TL;DR:
- Purpose of cytology: Detects precancerous stages and cervical cancer early, increasing the likelihood of sparing treatment.
- How it works: Examines exfoliating cells from the cervical disk and canal to assess abnormalities and tissue responses.
- Who should get tested: All sexually active individuals, pregnant women (1st and 3rd trimester), menopausal/postmenopausal women. Recommended frequency: annually, as per gynecologist advice.
- Preparation guidelines: Avoid intercourse, vaginal medications, and irrigation for 2–4 days before the test; wait 1 day after other gynecological exams.
- Conventional cytology: Involves collecting cervical cells with a brush, transferred to a slide; may face illegibility issues.
- Liquid cytology: Transfers samples to a liquid fixative, improving accuracy, reducing errors, and enabling additional tests (e.g., HPV).
- Comparison: Liquid cytology is more sensitive, accurate, and recommended by the Polish Gynecological Society. Both methods are lifesaving when done regularly.
Cytology allows microscopic examination of cells. It involves taking them from the mucous membrane of the cervical disc and canal. It makes it possible to detect precancerous stages and cervical cancer at an early stage. This greatly increases the likelihood of sparing treatment.
What the cytological examination consists of.
The main task of cytological examination from the vaginal part of the cervix is to assess whether the exfoliating cells are normal or pathological. Non-epithelial cells are also present in the smears along with epithelial cells from the cervical disc and canal. These cells are called "smear" and provide information, regarding the response of the patient's tissue to the pathological process occurring in the body.
Evaluating the background helps a lot and allows to refine the cytological diagnosis. Abnormal cells on a "clean" background are usually indicative of pre-invasive processes, while a "dirty" background may speak for a more advanced stage of the disease. It is often the case, unfortunately, that in a conventional cytological examination, these cells cause an illegible image, covering the cervical epithelial cells profusely. As a result, they cannot be evaluated. They can cause cytolysis of the cervical cells, as well as their inflammatory changes that are difficult to interpret clearly. This causes the illegibility of the cytological image. In such a situation, the result of cytology is not satisfactory, and it happens that it is necessary to take a smear again, after proper preparation of the patient. In such a case, liquid cytology is an excellent alternative, which minimizes the risk of error in evaluating the collected material.
Who should do cytology and why?
Cytology should be performed by all patients who have begun sexual activity. The test is also aimed at pregnant women, who should opt for cytology in the first and third trimesters. Menopausal and postmenopausal periods also do not exempt from cytology. It is recommended to have the test every year, but the frequency should always be consulted with a gynecologist. Remember to make an appointment for a cytology test no earlier than 4 days after your period and no later than 4 days before. In addition, 4 days before the cytology, it is not recommended to apply vaginal medications, and 2 – 3 days before, you should not have intercourse and perform vaginal irrigation. On the other hand, a day should have passed since the last gynecological examination or vaginal ultrasound. The space between the vagina and the uterus is the place that is most vulnerable to all kinds of micro-injuries that can occur during intercourse. It is responsible for the vast majority of cases of cervical cancer. Cytology makes it possible to detect the virus at an early stage. Thus, it is enough to use a simple and painless prophylactic test, which guarantees high efficiency in identifying any cell changes that have occurred.
What does a conventional cytology examination consist of?
During a cytological examination, a gynecologist places a speculum in the patient's vagina, which provides access to the cervix. A special cytology brush is then inserted. When performing conventional cytology, a soft silicone brush with longer bristles in the center is used. This allows it to better reach the inside of the cervix. Due to the flexibility of this brush, a large amount of collected material can be transferred to a specialized slide. Sticks, spatulas or cotton balls should not be used in the gynecological office. Their use increases the risk of bypassing the surface where abnormal cells may be present. In such a case, the result of the cytological examination will be falsely negative. The cytology brush is rotated in such a way as to collect the secretion along with exfoliated cells from the cervical epithelium. They are collected from the cervical disc and canal. While doing this, the patient may feel mild discomfort, although this is usually not the case. The test is painless and quick. The material placed on the slide is then transferred to the laboratory, where the cells present are evaluated under a microscope.
What does liquid cytology consist of?
Liquid cytology is a modified conventional method, which is classified as a new cytological technique. It involves the collection of material from the disc and canal of the cervix, which is then transferred to a container with liquid fixative (rather than a slide). The material to be processed is filtered and spread on a slide, and then stained. Fluid-fixed cytology is also distinguished by the different design of the toothbrush. At its central point there is a longer, but stiffer part covered with tiny tabs. This makes it even easier to reach the cervical canal and retrieve the material. The toothbrush goes directly into the container with the solution, so that all the collected cells are sent to the laboratory.
The technique of liquid cytology is distinguished by a number of advantages, which include:
- Reduction of reading error by separating most of the hindering elements – blood, pus, bacteria – from the suspension.
- Short time to prepare and analyze a single slide.
- The possibility of performing additional tests from the same sample – such as for HPV.
- Minimizing the situation in which too few cells may be secured.
- Noticing the smallest changes in cells that might be missed using a conventional method.
- Minimizing the risk of damage to the smear during transport to the laboratory.
- Liquid cytology is a solution to the inaccuracies that occur when using the conventional cytological method. This is especially true when the collected material is not evenly distributed on the slide.
By eliminating the disadvantages that conventional cytology has, the technique of liquid examination is more sensitive and accurate. The studies performed to compare conventional and thin-layer cytology state that with the help of liquid cytology, the chances of detecting cells at an early stage of development increase. It is recommended by the Polish Gynecological Society.
Which cytology method to choose?
According to the opinion of oncologists, liquid cytology has many advantages, and its use can improve the quality of prevention. It is distinguished by its high accuracy and efficiency in terms of detecting cell changes. This is especially true for lesions that are at an early stage of development. As a result, the chances regarding the patient's successful cure increase. Despite the undoubted advantages of liquid cytology, it is important to perform regular cytological examinations – regardless of the method used. Cervical cancer is one of the few cancers that can be detected and cured at an early stage. It is important to remember that this cancer may not produce any symptoms for several years. Pain and bleeding are signs of a very advanced stage of the disease, which is difficult to treat at such a stage. Cytology is a quick, painless and effective test that can save lives.
Conclusion
Cytology is essential—it detects cervical changes early, potentially saving lives. Both conventional and liquid methods have unique benefits, but liquid cytology offers improved accuracy and prevents errors. Regular testing, regardless of method, ensures early detection of cervical cancer, even before symptoms appear. Following preparation guidelines maximizes test effectiveness and clarity. Prioritize your health; timely cytology can make a life-changing difference. Prevention is simple, quick, and crucial—don’t wait.
