Improved anal Cytology Sampling: Tush Brush Compared with Dacron Swab

Daron Gale Ferris, Teresa M. Darragh, Sravan Kavuri, Nikhil Patel, Jennifer L Waller, Angela Goebel

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective The objective of this study was to determine the performance characteristics of the Tush brush (TB) compared with a saline moistened Dacron swab (DS) as anal cytology sampling devices. Materials and Methods TB and DS anal cytology tests were randomly collected from 146 patients presenting for anal cytology. High-resolution anoscopy and biopsies were obtained as indicated. Sensitivity and specificity as well as rates of satisfactory specimens were determined for each method using the areas under the receiver operating characteristic curve (AUCROC) and McNemar's test, respectively. Perceived discomfort of each device was determined using a visual analog scale and compared using a paired t test. Results The adjudicated AUCROC, sensitivity, and specificity were greater, but not significantly different, for the brush (0.63, 85.5, and 40.0, respectively) compared with the swab (0.50, 79.6, and 33.3, respectively) when the anal biopsy results were considered the criterion standard. In the 1 subject diagnosed with anal cancer, the swab cytology result was normal, but the brush result was abnormal. Specimen adequacy was 95.2% for the brush and 93.2% for the swab. Mean discomfort (visual analog scale) scores were swab 28.5 mm versus brush 35.6 mm (p =.0003) with both scores within the minimal to moderate discomfort range. Conclusions Anal cytology AUCROC, sensitivity, and specificity in detecting anal neoplasia were greater using the TB when compared with the DS. A novel anal cytology sampling device designed specifically to increase the detection of anal neoplasia would be clinically beneficial.

Original languageEnglish (US)
Pages (from-to)48-53
Number of pages6
JournalJournal of Lower Genital Tract Disease
Volume23
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Polyethylene Terephthalates
Cell Biology
ROC Curve
Visual Analog Scale
Sensitivity and Specificity
Equipment and Supplies
Anus Neoplasms
Biopsy
Neoplasms

Keywords

  • anal cancer
  • anal cytology
  • anal cytology test
  • sampling device

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Improved anal Cytology Sampling : Tush Brush Compared with Dacron Swab. / Ferris, Daron Gale; Darragh, Teresa M.; Kavuri, Sravan; Patel, Nikhil; Waller, Jennifer L; Goebel, Angela.

In: Journal of Lower Genital Tract Disease, Vol. 23, No. 1, 01.01.2019, p. 48-53.

Research output: Contribution to journalArticle

@article{c1c697056c9e47e5a42028d0414ded11,
title = "Improved anal Cytology Sampling: Tush Brush Compared with Dacron Swab",
abstract = "Objective The objective of this study was to determine the performance characteristics of the Tush brush (TB) compared with a saline moistened Dacron swab (DS) as anal cytology sampling devices. Materials and Methods TB and DS anal cytology tests were randomly collected from 146 patients presenting for anal cytology. High-resolution anoscopy and biopsies were obtained as indicated. Sensitivity and specificity as well as rates of satisfactory specimens were determined for each method using the areas under the receiver operating characteristic curve (AUCROC) and McNemar's test, respectively. Perceived discomfort of each device was determined using a visual analog scale and compared using a paired t test. Results The adjudicated AUCROC, sensitivity, and specificity were greater, but not significantly different, for the brush (0.63, 85.5, and 40.0, respectively) compared with the swab (0.50, 79.6, and 33.3, respectively) when the anal biopsy results were considered the criterion standard. In the 1 subject diagnosed with anal cancer, the swab cytology result was normal, but the brush result was abnormal. Specimen adequacy was 95.2{\%} for the brush and 93.2{\%} for the swab. Mean discomfort (visual analog scale) scores were swab 28.5 mm versus brush 35.6 mm (p =.0003) with both scores within the minimal to moderate discomfort range. Conclusions Anal cytology AUCROC, sensitivity, and specificity in detecting anal neoplasia were greater using the TB when compared with the DS. A novel anal cytology sampling device designed specifically to increase the detection of anal neoplasia would be clinically beneficial.",
keywords = "anal cancer, anal cytology, anal cytology test, sampling device",
author = "Ferris, {Daron Gale} and Darragh, {Teresa M.} and Sravan Kavuri and Nikhil Patel and Waller, {Jennifer L} and Angela Goebel",
year = "2019",
month = "1",
day = "1",
doi = "10.1097/LGT.0000000000000447",
language = "English (US)",
volume = "23",
pages = "48--53",
journal = "Journal of Lower Genital Tract Disease",
issn = "1089-2591",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Improved anal Cytology Sampling

T2 - Tush Brush Compared with Dacron Swab

AU - Ferris, Daron Gale

AU - Darragh, Teresa M.

