Summary
Vaginal vault cytology is commonly used for follow-up surveillance in patients treated for cervical cancer. It is known that the smear inadequacy rate is high, especially in patients post-radiotherapy at 10%. The current practice is to use Cervex-Brush®, which was designed for cervical smear taking. Cervix will shrink into a dimple with a flat vaginal vault and vagina may be stenotic after radiotherapy, rendering the use of the conventional sampling device difficult. Orcellex® Brush was designed to collect cells from oral mucosa, with high patient satisfaction and low smear inadequacy of 1% in one study. As both the vaginal vault mucosa and oral mucosa are flat surface lined with stratified squamous epithelium, the use of Orcellex® Brush in vaginal vault smear appeared applicable. It has a smaller head with a flat surface of hair, which might better fit the flat vault surface and narrow vaginal canal. It is postulated that the Orcellex® Brush helps in improving vaginal vault smear adequacy rate in patients after radiotherapy treatment for cervical cancer.
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Inclusion Criteria: * Patients with cervical cancer treated with primary radiotherapy * Patients aged 18 years or older * Patients requiring vaginal vault cytology for follow-up surveillance Exclusion Criteria: * Patients who refuse vaginal examination or vaginal vault smear at follow-up. * Patients who have visible tumour at vaginal vault requiring direct biopsy at speculum examination. * Patients who cannot understand the study purpose and procedure. * Patients who cannot read the words written in Chinese or English.