Pap Test, ThinPrep®

ThinPrep^®, Thin layer Pap specimen, ThinPrep^® Pap test, Liquid based Cytology, PAP TEST (THIN PREP), PAPT

Test Codes

EPIC: LAB1230097

Department

Cytology

Instructions

• The pap test is a screening test with limited sensitivity for the detection of cervical cancers and cancer precursors and is subject to both false negative and false positive results. This report should be interpreted in conjunction with patient history, clinical evaluation, and HPV test results.
• For optimal interpretation a Pap Test should be collected near the middle of the menstrual cycle. A patient should be counseled to refrain from intercourse, douching, using tampons, or using intravaginal medication for at least 48 hours before the examination to decrease the possibility that the number of exfoliated cells will be diminished or obscured by personal lubricants or spermicides. In addition, the patient should avoid scheduling her appointment during heavy menstrual bleeding.
• ThinPrep^® specimen cellularity can be greatly reduced by excessive usage of lubricant or usage of lubricants containing carbomers during the collection of the pap. Surgilube, Pap Test Lubricating Jelly, and CerviLube Lubricant are the only preferred lubricants that do not contain carbomers. All lubricants should be used sparingly and applied only to the exterior sides of the speculum blades, avoiding contact with the tip of the speculum.

• For HPV testing from the same ThinPrep^® Pap Test vial, please select one of the following choices:

1. HPV Cotesting – HPV is run if patient is 30 years of age or older, regardless of Cytologic diagnosis.
2. HPV Reflex:
   - HPV is run on patients 21 or older if pap Cytologic diagnosis is ASCUS.
   - HPV is run on patients 25 or older if pap Cytologic diagnosis is abnormal (ASCUS, LSIL, HSIL, ASCH, AGC, Malignant).
3. No HPV testing

• Chlamydia trachomatis and Neisseria gonorrhoeae testing can also be performed on the same ThinPrep^® Pap Test vial. Testing must be ordered at the same time as the ThinPrep^® Pap Test. It cannot be added after the ThinPrep^® Pap Test has been performed.
• The Cytology Laboratory can provide ThinPrep^® vials and collection devices for specimen collection:
  • Dearborn: 313-436-2369
  • Farmington Hills: 947-521-8247
  • Grosse Pointe: 313-473-1801
  • Royal Oak: 248-898-9035
  • Taylor: 313-295-5365
  • Trenton: 734-671-3868
  • Troy: 248-964-9050
  • Wayne: 734-467-4275
  • Outreach: 800-511-0488

Specimen Collection Criteria

Collect: Cellular material from scraping/brushing in a vial containing 40 cc of ThinPrep PreservCyt^® Solution. Ensure the solution is not expired prior to specimen collection.

• Label the specimen container with an EPIC specimen label with the patient's full name, date of birth, medical record number, source of specimen, test(s) ordered, and date of test.
• All specimens must have two patient identifiers on the vial and three on the requisition. Specimen may be procured with a cervi-spatula and brush OR a broom like device.
• For Endocervical Spatula and Brush:
  • Obtain an adequate sampling from the ectocervix using a plastic spatula. Rinse the spatula into the PreservCyt solution vial by swirling the spatula vigorously in the vial 10 times. Discard the spatula.
  • Obtain an adequate sampling from the endocervix using an endocervical brush device. Insert the brush into the cervix until only the bottommost fibers are exposed. Slowly rotate 1/4 or 1/2 turn in one direction. DO NOT OVER-ROTATE. Rinse the brush by rotating the device in the PreservCyt^® solution 10 times while pushing against the wall of the vial. Swirl the brush vigorously to further release material. Discard the brush.
• For Broom-Like Device:
  • Obtain an adequate sampling from the cervix using a broom-like device. Insert the central bristles of the broom into the endocervical canal deep enough to allow the shorter bristles to fully contact the ectocervix. Push gently and rotate the broom in a clockwise direction 5 times.
  • Rinse the broom into the PreservCyt^® solution vial by pushing the broom into the bottom of the vial 10 times, forcing the bristles apart. As a final step, swirl the broom vigorously to further release material. Discard the collection device.
• Tighten the cap so that the torque line on the cap passes the torque line on the vial. Do not over-tighten the cap on the vial.
• In house cytology specimens should be ordered in EPIC order entry. In the “additional orders” field input “CYTOLOGY PAP TEST (ThinPrep^®)” and fill in all appropriate fields. Label specimen container and requisition with EPIC specimen labels. 
• All Cytology specimens should be accompanied by a requisition and must include the patient name, medical record and visit/CSN number, date of birth, date of specimen collection, pertinent patient history, ordering physician name and source of specimen. Place an EPIC specimen label on the requisition.
• OR specimens ordered using specimen navigator: Testing will be delayed unless specimen source is provided.  Please order test in specimen navigator and fill out paper Cytology requisition provided with the ThinPrep® vial (patient name, medical record and visit/CSN number, date of birth, date of specimen collection, pertinent patient history, ordering physician name, source of specimen, screening vs. diagnostic pap, ICD-10 code, HPV test request, LMP/menstrual status). Label the specimen container and requisition with an EPIC specimen label.
• NOTE: If pap specimen was collected during evaluation of patient candidacy for transplant please indicate STAT on the requisition and specimen vial.
• It is imperative when submitting multiple specimens on the same patient that the labels on the requisition and vial match the correct EPIC order to ensure proper source/collection type to be assigned to the specimens.  Ensure the vial and requisition has the specific specimen source on it (example: L or R cervix).
  

