Liquid-Based Cytology (LBC) and HPV Test Gdańsk

Liquid-based cytology (LBC) and the high-risk HPV test are used in cervical cancer prevention. At Tartaczna 2 Medical Centre in Gdańsk, a cervical sample can be collected during a gynaecological consultation or an appointment with a midwife.

Cervical screening can detect a high-risk human papillomavirus infection and abnormal cervical cells before symptoms develop. Early detection of precancerous changes allows appropriate monitoring or treatment and significantly reduces the risk of cervical cancer.

Important update: according to current recommendations, the high-risk HPV molecular test is the primary cervical screening test. If the HPV HR result is positive, liquid-based cytology is performed as an additional test.

How does this work at Tartaczna 2 Medical Centre? If a patient chooses to have LBC and HPV testing at the same time, the sample is collected into a SurePath vial suitable for both tests. If the patient chooses the HPV test alone, the sample is collected using a different transport medium. If the standalone HPV test is positive, another appointment and a new sample collection for LBC are required.

Liquid-based cytology in Gdańsk – what does the test involve?

Liquid-based cytology (LBC), also known as thin-layer cytology or a liquid-based smear test, involves collecting cells from the surface and canal of the cervix using a dedicated cervical brush. The collected material is placed in a container with a special preservative fluid.

At Tartaczna 2 Medical Centre, we use the SurePath system for liquid-based cytology. In the laboratory, the sample is processed and prepared as a thin, even layer of cells on a microscope slide. It is then examined under a microscope by a laboratory diagnostician or pathologist.

The purpose of cervical cytology is to detect abnormal cervical cells, including intraepithelial lesions that may require monitoring, HPV testing, colposcopy or further diagnostic procedures.

Does cervical cytology detect HPV?

LBC itself does not detect HPV genetic material. It assesses the appearance of cervical cells and determines whether any cellular abnormalities are present.

A high-risk HPV molecular test is used to detect an HPV infection. It identifies the DNA or RNA of HPV types associated with a higher risk of cervical cancer.

At Tartaczna 2 Medical Centre, patients can choose:

• liquid-based cytology alone,
• a high-risk HPV test alone,
• liquid-based cytology and a high-risk HPV test performed together.

If both tests are requested at the same time, the sample is collected into a SurePath vial and can be used for both cytological assessment and high-risk HPV testing.

If the HPV test alone is selected, the sample is collected using a transport medium other than SurePath. Therefore, if the standalone HPV test is positive, the patient should attend another appointment so that a new sample can be collected for liquid-based cytology.

A cervical cytology report may also describe inflammatory changes or the presence of certain microorganisms. However, cytology is not the primary test used to diagnose vaginal infections or an HPV infection.

How does LBC differ from conventional cervical cytology?

In conventional cytology, the collected cells are spread directly onto a microscope slide. Some of the material may remain on the brush, while blood, mucus or inflammatory cells may make the slide more difficult to assess.

In liquid-based cytology, the collected material is placed in a container filled with preservative fluid. A thin, even layer of cells is prepared in the laboratory before microscopic assessment.

LBC may reduce the risk of obtaining a sample that is unsuitable for assessment and may allow additional tests to be performed when the sample has been collected into a compatible medium. However, liquid-based cytology should not be presented as providing 100% effectiveness or as always being twice as sensitive as conventional cytology.

Comparison of conventional cytology and liquid-based cytology

Left: conventional cytology. Right: liquid-based cytology.

High-risk HPV testing and LBC – the current screening pathway

Under the current cervical screening pathway, the first step is a molecular test for high-risk HPV types. In the Polish cervical cancer screening programme, the test is offered to women aged 25 to 64.

Negative high-risk HPV result

A negative result means that the genetic material of the HPV types covered by the test has not been detected in the sample. For women in the general population, the next screening test is usually recommended after five years, unless their previous results or individual risk factors indicate that a different interval is appropriate.

Positive high-risk HPV result

A positive high-risk HPV result does not mean that the patient has cervical cancer. It means that an HPV type associated with an increased risk of precancerous cervical changes has been detected. Most HPV infections clear spontaneously, but a persistent infection requires appropriate follow-up.

Liquid-based cytology should be performed following a positive high-risk HPV result. Further management depends on factors including the HPV genotype, cytology result, the patient’s age and previous cervical screening history.

If only a high-risk HPV test was performed at Tartaczna 2 Medical Centre and the result is positive, another appointment and a new sample collection for LBC are required.

