CA1307180C - Cervical cytology device - Google Patents

Abstract

ABSTRACT

A method and device for simultaneously collecting cytology cell samples from the endocervix and exocervix are disclosed. The device includes a handle for manipulating and rotating the device. Adjacent the handle is an intermediate cell collecting surface which is sized and configured to scrape cell samples from the exocervix when it is in contact with the exocervix and the device is rotated. The device also includes a distal cell collecting surface adjacent the intermediate cell collecting surface. The distal section is sized and configured to scrape cytology cell samples from the endocervical canal when it is located within the canal and in contact with the walls thereof and the device is rotated. The distal and intermediate surface are further positioned on the device with respect to each other to enable the endocervical canal and exocervix to be scraped simultaneously as the device is rotated.

Description

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CERVIC~L CYTOLOGY Dl~VICE

Technical Field The invention relates cJenerally to a method and apparatus for collecting cell specimens for diagnostic 05 purposes and more particularly to a cervical cytology device and method for collecting cytology cell samples from the uterine endocervix and exocervix.

Bac~qround Art l~ It is well-known that uterine cervical cancer can be prevented and/or even cured if it is detected early enough, preferably in its precancerous or precursor stages. Accordingly, women are being encoura~ed to come in for examinations on a regular basis. Improvements in early detection devices and techniques will also, quite obviously, enhance the physician's ability to accurately detect the presence of cancer in its early stages.
~ccordingly, much effort is being directed to developing such devices.
~0 Drs. Christine Bergeron, M.D. and A~ex Ferenczy, M.D. in their article entitled "Screenin~ Devices for Cervical and Endometrial Ca" published in Contemporary OB-GYN (1987), set forth on pages 55-66 an extensive listing of cervical cytologic sampling and screening devices, and also discuss how the devices should be used to effectively detect the presence of cancer and its precursors.
U.S. Patent No. 3,881,464 to Levene also discloses a device for obtaining endocervical cell and tissue 3~ samples. The device comprises a generally frusto conical brush having a coa~ial handle projecting from its lar~er end. The frusto conical brush consists of soft radially pr~jecting bristles of cellulose acetate which are soluble in a liqu1.d that does not cause morphological damage when the brlstles and cell samples ~L3~7~

are immersed in the liquid. While useful in obtaining ce71 samples from the endocervical canal, the brush's frusto conical shape does not lend itself to collecting cells from the exocervix.
05 While the a~orementioned devices undoubtedly work as intended, t~lere is s~ill a need for devices which are capable of collecting sarnples containing more cells, particularly from the exocervix area. The aforementioned wooden spatula does not generally collect enough cells from the exocervix to enable one to acc~lrately determine whether any abnormal cells are present. The problem is even worse with women who have an abnormally or unusually shaped exocervix since the spatula's long rigid lobe may not even make contact with the exocervix. Accordingly, a need still exists for a device which is capable o~ collecting larger cell samples from the uterine exocervix. Such a device would be even more desirable if it also had the capability of collecting cell samples from the endocervical canal.
~0 Such a device would make better use of the physician's time and be more palatable to the patient since it would enable the samples to be taken quicker. Such a device would also be more accurate than presently available devices since it would make it possible to collect larger cell samples from the exocervix.

Disclosure o~_the Invention The present invention addresses the a~orementioned concerns and needs by providing a cervical cytology device ~or simultaneously collecting cytology cell samples from the uterine endocervix and exocervix. In its broad form the device includes a handle ~or manipulating and rotating the device, an intermediate cell collecting suxface region a~jacent the handle Eor 3 ~

