Does speculum lubricant affect liquid-based Papanicolaou test adequacy?

Area of Science:

• Gynecologic Oncology
• Cytopathology

Background:

• Limited data exists on vaginal lubricant effects on liquid-based Papanicolaou (Pap) test specimen adequacy.
• Manufacturer recommendations caution against lubricants, particularly carbomer-containing ones, but evidence is conflicting.

Purpose of the Study:

• To evaluate the impact of vaginal lubricants on liquid-based Pap test specimen adequacy.
• To compare adequacy rates for specimens collected with and without lubricants, and differentiate based on lubricant composition (carbomer vs. non-carbomer).

Main Methods:

• Retrospective review of liquid-based Pap tests from January 2010 to March 2012.
• Comparison of specimen adequacy for vaginal and cervical samples collected with and without lubricants.
• Analysis of specimens based on whether lubricants contained carbomers.

Main Results:

• No significant difference in specimen adequacy was found for Pap tests using water-soluble lubricants without carbomers compared to no lubricant.
• A significantly higher rate of insufficient specimens occurred when carbomer-containing lubricants were used (26.9% for vaginal tests vs. 1.2%).

Conclusions:

• Carbomer-containing lubricants significantly decrease liquid-based Pap test specimen adequacy and should be avoided.
• Lubricants without carbomers do not adversely affect Pap test specimen adequacy.
• Cytology laboratories should communicate with clinicians regarding any unusual increases in unsatisfactory Pap tests.