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Taking a cervical cytology or HPV sample and assisting the pelvic examination

  • Procedure

The nurse prepares the woman, places the speculum, takes cells from the cervix for cytology or the HPV test, and records and tracks the result.

Updated

What it is

A cervical sample collects cells from the cervix through a speculum. The cells go to the laboratory for cytology or for a high-risk HPV DNA test. In Colombia, nursing professionals take both samples (Resolución 3280 de 2018). When the HPV test is used, the cytology sample is taken first and the HPV sample second, in the same visit. The procedure is short, but privacy, a clear explanation and a good record decide whether the woman comes back.

Indications

  • Cytology screening at 25–29 years (scheme 1-3-3).
  • HPV DNA screening at 30–65 years (scheme 1-5-5), with a cytology sample for triage.
  • Women under 25 with risk factors, by the nurse's or doctor's judgement (opportunistic screening).
  • Cytology or HPV test in dispersed rural areas at 51–65 years, by availability.

Contraindications and precautions

  • The woman's consent: she may stop the examination at any moment.
  • Possible pregnancy, a previous abnormal result or a positive HPV test: tell the professional in charge before the sample.
  • Heavy bleeding on the day: the professional decides whether the sample can be taken.
  • Aseptic and antiseptic conditions, and the storage the laboratory and the test maker require.

Equipment

  • Examination table with leg rests, a good light and a screen or private room.
  • Disposable speculum in a suitable size and non-sterile gloves.
  • Sampling devices for cytology (and liquid-based medium if used) and the HPV DNA kit, per the laboratory.
  • Slides, fixative and labels, request form, consent form and the screening card.

Step by step (and why)

  1. Identify the woman and confirm age, last test and result — they decide which sample is due.
  2. Explain each step and that a positive HPV test is not cancer, and obtain consent — understanding reduces fear and loss to follow-up.
  3. Ask her to empty her bladder and offer a gown and a screen — an empty bladder makes the examination more comfortable.
  4. Position her on her back with feet in the rests and cover her legs — position exposes the cervix while keeping her dignity.
  5. Perform hand hygiene, put on gloves and insert the speculum gently, telling her before each movement — a gentle, announced technique reduces pain.
  6. Look at the cervix and note discharge, lesions or bleeding — some findings need urgent referral whatever the screening result.
  7. Take the cytology sample first and then the HPV sample, as the laboratory instructs — the order protects the quality of both samples.
  8. Fix or seal and label the samples at once, then remove the speculum gently — unlabelled or dried samples have to be repeated.
  9. Tell her what she may feel, give her the card and the date for her result — returning for the result is part of screening.
  10. Record the procedure, the findings and the next appointment in the record and the information system — the route asks for this register.

Complications

  • Discomfort, pressure or cramping during the examination.
  • Light spotting after the sample.
  • Pain or anxiety that leads the woman to stop: stop and offer another visit.
  • Sample not suitable (unlabelled, dried, wrong medium): the woman has to come back.

Next step: when to call for help

  • Signs that suggest invasive cancer: tell the woman, raise an alert and inform the professional in charge to arrange colposcopy and biopsy within 1 week.
  • Heavy bleeding, severe pain or a mass during the examination: stop and inform the professional in charge.
  • Positive cytology: search for the woman and arrange a medical or nursing visit within 1 week and colposcopy within 30 days.
  • Positive HPV test: search for the woman and arrange the visit within 2 weeks; the triage cytology is read within 1 week.
  • Signs of violence, or a girl under 14 who is sexually active: activate the violence route.

Test yourself

Think of the answer, then tap the question to see it.

When the HPV DNA test is used, in what order are the samples taken?

Cytology sample first, then the HPV DNA sample, in the same visit and under aseptic conditions.

What should the woman avoid in the 24 hours before the sample?

Sexual intercourse, douching and tampons. She should try to avoid the days of her period.

What is expected after a cervical sample?

Mild cramping or pressure and light spotting. Heavy bleeding or severe pain is not expected and needs a visit.

Within what time should a woman with positive cytology have colposcopy?

Within 30 days, after a medical or nursing visit arranged within 1 week.

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Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: Resolución 3280 de 2018: Ruta Integral de Atención para la Promoción y Mantenimiento de la Salud (section 9, early detection of cervical cancer) (Ministerio de Salud y Protección Social de Colombia, 2018); Pap test (MedlinePlus, U.S. National Library of Medicine, 2025); Cervical cancer (fact sheet) (World Health Organization, 2026).

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