scraping cytology cells from the exocervix and a distal cell collecting sur~ace adjacent the intermediate cell collecting surface for scraping cytology cells from the endocervical canal. The cell collecting surfaces are 05 sized and configured to be capable of scraping cytology cell samples frorn their respective cervical areas when they are in contact with their respective regions of the cervix the device is rotated. The distal and intermediate cell collecting surfaces also positioned with respect to each other on the device so as to enable the endocervical canal and exocervix to be scraped simultaneously as the device is rotated.
A first embodiment of the cervical cytology device of the present invention is a brush which includes a rigid yet bendable shaft having less than three bends which define four sections of the brush. The first bend joins an outwardly projecting or distal cell collecting surface and an intermediate cell collecting surface of the brush. The bend is provided such that the cell ~0 collecting surfaces define less than a 90 included angle between their respective shafts. The second bend on the brush's shaft adjoins the intermediate cell collecting surface and an offset intermediate section, and the bend is such that the intermediate sections define approximately a 10 included angle. The third bend joins the intermediate offset section and an outwardly projecting handle section of the brush. This third bend is such that the offset and handle sections define at least a 90 included angle. The bends are also provided so that the distal and handle sections of the brush are axially aligned. In addi'tion, the distal cell collecting surface of the hrush is sized and configured to collect cytology cell samples from the endocervlcal canal when the brush is rotated and the distal cell collecting sur~ace is located within the canal and in contact with the wall thereof. The intermediate cell collecting surface is also sized and configured to collect cytology cell samples from the 05 surface of the exocervix as the distal cell collecting surface is rotated to collect cytology cell samples ~rom the endocervical canal. Accordingly, cell samples from the endocervical and exocervical surface can be collected simultaneously.
The angles described above between the di~ferent sections of the brush can be altered at will by -the physicians by bending the shaft of the brush. The physician, in effect, can mold the brush to "customize"
a "fit" for each individual patient.
In a second embodiment, a distal bristled region is attached to the distal end of a handle and extends axially therefrom. An intermediate bristled region is attaehed to a disc which surrounds and extends at right angles from a hollow sha~t which telescopicly and fixedly engages the distal bristled region shaft and extends substantially the length thereof. With the two portions assembled, the distal bristled region is inserted in the endocervix with the bristled region of the disc against the exocervix. The entire device is ~5 rotated so as to collect eells on the respective bristled portions. The portions are then separated from each other whereupon the cells collected on the distal bristled portion from the endocervix ean be applied to a flrst slide and cells colleeted on the intermediate bristled portion of the disc from the exocervix can be plaeed on a seeQnd slide.
In a third embodiment, a distal bristled portion is provided which is attached to a handle, which is substantially identical to that of the previous ~3~7~L~O

embodiment. However, the intermediate bristled portion is provided on a second identical handle and extends at an angle to the distal brush. The two handles are attached to aach other along their contiguous surfaces S by a fracturable adhesive or weld. When in the assembled welded condition, the brushes are used as described with respect to the previous embodiment.
After the cells have been collected, the handles are broken apart along the fracturable weld and the cell samples placed on separate slides for viewing.
The present invention also provides a method of collecting cytology cell samples from the endocervix and exocervix simultaneously. The method includes providing a rotatable cervical cytology device having a first cell collecting surface which is sized and confi~ured to collect cells from the exocervix and a second cell collecting surface which is sized and configured to collect cells ~rom the endocervical canal where the device is rotated. The method further includes inserting the second cell collecting surface into the endocervical canal until the first cell collecting surface is positioned against the surface of the exocervix. The device is then rotated so that cytology cell samples are scraped from the respective surfaces of the exocervix and endocervix simultaneously. As such, the cell samples will collect on tha respective first and second cell collecting surface of the device. The device is then withdrawn from the patient. The samples are then removed from the device and examined to determine whether any abnormal cancerous, precancerous or virally diseased cells are present.
Additional advantages of this invention will become apparent from the detailed description which follows, taken ln con;unction with the accornpanying drawings.

