Specimen Requirements

SurePath collection vial containing head of collection device is required. 

Specimen Type: Cervix

Container/Tube: Pap collection kit (SurePath collection vial, collection device, and request form) is provided by request from Pathology Laboratory

Specimen Volume: Brush head

Collection Instructions:

1. Label SurePath collection vial with patient’s name (first and last), medical record number or date of birth, date of collection, specimen source, and name of ordering physician prior to specimen collection. Have patient verify information.

2. Under direct visualization, swab away any excess mucus or blood from patient’s cervix.

3. Insert tip of Rovers Cervex-Brush into cervical os. Apply gentle pressure until outside bristles splay a bit onto ectocervix. Rotate brush 5 times in a clockwise direction and remove.

4. Disconnect brush head from stem of collection device with thumb and deposit into SurePath collection vial. Cap collection vial and place in a biohazard specimen bag.

Additional Information:

1. Best time for obtaining a Pap specimen is the first half of menstrual cycle (day 5-16).
2. Patient should refrain from intercourse the preceding 24 hours; and from using contraceptive foam or jellies, vaginal medication, or douching during the preceding 72 hours.

3. The following specimens will be discarded and an unsatisfactory report will be generated:

a. SurePath vial unlabeled/mislabeled with patient’s name

b. Unlabeled/mislabeled Pap smear slide

c. Shattered glass slide

Forms:  Order in EPIC or complete all shaded areas of request form with the following information:

1. Last menstrual period, previous abnormal reports, treatment, or biopsy information
2. For third party or Medicare/Medicaid billing, include group and certificate number or Medicare/Medicaid number

3. Indicate if patient is at high risk for:
a. Abnormal vaginal bleeding
b. History of previous abnormal Pap smear (HPV, dysplasia, carcinoma)
c. Prior malignant or pre-malignant disease of genital tract
d. Prior genital viral or Chlamydia infection (herpes, warts)
e. Onset of sexual intercourse prior to age 18
f. Multiple sexual partners or male partner who has had multiple sexual partners
g. Mother took DES (diethylstilbestrol) during pregnancy