AU - Kavuri, Sravan

AU - Patel, Nikhil

AU - Waller, Jennifer L

AU - Goebel, Angela

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective The objective of this study was to determine the performance characteristics of the Tush brush (TB) compared with a saline moistened Dacron swab (DS) as anal cytology sampling devices. Materials and Methods TB and DS anal cytology tests were randomly collected from 146 patients presenting for anal cytology. High-resolution anoscopy and biopsies were obtained as indicated. Sensitivity and specificity as well as rates of satisfactory specimens were determined for each method using the areas under the receiver operating characteristic curve (AUCROC) and McNemar's test, respectively. Perceived discomfort of each device was determined using a visual analog scale and compared using a paired t test. Results The adjudicated AUCROC, sensitivity, and specificity were greater, but not significantly different, for the brush (0.63, 85.5, and 40.0, respectively) compared with the swab (0.50, 79.6, and 33.3, respectively) when the anal biopsy results were considered the criterion standard. In the 1 subject diagnosed with anal cancer, the swab cytology result was normal, but the brush result was abnormal. Specimen adequacy was 95.2% for the brush and 93.2% for the swab. Mean discomfort (visual analog scale) scores were swab 28.5 mm versus brush 35.6 mm (p =.0003) with both scores within the minimal to moderate discomfort range. Conclusions Anal cytology AUCROC, sensitivity, and specificity in detecting anal neoplasia were greater using the TB when compared with the DS. A novel anal cytology sampling device designed specifically to increase the detection of anal neoplasia would be clinically beneficial.

AB - Objective The objective of this study was to determine the performance characteristics of the Tush brush (TB) compared with a saline moistened Dacron swab (DS) as anal cytology sampling devices. Materials and Methods TB and DS anal cytology tests were randomly collected from 146 patients presenting for anal cytology. High-resolution anoscopy and biopsies were obtained as indicated. Sensitivity and specificity as well as rates of satisfactory specimens were determined for each method using the areas under the receiver operating characteristic curve (AUCROC) and McNemar's test, respectively. Perceived discomfort of each device was determined using a visual analog scale and compared using a paired t test. Results The adjudicated AUCROC, sensitivity, and specificity were greater, but not significantly different, for the brush (0.63, 85.5, and 40.0, respectively) compared with the swab (0.50, 79.6, and 33.3, respectively) when the anal biopsy results were considered the criterion standard. In the 1 subject diagnosed with anal cancer, the swab cytology result was normal, but the brush result was abnormal. Specimen adequacy was 95.2% for the brush and 93.2% for the swab. Mean discomfort (visual analog scale) scores were swab 28.5 mm versus brush 35.6 mm (p =.0003) with both scores within the minimal to moderate discomfort range. Conclusions Anal cytology AUCROC, sensitivity, and specificity in detecting anal neoplasia were greater using the TB when compared with the DS. A novel anal cytology sampling device designed specifically to increase the detection of anal neoplasia would be clinically beneficial.

KW - anal cancer

KW - anal cytology

KW - anal cytology test

KW - sampling device

UR - http://www.scopus.com/inward/record.url?scp=85059028912&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85059028912&partnerID=8YFLogxK

U2 - 10.1097/LGT.0000000000000447

DO - 10.1097/LGT.0000000000000447

M3 - Article

C2 - 30407936

AN - SCOPUS:85059028912

VL - 23

SP - 48

EP - 53

JO - Journal of Lower Genital Tract Disease

JF - Journal of Lower Genital Tract Disease

SN - 1089-2591

IS - 1

ER -