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Brief_Description of the Drawinqs Figure 1 is a perspective view of a conventional prior art wooden spatula and an endocervical brush which are used by physicians to scrape cytology cell samples 05 from different areas of a uterus.
Figure 2 is a perspective view of a preferred embodiment o~ the present invention ~or scraping cytology cell samples from the endocervix and exocervix simultaneously.
Figure 3 is an exploded perspective view o~ another embodiment of the present invention for scraping cytology cell samples from the endocervix and exocervix simultaneously.
Figure 4 is a perspective view of a preferred 1~ embodiment of the invention having separable handle portions.
Figure 5 is an enlarged vertical section, taken along line 5-5 of Figure 4.

Best Mode for Carrvinq Out the Invention Figure 1 illustrates a conventional wooden spatula 5. Drs. Bergeron and Ferenczy describe spatula 5 on page 56 of their above-mentioned article as being a tool for sampling the squamocolumnar junction, the exocervix and to a lesser degree the endocervix. As seen in Figure 1, one end of spatula 5 is provided with a handle portion 6 for manipulating the spatula. At its other end, spatula 5 is provided with a long lobe 7 and a short lobe 8. In order to collect cervical cell samples for determining whether any abnormal cells are present, spatula 5 is held by handle 6 and inserted into the vagina until the spatula's short lobe 8 is positioned within the patient's endocervical canal entrance and the ~` ' ' , .
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spatula's long lobe 7 is positioned against the exocervix. Long lobe 7 i5 then rotated about the exocervix with the short lobe essentially pivoting in the endocervix canal entrance. As such, the long lobe 05 scrapes and collects cells from the surface of the exocervix. The spatula is then withdrawn from the patient and the cells having been collected on the spatula are then removed therefrom and prepared for examination.
Since the spatula's short lobe 8 merely pivots about the endocervical canal entrance, it scrapes and thus collects very few cells from the endocervix.
Accordingly, many physicians use other devices to collect endocervical cell samples. Figure 1 also lS illustrates an endocervical brush 10 which is one o~ the more commonly used devices for endocervical sampling.
One such brush is sold by International Cytobrush, Inc.
under the trademark "Cytobrush". Brush 10 has a thin cylindrical stem-like handle 11 which is about 7 1/2"
long. One end of handle 11 is provided with a generally cylindrical brush portion 12 which is generally about 3/4" long and about 1/4" in diameter. Drs. Bergeron and Ferenczy point out on page 60 of their article that endocervical samples are taken by inserting the brush into the endocervical canal and then slowing rotating it one-half to one full turn. The brush is then removed from the endocervical canal and a pap smear is prepared by rolling and twisting the brush on a glass slide.
Figure 2 illustrates a first embodiment of a brush 20 of the present invention which is used for collecting cytology cell samples from the uterine endocervix and exocervix simultaneously. Brush 20 includes a handle 22 preferably made from a suitable material, such as, plastic, which is mounted on a shaft 2~. It can also be .
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seen that sha~t 24 is bent in three places which are identified as bends 26, 28 and 30. Brush 20 is provided with a plurality of radially projecting bristles 32 which extend from bend 28 to the distal end of the 05 brush. The bristles extending between bend 30 and 23 define a generally cylindrically shaped cell collecting surface which is referred herein as the interrnediate bristled section of brush 20. It can also be seen that bristles 32 gradually taper from bend 30 to the brush's distal end and, as such, define a generally conical cell collecting surface which is referred to herein as the distal bristled section of the brush. The nonbristled area of shaft 2~ between bends 28 and 2G is referred to herein as the intermediate offset section of the brush.
The diameter of the intermediate bristled section (i.e.
its brush portion) is preferably about 1/4". The diameter of the distal bristled section preferably tapers from about 1/4" at bend 30 to approximately 1/8"
at the brush's distal end.
Bristles 32 are secured to shaft 24 in the conventional helically wound manner (not shown).
Accordingly, those skilled in the relevant art will recognize that shaft 24 comprises a pair of strands twisted together. The bristles are tightly secured to the shaft by being interposed between the twisted strands of the shaft~
While the cell collecting surfaces are bristled in the illustrated embodiment it should be understood that they could be made in accordance with the present invention from material which is suitable ror collecting or scraping cells from the respective cervical surfaces.
Such materials include closed cell foam materials such as urethane and polyurethane. Other possible materials lnclude sponge-like materlals and cotton-like rnaterials `~ ~

