Endocervical brush versus cotton swab for obtaining cervical smears at a clinic: A cost comparison

Use of the nylon endocervical brush has been shown to increase the proportion of Papanicolaou smears with endocervical cells in a variety of populations. Each endocervical brush is approximately 100 times more expensive than the cotton swab that has been used routinely for cervical cytology collection. We sought to determine prospectively whether the endocervical brush would be cost effective by reducing the need for repeat sampling due to Papanicolaou smears' lacking endocervical cells. Cervical cytology specimens showed no endocervical cells in 114 (20%) of 561 women sampled with a cotton swab and Ayre spatula. In contrast, 37 (7%) of 511 women sampled with the endocervical brush and Ayre spatula had no endocervical cells in their specimens. A cost analysis showed that at our clinic, where approximately 3,300 Papanicolaou smears are performed annually, annual savings of > $22,000 would be realized by use of endocervical brushes.