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Test Code LAB5000 Thin Prep Pap test – SurePath is no longer available at BAH

Specimen Requirements

ThinPrep PreservCyt Vial, white cap, 20 ml.
ThinPrep vial holder.
Brush and spatula or broom like collection device.
Check expiration date on vial before collection.
Discard outdated vials.
Expired vials will be rejected.
Transport ambient, room temperature.
Place specimen inside a biohazard bag with the request form in the outside pocket of the bag. Transport specimen to Laboratory.

Additional Instructions

Patient Preparation

  • Avoid vaginal medications, vaginal lubricants, vaginal contraceptives, excessive blood, or douches 48 hours prior to the Pap Test.
  • Use only Surgilube or ThinPrep Lubricating Jelly brand lubricants sparingly, if lubricant is required during the exam. Other lubricants will cause an unsatisfactory Pap result.
  • Do not schedule a Pap test during menses.
  • Perform a visual exam of the cervix.
  • If excess mucus or other discharge is present on the cervix – gently remove with dry gauze pad or swab prior to sample collection.

Collection Instructions

Prefered Pap Collection Method

  1. Spatula / Endocervical Brush Protocol
    1. Rotate the white plastic spatula at least 1 full turn around the cervical Os and ectocervix. Quickly rinse the spatula in the ThinPrep vial. Swirl vigorously 10 times. Discard the spatula. Do not clip into the vial.
    2. Insert the brush (looks like a long handled pipe cleaner) into the Os until just the bottom bristles are exposed. Slowly rotate the brush ¼ to ½ turn in one direction. DO NOT OVER ROTATE. Quickly rinse the brush in the ThinPrep vial. Rotate and push the brush against the vial wall 10 times. Vigorously swirl the brush again. Discard the brush. Do not clip into the vial.
    3. Tighten the vial cap. The torque line on the cap must pass the torque line on the vial. Failure to tighten the cap on the PreservCyt vial may cause loss of specimen. DO NOT wrap the vial lid with Parafilm. Label the vial with the patient label. Place the vial in a biohazard bag with any additional patient labels. See Required Information section below for Non-EPIC Pap orders. Transport to the lab.
  2. Alternative white broom-like Device Protocol
    1. Insert the central bristles into the endocervical canal. Allow the shorter bristles to fully contact the ectocervix. Push gently and fully rotate the broom CLOCKWISE 3 – 5 times. Quickly rinse the broom in the vial. Push the broom against the bottom of the vial 10 times. Swirl again vigorously. Discard the broom. DO NOT LEAVE THE BROOM HEAD IN THE VIAL.
    2. Follow steps in A.3 from prior protocol.

Acceptable Pap Collection Method
  1. Conventional Pap Smear Protocol
    1. Conventional Pap smear is performed following the collection protocols above, then spread specimen evenly but quickly over the surface of a properly labeled glass slide.
    2. Immediately immerse slide in glass vial containing 95% ETOH. Any delay in fixation in ETOH will air dry the cells and destroy cellular morphology.
    3. ETOH vials available from Cytology @ 269-8454
    4. HPV Genotyping cannot be performed on conventional Paps

Required Information

Non-EPIC Orders

  1. TP Pap Hard Copy Requisition and HPV request information: Patient full name, date of birth, last menstrual period date, requesting physician’s name, medical diagnosis (ICD-10 code), date of collection, patient billing information and source (Cervical/Endocervical or Vaginal).
  2. Include HPV Reflex Option, HPV Cotest, or No HPV in the Pap order.
  3. ABN required for Pap Tests not meeting Medicare Medical Necessity requirements based on age, history and previous abnormalities
  4. If HPV Genotyping only is requested, write in red or bold HPV ONLY, NO Pap
  5. Conventional slides must have patient’s name and DOB written with pencil in frosted area. HPV cannot be ordered on conventional Paps.

Additional Information

HPV Information
HPV is ordered within the Pap order as a reflex or co-test. HPV should NOT be ordered separately unless it is an add-on to a previous Pap order after the Pap has been sent to the lab, or after it has been resulted, but within 35 days (5 weeks) of the collect date.

See HPV Genotyping ThinPrep for more information:https://bayareahospital.testcatalog.org/show/BAHHPV

Also refer to Pap and HPV resources here: https://www.asccp.org/Guidelines

Test is only performed Monday-Friday, 0800-1630

Synonyms

CB Pap test, Lab5000, Cytology, ThinPrep, Pap Smear, Pap Test, HPV

Department

Cytology