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g such as a cotton swab.
Returning to Figure 2, bend 30 defines an included angle A between the distal and intermediate bristled sections which is less than 90, preferably about 85.
05 Bend 26 between the nonbristled intermediate offset section and the handle section of brush 20 also preferably defines an included angle C of about 100.
Included angle B defined by bend 28 between the intermediate sections is preferably 10 or greater. In addition, the portions of shaft 24 extending through the distal bristled section and the handle section are preferably axially aligned. Further, the height of the of~set portions is preferably 3/4" as measured from bend 28 to an imaginary line extending between the angled axis of the handle and distal shaft. A brush manufactured as described will conform to the shape of most womens uterine cervixes. However, shaft 2~ may be bent to conform to an irregularly shaped cervix. The angle of the bends may also be altered by the physician to custom fit each patient, as required.
In using brush 20 of the present invention, the patient's vaginal cavity is first opened wide, preferably with a vaginal speculum. This permits brush 20 to be easily inserted into the vaginal cavity. The attending physician can also look into the vaginal cavity to see whether the exocervix of the patient is unusually shaped, and if so the physician can bend the brush so that it conforms to the irregularly shaped exocervix. The physician then inserts the brush into the patient's vaginal cavity until the distal bristled end of the brush is inserted within the endocervical canal and the intermediate bristled section of the brush is in contact with the exocervix. The intermediate bristled section should be in contact wlth the exocervix ~L3()7~ 8~

along its entire length (i.e. from bend 30 to bend 2~).
If it is not, it should be bent as previously described until it makes such contact. The physician ~hen rotates the brush by rotating the brush handle wi~h his hand so 05 that the bristles of the intermediate bristled section scrape cell samples from the exocervix. ~s this occurs, cell samples will also be scraped from the endocervical canal walls by the distal bristled section of the brush which will be rotating within the endocervical canal as the brush rotates~ After a suitable sample of cells is collected from the endocervix and exocervix, generally after one or two rotations of the brush, the brush is withdrawn from the vaginal cavity. The cell samples on the bristles of the respective brush portions are then removed from the bristles. Since the endocervical and ~exocervical samples are preferably analyzed separately, the endocervical cells on the distal bristled portion of the brush are removed by smearing them along the length of a first glass side which preferably is done by slowly rotating the distal end of the brush on the slide. The exocerYical cells on the intermediate bristled portion of the brush are removed therefrom similarly by smearing them alony the length of a second glass slide. The cells of both slides are then placed in a chemical fixative to preserve the cells until they are examined by a pathologist. The pathologist prepares the cells for examination generally by staining them with a Papanicoloff s-tain. The cells are then examined by the pathologist under a microscope to determine if any abnormal cancerous, precancerous or virally diseased cells are present.
A brush similar to that described in Figure 2 was tested and found to collect exceedingly good samples, particularly exocervical samples. Ill fac~, the .

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exocervical samples contained on average approximately five times as many cells as those collected by the conventional wooden spatula. These large samples will enhance the physician's ability to more accurately 05 detect the presence of abnormal cancerous and precancerous cells. The samples have also been large enouyh to enable physicians to detect the presence of virally diseased cells such as herpes.
Figure 3 illustrates an alternative brush 40 of the present invention for collecting cell samples from the exocervix and endocervix simultaneously. srush 40 is provided with two cell collection surfaces, an exocervical brush portion 42 and an endocervical brush portion 44 having bristles 45 at the distal end. While bristled, it should again be understood that other materials suitable for collecting cells could also be used such as urethane or pol,yurethane.
Endocervical brush portion 44 is similar to the - endocervical brush described in Figure 1, i.e., brush 10. Exocervical brush portion 42 is provided with a hollow shaEt 46 which is sized and configured to telescope over the shaft of the endocervical brush portion 44 and fixedly or frictionally engage therewith (i.e., by interference fit) to enable the shafts to rotate together when rotat~d by an attending physician.
Fixed engagement could also be provided by making shallow shaft 46 out of a flexible material which would enable it to compress and frictionally engage the surface of shaft 44 when grabbed by a physician.
Interlocking ribs on shafts 44 and 46 could also be employed to provide fixed engagement between the sha~ts.
Returning to Figure 3, it can be seen that exocervical brush portion 42 is provided with a disc ~8 which is axlally disposed on hollow shaft 46 at one end .. . . .

