal Oak

• Deliver specimen directly to the Cytology Laboratory (Research Building, lower level) Monday – Friday, 6:00 am – 4:30 pm or to Clinical Pathology Specimen Receiving (located on the first floor of the Beaumont Laboratory Research Building).
• Specimens are also picked up from the surgical floors, Endoscopy and Clinical Pathology Monday – Friday, 8:00 am – 7:00 pm, Saturday, 7:00 am – 11:00 am, NT and Endoscopy ONLY.

Troy

• All specimens must be delivered to the Specimen Reception department (tube station #201; phone number: 248.964.8030, or x48030)
• Specimens are also routinely picked up throughout the day from the surgical floors and Endoscopy Monday – Friday, 8:00 am – 4:00 pm.

Dearborn

• Deliver the specimen to the main lab drop off window and sign in. Open 24/7.
• Deliver directly to Cytology, Monday – Friday, 7:00 am – 4:30 pm. 
• Deliver directly to Histology lab, Monday – Friday open 24 hours, Saturday 8:00 am – 12:00 pm, closed on Sunday.
• Specimens are also picked up throughout the day from the surgical area and endoscopy. Monday – Friday, 6:00 am – 4:30 pm, Saturday 8:00 am – 12:00 pm.
• When the Cytology lab is closed specimens must be delivered to the main lab window and signed in.

Taylor

• Deliver to histology 8:00 am – 2:00 pm. 
• After hours:  Deliver the specimen to the main lab. Open 24/7.

Trenton

• Specimens are picked up from Emergency Dept., Interventional Radiology, and operating rooms from 8:00 am – 2:00 pm.
• After hours deliver specimens to the main lab. Open 24/7.

Wayne

• Specimens are picked up from Emergency Dept. and Interventional Radiology from 8:00 am – 2:00 pm.
• After hours deliver specimen to the main lab. Open 24/7. 

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): Indefinite
Refrigerated (2-8°C or 36-46°F): Acceptable, but not recommended
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Room Temperature (20-26°C or 68-78.8°F): 8 years

Laboratory

Dearborn Cytology Laboratory

Taylor, Trenton and Wayne specimens are sent to Dearborn Cytology Laboratory for preparation, screening and issuing final results. 

Trenton specimens are sent to Dearborn Cytology Laboratory for preparation and screening. Final results are issued by Trenton hospital.

Royal Oak Cytology Laboratory

Farmington Hills, Grosse Pointe and Troy paps are sent to Royal Oak Cytology Laboratory for testing preparation and screening. Pap final results are issued at Royal Oak, Farmington Hills, Grosse Pointe and Troy. 

Troy Cytology laboratory  

Performed

Monday – Friday, 7:00 am – 4:30 pm (Royal Oak).
Monday – Friday, 8:00 am – 3:30 pm (Farmington Hills).
Monday – Friday, 7:00 am – 4:30 pm (Troy).
Monday – Friday, 8:30 am – 4:00 pm (Grosse Pointe).
Monday – Friday, 7:00 am – 4:30 pm (Dearborn).
Monday – Friday, 7:00 am – 3:00 pm (Taylor).
Monday – Friday, 7:00 am – 3:00 pm (Trenton).
Monday – Friday, 7:00 am – 3:00 pm (Wayne).

Most results are available within 48 hours of receipt in the Cytology Laboratory if received Monday – Friday. The Cytology Laboratory is closed on weekends and holidays. Specimens received after 3:00 pm on Friday will be processed the following Monday and resulted on Tuesday. Specimens received after 3:00 pm the day before a holiday will be processed the next working day and resulted out within 48 hours. 

Test Methodology

Smear Preparation, manual microscopic screening by a cytotechnologist.

CPT Codes

CPT: 88164 (88141 in the event of a professional review).
LOINC: 47528-5. 

Contacts

Last Updated

3/17/2021