PAP smear by Liquid based cytology (LBC)

LBC Test is done for detection of cervical cancer and early cancerous changes in the cervix. It also additionally detects any infections of cervix. The test is usually done between 25 to 65 years every three or five years as per the doctor's recommendation. It may be done as a routine test along with the pelvic exam or is also done in certain high risk cases. It is often combined with HPV (Human papilloma virus ) testing which is more effective in detecting early changes of cancer since HPV infection is one of the major risk factor linked to cervical cancer. Other risk factor include:

• History of previous cervical infection or precancerous cells in previous exam.
• History of sexually transmitted infections like HIV.
• Weakened immunity such as auto-immune disorder or previous organ transplant.
• Exposure to DES (Diethylstilbestrol) prior to birth.

LBC test measures the amount of precancerous cells in the cervix (lower end of the vagina) as well as HPV.

Pap smear is usually performed at the doctor's clinic. A speculum is inserted into the vagina for a cervical examination, and using a spatula or soft brush the cervical cells are collected. The cells are dissolved in a liquid (LBC) for better results.

Mostly in general population with low risk factors the test is negative. Normal or negative result rules out risk for cervical cancer. Next screening may be recommended after 3-5 years depending on your age and clinical history. In cases of infections and mild abnormal changes, strict vigilance, proper infection control and follow up after 3-5 years is required as changes tend to regress spontaneously. PAP smear with LBC reduces the chances of false positive. Hence, preferred over the conventional method. Major or severe abnormalities have increased risk of cancer progression and require early and timely intervention. Regular Pap smear test thus helps in early diagnosis and better prognosis.

Negative result: A negative result means that you are not at risk of developing cervical cancer at least for a few years.

Positive result: A positive result could mean that there are changes in your cervical cells, which could be due to several reasons:

• Inflammation due to intercourse or usage of diaphragms
• HPV or other infection
• Pre-cancer or cancer
• False positive

Usually, after a positive result, your gynaecologist may ask you to undergo an HPV DNA test to look for the presence of the HPV and the likelihood of cervical cancer.

No, the test is not painful. Your doctor uses a speculum to widen the opening of the vagina and uses a cell scraper to scrape some cells of the cervix.

The cells are stored in a vial and are taken to a pathologist. The pathologist examines the cells under a microscope and looks for abnormalities in shape, structure and organisation.

Yes. Your doctor may ask you to refrain from having sex or using tampons, ointments or creams at least 48 hours before the test. You may also be asked to avoid taking some medication that may bring about changes in the cervix.

No. The test is taken only away from your menstruation days in order to obtain the most appropriate results.

No. It does not mean that you have cervical cancer. Your doctor has suggested the test to look for infections and inflammation or to look for changes in the cervix, which may or may not be due to cervical cancer.

No, it is a non-invasive test. Even though the test is performed intravaginally, there is no cut involved.

For the conventional type of PAP smear test, the cells collected with a brush and a spatula are smeared on a slide and stained with PAP stain. For the liquid-based cytology type, cells collected brush are thoroughly rinsed in a preservation vial.

A pap smear liquid-based cytology test is similar to the conventional test in the procedure, the only difference is the method opted to analyse the cells under a microscope. Your gynaecologist inserts a speculum through your vagina to widen the opening and scrape a few cells from your cervix. The collected cells will then be stored in a vial and given to the pathology team for analysis under a microscope.

You may be asked to refrain from having sex or using tampons, creams, powders, contraceptives, suppositories or anything that could interfere with the cells in the cervix for at least 48 hours prior to the test.

A pap smear test is a common procedure that every woman of reproductive age (25 to 55 years) should undergo once every 3 to 5 years.

You may be asked to undergo a pap smear test more often if you:

• Show signs of cervical cancer
• Have early-stage cervical cancer
• Have HIV infection
• Have a family history of cervical cancer
• Have auto-immune disorders

Since this test only gives information on the changes occurring in the cells, it is paired often with a Human Papilloma Virus (HPV) test to detect the presence of the HPV that causes cervical cancer in the cervix.

Other tests that may be ordered along with a Pap smear liquid-based cytology test include:

• A pelvic examination to check
  for any abnormalities in the reproductive organs  
• A mammogram to check for any
  changes in the breast tissue

• Thinprep test
• Liquid-based cytology test
• LBC test

The liquid-based cytology (LBC) test is a modern cervical cancer screening technique that collects cervical cells in a liquid medium, enhancing specimen quality and diagnostic accuracy. The cells are suspended in a fixative fluid, creating a monolayer slide that reduces cell overlapping and improves analysis.

The LBC blood test detects pre-cancerous and cancerous changes in the cervix, including low-grade cervical alterations (LSIL), high-grade cervical alterations (HSIL), and the presence of high-risk human papillomavirus (HPV) strains, if combined with HPV testing.

If the LBC test reports are positive, it indicates the presence of abnormal cells or high-risk HPV. This may lead to further diagnostic procedures such as colposcopy, biopsy, and follow-up tests to monitor the condition and determine the best course of treatment.

The benefits of the LBC test include improved accuracy, reduced inadequate samples, early detection of cervical abnormalities, a less invasive procedure, and the ability to combine with HPV testing without requiring an additional sample.

The LBC test is generally safe and non-invasive. Some women may experience minor discomfort or spotting after the procedure. Although false positives or false negatives can occur, they are less common compared to conventional Pap smears.

The LBC test is primarily used to diagnose cervical cancer, cervical dysplasia (abnormal cell changes that could potentially develop into cancer), and HPV infection (if combined with HPV testing).

Medications are unlikely to directly affect the LBC test results. However, recent vaginal douching, use of vaginal creams or suppositories, or menstrual bleeding can interfere with the accuracy of the test. It is advisable to avoid these activities before undergoing the LBC test.

No fasting is required before taking the LBC test. It involves collecting a sample of cervical cells during a pelvic exam, with no special diet required.

Several factors can affect LBC test results, including recent vaginal douching or use of vaginal creams or suppositories, menstrual bleeding, infection or inflammation, and the presence of blood, mucus, or other debris in the sample.

LBC (Liquid-Based Cytology) test reports will be ready within 3-4 days after the sample is collected.