The IMVS Cytology Service:

• AutoPap Rescreening of Pap Smears
• ThinPrep Testing
• Turnaround Times
• Fine Needle Aspiration (FNA) Service
• Standardised Report Format and Terminology
• Specialised Customer Reports
• Recall and Reminder Service
• Pap Smear Collection
• Tips for Better Pap Smears
• General information

The IMVS was the first laboratory in Australia to utilise the AutoPap for Pap smears. This is an important quality control initiative designed to minimise the chance of missing a treatable lesion.

A small false negative error rate is associated with manual screening and studies have shown that computerised rescreening is far superior to other quality control checks.

This comprehensive service is offered free of charge and customers do not need to specifically request this service

Conventional Pap smears, prepared using the combined spatula-cytobrush technique, are suitable for scanning.

A supplementary report is only issued when a discrepancy is noted. The turnaround time for issuing this supplementary report is approximately 7 days.

Detailed information about the technology .

The ThinPrep test is an improved collection technique whereby cells are rinsed from the sampling instrument into a special fixative. The cells in suspension are then placed on a slide by a machine which separates the cervical cells from blood, mucus and other non-diagnostic debris.

An MSAC Report on Liquid-Based Cytology (LBC) for cervical screening has recently been published following a thorough analysis of the literature and advice to MSAC provided by an expert committee. MSAC concluded that there is insufficient scientific evidence to support a claim that LBC is superior to the Pap smear in detecting high-grade lesions or invasive cancer. Consequently, the conventional Pap smear continues to be the only form of cervical cytology listed in the Medical Benefits Schedule.

Acting on the conclusions of the MSAC Report, from the 1 August 2003 the IMVS will restrict the use of liquid-based samples accompanying Pap smears to the following situations:

Flow diagram summarises selective use of liquid based cytology.

To view the MSAC report, click here (note: large file warning 573k pdf)

By the application of conventional screening of Pap smears combined with computerised rescreening of normal smears and the selective use of LBC, the IMVS will continue to provide a first-class cervical cytology screening service for South Australian women.

Smear collection can be performed using the combined spatula (plastic) and cytobrush technique. The IMVS recommends that a conventional Pap smear accompany requests for the ThinPrep test.

Collection instructions.

To request the test you need to obtain collection vials and collection details from the IMVS (phone 08 82223997). The test is offered free of charge to customers of the IMVS.

Test	Turnaround Time
Pap Smears:	2-3 working days
FNA:	24 hours
Non-gynaecological specimens:	1-2 working days

The central Institute at Frome Road offers a FNA service on an out-patient basis in the Patient Centre located on the second floor. To make bookings at the central Institute or one of the IMVS Branch laboratories please refer to the contact information provided below:

The FNA procedure is a relatively quick and painless method of gaining samples for rapid diagnosis; in-patient hospital admission or operating theatre facilities are not essential.

When performed by experienced pathologists on a regular basis, the reliability of the diagnostic information is high.

Results are available within 24 hours. The Division of Tissue Pathology has the added advantage of having its specialised immunocytochemistry and electron microscopy laboratories immediately available for gaining of additional information when the need arises in difficult cases.

Pap smear reports issued by the IMVS follow NHMRC Guidelines (2005). The general reporting categories are as follows:

SPECIMEN: the site is reported eg cervix or vagina. Furthermore if both a conventional smear and liquid based sample is examined then this is specified on the report.

RESULT: Click here to view the new reporting categories and comparison with previous terminology.

SPECIFIC DIAGNOSIS: The CIN terminology eg CIN-3 is used. A statement regarding the presence or absence of an endocervical component is also given.

RECOMMENDATIONS: are consistent with current NHMRC guidelines on the management of women with screen detected cervical abnormalities. Click here to view a summary of these guidelines.

Sample IMVS Pap smear report.

Specialised customer reports are provided to assist with patient management and quality assurance practises. These reports are as follows:

PAP SMEAR CUMULATIVE REPORTS: This report includes results from the patient's previous Pap smears taken by the doctor specified on the current request form. [SAMPLE REPORT]

PATIENT LISTS: This report lists those patients who have had a Pap smear reported by the IMVS in the past month. [SAMPLE REPORT]

PAP SMEAR STATISTIC REPORT: presents statistic data on the number of Pap smears you have referred to the laboratory and an indication of your endocervical 'strike rate'.

PATIENT RESULT NOTIFICATION AND RECALL LETTER: enables you to notify the patient of the Pap smear result and suggested time for repeat smear. [SAMPLE REPORT]

More information.

To arrange for one or more of these reports to be supplied, please phone the laboratory on 08 82223622.

The laboratory provides a comprehensive reminder service.

The service is offered in conjunction with the South Australian Back Up Registry and is designed to provide support to doctors for case management and quality assurance purposes.

Reminder letters are sent to the doctor who took the smear or the woman herself, depending on the smear result and the length of time since the smear or biopsy.

There is no charge for this service nor do customers need to specifically request reminder letters.

Diagnostic accuracy is very much dependant on optimal collection of smears for cytological examination.

Select the collection method listed to view instructions regarding collection.

	Combined Spatula Cytobrush Technique (Conventional Smear only)
	CERVEX Brush Technique (Conventional Smear only)
	Combined Spatula Cytobrush Technique (ThinPrep Test)
	CERVEX Brush Technique (ThinPrep Test)

The IMVS provides Pap smear collection kits for customers. To order these kits please contact the Coordinator, Transport Consumer Products on 08 82223997.