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thereof. Disc ~8 iS provided with bristles 50 on one side and is preferably about 1 1/2" in diameter.
Bristles 50 form a generally planar brushing surface.
In addition, bristles 50 are lony enough (preferably 05 3/8" long), to enable the brushing surface to conform to the surface of the exocervix, even an irregularly shaped exocervix.
Use of brush 40 is similar to that of brush 20 previously described. The attendin~ physician (after having opened ~he patient's vaginal cavity with a vaginal speculum) inserts the brush into the vaginal cavity until the endocervical brush portion is located within the endocervical canal and the brushing surface of disc 48 is positioned against the patient's exocervix. The brush is then rotated one or two times to scrape cell samples from the respective endocervix and exocervix. The brush is then withdrawn from the vaginal cavity and the two brush portions, (i.e., exocervical brush portion 42 and endocervical brush portion 44) are separated~ Cell samples on the exo~ervical brush portion are preferably smeared onto one slide and the cell samples from the exocervical brush portion are preferably smeared on another slide.
The slides are then prepared and examined to determine if any abnormalities exist.
A third embodiment in the form of brush 60 is illustrated in Figures 4 and 5. Brush 60 has two cell collection surfaces, an exocervical brush portion 62 and endocervical brush portion 64, the later having a handle 66, in the form of a rod, with bristles 68 at the distal end. Although it is illustrated as being bristled, it -should be understood that other materials suitable for collecting cells could al50 be used, such asr~urethane or polyurethane. Conveniently, the brush includes a central . .
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wire 70 which extends into a tubular passageway 72 in handle 66. The wire size may be configured to frictionally fit in the passageway or may be secured by a suitable adhesive (not shown).
05 The exocervical brush portion 62 includes a handle 74 in the form of a rod. An exocervical brush 76 has a central wire 7~ which extends into a longitudinal passageway 80 of handle 74. This wire is either sized to frictionally fit in passageway ~0 or is attached therein by a suitable adhesive (not shownl.
Conveniently, wire 7~ is bent at an angle so that endocervical brush 68 and exocervical brush 78 have an included angle D between them. This angle, is conveniently approximately 85 degrees. The brush is used in the same manner as the previous embodiment wherein brusll 68 is inserted in the endocervix with the brush 76 contacting the exocervix.
The brush 60 is rotate~l along the longitudinal axis of handle 66 so as to collect endocervix cells on brush 68 and exocervix cells on brush 76. The handle 66 and 74 are attached by a weld or adhesive area ~2, shown in Figure 5 which is fracturable. Thus, after the cell samples are collected, the two handles 66 and 74 can be broken apart along the weld 82 and cells on the respective brushes apply to different slides for viewing.
~rom the ~oregoing, the advantages of this invention are readily apparent. ~ cytology brush has been provided which in the various embodiments includes separate cell collecting surfaces, one Eor collecting the cells from the endocervix and one for collecting cells from the exocervix. After collection, these cell - samples can be placed on separate slides ~or viewin~ to determine if the patient has any abnormal cell growth.

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Tha invention has been described in detail with particular reEerence to several embodiments thereof, but it will be understood that variations and modifications can be effected within the spirit and scope of the 05 invention.