Physician Office/Draw Specimen Preparation

Maintain vial containing sample and ThinPrep^® PreservCyt^® Solution at room temperature (20-26°C or 68-78.8°F) prior to transport to the Laboratory.

Preparation for Courier Transport

Rejection Criteria

• Improper labeling of specimen container or requisition.
• Requisitions not accompanied by a specimen.
• Improper collection of specimen (such as improper fixation).
• Any specimen received without all of the required information will result in a delay of processing until all information can be verified. (Date of service, date of birth, last menstrual period, etc.)
• Specimens that leak outside of specimen container into transport bags. Even if a small amount of fluid leaks out it can dissolve the ink on the patient identifiers written/labeled on the vial, making it an unacceptable specimen.
• Cytology cannot be run off a vaginal self-collect HPV testing sample.

Inpatient Specimen Preparation

Dearborn

• Deliver the specimen to the Main Lab drop off window and sign in. Open 24/7.
• Deliver directly to Cytology: Monday – Friday, 7:00 am – 5:00 pm. 
• Deliver directly to Histology Lab: Monday – Friday, open 24 hours, Saturday 8:00 am – 12:00 pm, closed on Sunday.
• Specimens are also picked up throughout the day from the surgical area and Endoscopy: Monday – Friday, 6:00 am – 4:30 pm, Saturday 8:00 am – 12:00 pm.
• When the Cytology and Histology Labs are closed, specimens must be delivered to the Main Lab window and signed in.

Farmington Hills

• Deliver the specimen directly to the Anatomic Pathology Department.
• After 4:30 pm and on weekends/holidays: deliver to Lab Central Processing.
• Specimens are also picked up throughout the day from surgical floors: Monday – Friday, at 9:00 am, 11:00 am, 1:00 pm, and 3:00 pm. 

Grosse Pointe

• Deliver the specimen directly to the AP Lab (first level): Monday – Friday, 8:00 am – 4:30 pm. After hours, the specimens are taken to the Clinical Pathology Main Lab (Lower Level), entered in the specimen log, handed to lab staff and placed in the refrigerator.
• Specimens are picked up by the AP Lab staff throughout the day from the Surgical Department and Clinical Pathology Main Lab: Monday – Friday, 8:30 am – 4:00 pm. Endoscopy and radiology specimens are delivered to the AP Lab throughout the day.
  
• When the AP Laboratory is closed, specimens are delivered to the Clinical Pathology Main Lab specimen processing area. Specimens are to be entered into the specimen log, handed to lab staff and placed in the refrigerator.
  

Royal Oak

• Deliver specimens directly to the Cytology Laboratory (Research Building, Lower Level): Monday – Friday, 7:00 am – 3:30 pm or to Clinical Pathology Specimen Receiving (located on the first floor of the Corewell Health Laboratory Research Building).
• Specimens are also picked up from the surgical floors, Endoscopy and Clinical Pathology: Monday – Friday, 8:00 am – 7:00 pm, Saturday, 7:00 am – 11:00 am, NT and Endoscopy ONLY.
  

Taylor

• Deliver to Histology: Monday – Friday, 8:00 am – 2:00 pm. 
• After hours: Deliver the specimen to the Main Lab. Open 24/7.

Trenton

• Specimens are picked up from Emergency Department, Interventional Radiology, and operating rooms from 8:00 am – 2:00 pm.
• After hours: Deliver specimens to the Main Lab. Open 24/7.

Troy

• All specimens must be hand-delivered to the Specimen Reception Department: phone number: 248-964-8615.
  

Wayne

• Specimens are picked up from Emergency Department and Interventional Radiology: Monday – Friday, 8:00 am – 2:00 pm.
• After hours: Deliver specimen to the Main Lab. Open 24/7. 

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 4 weeks
Refrigerated (2-8°C or 36-46°F): Acceptable, but not recommended
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Room Temperature (20-26°C or 68-78.8°F): 30 days

Laboratory

 

Royal Oak Cytology Laboratory
Farmington Hills, Grosse Pointe, Dearborn and Troy paps are sent to Royal Oak Cytology Laboratory for preparation and screening. Pap final results are issued at Royal Oak, Farmington Hills, Dearborn, and Troy.

Farmington Hills, Dearborn, Taylor, Trenton Wayne Laboratories
Ordering of the pap specimens takes place prior to sending to Royal Oak.

Performed

Monday – Friday, 6:00 am – 4:30 pm. (Royal Oak)
Most results are available within 5 days of receipt in the Cytology Laboratory if received Monday – Friday. 
The Cytology Laboratory is closed on weekends and holidays.

Test Methodology

Thin layer cytologic preparation, ThinPrep^® imaging system (Most ThinPrep^® specimens are successfully imaged by the imaging system. However, up to 7% may be unsuccessfully imaged and require manual screening by a Cytotechnologist).

CPT Codes

CPT: 88142 (88175 if imaged Pap, 88141 in the event of a professional review).
LOINC: 47527-7. 

Contacts

Last Updated

10/2/2025