title: Does speculum lubricant affect liquid-based Papanicolaou test adequacy?
abstract: BACKGROUND
  There is a paucity of data on the effect of vaginal lubricants on specimen adequacy in the era of liquid-based Papanicolaou (Pap) tests. Current manufacturer recommendations advise against the use of lubricants, especially those that contain carbomers or carbopol polymers. There is, however, no conclusive evidence to support this recommendation. Moreover, the data that does exist is conflicting.
  
  
  METHODS
  Retrospective review was performed of all liquid-based Pap tests collected between January 2010 and March 2012 by the Gynecologic Oncology division at a single hospital. Specimen adequacy was compared for vaginal and cervical specimens that were collected with and without a lubricant. Results were also compared for specimens collected with lubricants that did or did not contain carbomers.
  
  
  RESULTS
  There was no significant difference in specimen adequacy for cervical or vaginal Pap test specimens collected with a water-soluble lubricant not containing carbomers, compared to those collected without a lubricant. There was, however, a significantly higher rate of insufficient specimens when a water-soluble lubricant containing carbomers was used. This difference was most pronounced for vaginal Pap tests (26.9% versus 1.2%, OR = 30.3, 95% CI = 16.6-55.1, P < .0001).
  
  
  CONCLUSIONS
  Lubricants containing carbomers should be avoided when collecting liquid-based Pap tests because they can significantly decrease specimen adequacy. Lubricants that do not contain these substances do not significantly affect specimen adequacy. If there is an unusual increase in unsatisfactory Pap tests, the cytology laboratory should notify clinicians and work with them to determine the cause.
authors.affiliation: Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.
authors.forename: Stephanie N
authors.initials: SN
authors.lastname: Lin
authors.forename: Jolyn
authors.initials: J
authors.lastname: Taylor
authors.forename: Susan
authors.initials: S
authors.lastname: Alperstein
authors.forename: Rana
authors.initials: R
authors.lastname: Hoda
authors.forename: Kevin
authors.initials: K
authors.lastname: Holcomb
mesh_terms: D000180:Acrylic Resins / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000075202:Contraindications; D005260:Female; D006801:Humans; D054327:Lubricants; D008875:Middle Aged; D065006:Papanicolaou Test / Q000379:methods*; D011108:Polymers / Q000009:adverse effects; D011145:Polyvinyls / Q000009:adverse effects; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013525:Surgical Instruments; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology; D014626:Vaginal Smears / Q000379:methods*
chemical_list: D000180:Acrylic Resins; D054327:Lubricants; D011108:Polymers; D011145:Polyvinyls; C479038:carbomer; C006912:carboxypolymethylene
keywords: Papanicolaou smear; Papanicolaou test; cervical smear; lubricants; vaginal smear