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Claims (24)

1. A cervical cell collection device for simultaneously collecting cytology cell samples from the endocervix and exocervix, said brush comprising:
handle means for manipulating and rotating said device;
an intermediate cell collecting surface adjacent said handle for collecting cytology cell samples from the exocervix, being sized and configured so as to be capable of scraping cytology cell samples from the exocervix when the device is rotated and said intermediate cell collecting surface is in contact with the exocervix; and a distal cell collecting surface adjacent said intermediate cell collecting surface for collecting cytology cell samples from the endocervical canal, said distal cell collecting surface being sized and configured so as to be capable of scraping cytology cell samples from the endocervical canal when the device is rotated and said distal cell collecting surface is substantially located within the endocervical canal and in contact with the walls thereof, said distal cell collecting surface also being positioned on the device with respect to the intermediate cell collecting surface so as to enable the endocervical canal and exocervix to be scraped simultaneously, thereby enabling the samples to be collected simultaneously.

2. A device as claimed in Claim 1, wherein:
at least one of said cell collecting surfaces includes bristles forming a brushing surface for collecting cytology cell samples.

3. A device as claimed in Claim 1, wherein:
at least one of said cell collecting surfaces includes closed cell foam for collecting cytology cell samples.

4. A device as claimed in Claim 3, wherein:
said closed cell foam is selected from the group consisting of urethane or polyurethane.

5. A device as claimed in Claim 1, wherein:
at least one of said cell collecting surfaces includes sponge-like material for collecting cytology cell samples.

6. A device as claimed in Claim 1, wherein:
at least one of said cell collecting surfaces includes a cotton swab or cotton-like material for collecting cytology cell samples.

7. A cervical cytology device for simultaneously collecting cytology cell samples from the endocervix and exocervix, said brush comprising:
handle means for manipulating and rotating said brush;
an intermediate bristled region adjacent said handle, said intermediate bristled region being sized and configured so as to be capable of scraping cytology cell samples from the exocervix onto its bristles when the device is rotated and said intermediate bristled region is in contact with the exocervix; and a distal bristled region adjacent said intermediate bristled region, said distal bristled region being sized and configured so as to be capable of scraping cytology cell samples from the endocervix onto its bristles when the device is rotated and said distal bristled region is in contact with the endocervix, said distal region also being positioned on the brush with respect to the intermediate region so as to enable the endocervix and exocervix to be scraped simultaneously, thereby enabling the samples to be collected simultaneously.

8. A brush, as claimed in Claim 7, wherein:
said handle means and distal bristled region are in axial alignment with respect to each other.

9. A brush, as claimed in Claim 7, wherein:
the distal bristled region includes a shaft provided with a plurality of bristles attached to and projecting radially from said shaft, said bristles forming a generally cylindrical or conical brush portion.

10. A brush, as claimed in Claim 9, wherein:
the intermediate bristled region includes a shaft provided with a plurality of bristles attached to and projecting radially from said shaft, said bristles forming a generally cylindrical brush portion, said intermediate bristled region shaft being integral with said distal bristled region shaft but extending laterally from said distal bristled region at an angle so as to provide an included angle between the respective shafts which is less than 90°.

11. A brush, as claimed in Claim 10, wherein:
the included angle is about 85°.

12. A brush, as claimed in Claim 9, wherein:
the intermediate bristled region includes a disc provided with a plurality of bristles on one side of the disc, said bristles forming a generally planar brushing portion for scraping cytology cell samples from the exocervix, said distal bristled region and said disc-shaped intermediate bristled region being located with respect to each other such that the shaft of the distal bristled region projects outwardly from the bristled side of the disc at a right angle.

13. A brush, as claimed in Claim 12, wherein:
the handle projects outwardly from the other side of the disc at a right angle.

14. A brush, as claimed in Claim 13, wherein:
the handle further comprises a hollow shaft which telescopicly and fixedly engages with the distal bristled region shaft which extends the length of the brush.

15. A brush, as claimed in Claim 10, wherein:
the handle is provided with a shaft which integrally adjoins the shaft of the intermediate bristled region.

16. A brush, as claimed in Claim 15, wherein:
the handle shaft is bent to provide an outwardly extending handle portion and an inwardly extending offset portion such that, said offset portion integrally adjoins the shaft of the intermediate bristled region, and said handle portion is axially aligned with the shaft of the distal bristled region.

17. A brush, as claimed in Claim 1, wherein:
said brush is rigid yet bendable so that said brush is capable of being bent to conform to the shape of a particular exocervix and endocervix to be scraped, said rigidity being such that said brush retains its shape until it is bent again.

18. A brush, as claimed in Claim 9, wherein said handle means includes:
a pair of parallel rods having surfaces positioned in contiguous relationship, each shaft having a distal end and a proximate end;
fracturable means joining said rods so that they can be separated after use;
said distal bristled region extending axially from said distal end of one of said rods; and said intermediate bristled region extending at an angle from said distal end of said other of said rods.

19. A brush, as claimed in Claim 18, wherein:
each of said rods is tubular;
said distal bristled region has a shaft fixed in said distal end of one of said rods; and said intermediate bristled region has a shaft fixed in said distal end of said other of said rods;
said shaft of said intermediate bristled region being bent at an angle beyond the distal end of said other of said rods so that said distal bristled region and said intermediate bristled regions are at an angle with respect to each other.

20. A brush as claimed in Claim 19, wherein:
the included angle between said distal bristled region and said intermediate bristled region is approximately 85°.

21. A brush, as claimed in Claim 18, wherein said fracturable means is:
a fusion of the rods along said contiguous surfaces.

22. A cervical cytology brush for simultaneously collecting cytology cell samples from the endocervical canal and exocervix, said brush comprising:
a rigid yet bendable shaft having at least a first, second and third bend defining four sections of the brush;
said first bend joining an outwardly projecting or distal cell collecting surface and an intermediate cell collecting surface, said first bend being such that said surfaces define less than a 90°
included angle;
said second bend joining said intermediate cell collecting surface and an intermediate offset section, said second bend being such that said intermediate sections define at least a 10° included angle;
said third bend joining said intermediate offset section and an outwardly projecting handle section, said third bend being such that said offset and handle sections define at least a 90° included angle, said bends also being such that said distal and handle sections are axially aligned;
said distal cell collecting surface further being sized and configured to collect cytology cell samples from the endocervical canal when the brush is rotated and the distal cell collecting surface is located within the canal and in contact with the walls thereof; and said intermediate cell collecting surface further being, sized and configured to collect cytology cell samples from the surface of the exocervix as the distal cell collecting surface is rotated to collect cytology cell samples from the endocervical canal.

23. A method of collecting endocervical and exocervical cell samples from a patient simultaneously with a cervical cytology device having a first cell collecting surface which is sized and configured to collect cells from the exocervix when it is placed in contact with the exocervix and the device is rotated and a second cell collecting surface which is sized and configured to collect cells from the walls of the endocervical canal when it is placed in the canal, in contact with said walls, and the device is rotated, the second cell collecting surface also being positioned on the device with respect to the second cell collecting surfaces, to be collected simultaneously as the device is rotated, said method comprising:
inserting the second cell collecting surface into the patient's endocervical canal until the first cell collecting surface is located against the surface of the exocervix;
rotating the device so the cells are collected from the surface of the exocervix and the walls endocervical canal simultaneously, the exocervical cells being collected on the first cell collecting surface and the cells from the endocervix being collected on the second cell collecting surface;
withdrawing the device from the patient;
removing the cells from the respective cell collecting surfaces; and examining the cells to determine whether any abnormal cancerous, precancerous or virally diseased cells are present.

24. A method as claimed in Claim 23, wherein:
the removing step includes placing cells from each surface on separate viewing surfaces, and the step of examining includes examining cells from each surface separately.