Depending on the results, the doctor may recommend:

• repeating the high-risk HPV test after a specified interval,
• performing or repeating liquid-based cytology,
• a colposcopy examination,
• colposcopy with cervical biopsies for histopathological examination,
• another form of follow-up based on the patient’s individual risk assessment.

HPV types 16 and 18 are particularly important because together they are responsible for approximately 70% of cervical cancer cases worldwide. More information is available on our page about human papillomavirus infection and HPV testing.

How should an LBC result be interpreted?

Cervical cytology results are usually reported using the Bethesda System. Possible terms include:

• NILM – negative for intraepithelial lesion or malignancy,
• ASC-US – atypical squamous cells of undetermined significance,
• LSIL – low-grade squamous intraepithelial lesion,
• ASC-H – atypical squamous cells where a high-grade lesion cannot be excluded,
• HSIL – high-grade squamous intraepithelial lesion,
• AGC – atypical glandular cells,
• AIS – adenocarcinoma in situ.

An abnormal cytology result does not necessarily mean cervical cancer. It indicates that further management may be required. The recommended pathway depends on the HPV result, the type of cellular abnormality and the patient’s previous screening history.

Benefits of liquid-based cytology

• an even distribution of cells on the microscope slide,
• reduction of mucus, blood and other elements that may make assessment more difficult,
• a lower risk of obtaining a sample that is unsuitable for assessment,
• better preservation of the sample during transport to the laboratory,
• the option of performing high-risk HPV testing from a SurePath sample when both tests have been requested at the same time,
• the possibility of performing selected additional tests, depending on the transport medium and laboratory requirements.

When should I have an HPV test or liquid-based cytology?

In the Polish cervical cancer screening programme, high-risk HPV testing is offered to women aged 25 to 64. Following a negative result and in the absence of additional risk factors, the standard screening interval is usually five years.

A shorter follow-up interval may be recommended if:

• the high-risk HPV result is positive,
• a previous cytology result was abnormal,
• the patient is being monitored following the diagnosis or treatment of an intraepithelial lesion,
• the patient has an immune disorder or is receiving immunosuppressive treatment,
• the doctor identifies other factors associated with an increased risk.

For women under 25 or over 64, the decision to perform cervical cytology or HPV testing is made individually, taking into account symptoms, previous results, treatment of cervical lesions and individual risk factors.

Cervical cytology and HPV testing during pregnancy

Pregnancy itself does not increase the risk of progression of cervical intraepithelial lesions. Pregnant women undergo cervical screening according to the recommendations appropriate for their age and previous screening history.

If a pregnant patient has up-to-date normal results and the next test is not yet due, pregnancy alone does not mean that cytology must be repeated. If cervical screening is due, a sample can usually be collected during pregnancy following assessment by a doctor.

Symptoms that require a consultation regardless of screening results

Cervical cytology and high-risk HPV testing are screening tests intended primarily for patients without symptoms. A normal result does not replace a gynaecological consultation when concerning symptoms are present.

Consult a doctor regardless of when your last cervical screening test was performed if you experience:

• bleeding after sexual intercourse,
• bleeding between periods,
• bleeding after the menopause,
• recurrent unusual vaginal discharge,
• pelvic pain or pain during sexual intercourse,
• a visible abnormality of the cervix.

How should I prepare for LBC and HPV testing?

Sample collection usually takes only a few minutes. It may cause brief discomfort associated with the insertion of a speculum, but it is generally well tolerated.

To help obtain a suitable sample:

• it is best to arrange the test when you are not experiencing heavy menstrual bleeding,
• avoid vaginal medicines, pessaries, creams and other vaginal products for approximately 48 hours before the test, unless advised otherwise by your doctor,
• avoid sexual intercourse for approximately 24–48 hours before sample collection,
• do not douche,
• tell the person collecting the sample if you are pregnant, experiencing bleeding, using any medication or have previously received abnormal screening results.

There is no requirement to undergo cervical screening specifically between days 10 and 14 of the menstrual cycle. The most important considerations are avoiding heavy bleeding at the time of sample collection and following the instructions provided by the healthcare professional performing the test.

Liquid-based cytology and HPV test in Gdańsk – price

A sample for liquid-based cytology and high-risk HPV testing can be collected during an appointment at our gynaecology clinic in Gdańsk or during an appointment with a midwife at Tartaczna 2 Medical Centre.

Patients may choose liquid-based cytology alone, a high-risk HPV test alone or both tests performed at the same time. When LBC and HPV testing are selected together, the material is collected into a SurePath vial.

If only the HPV test is performed and the result is positive, another appointment and a new sample collection for liquid-based cytology will be required.

The price depends on the selected range of tests. Please contact our reception team to confirm the current price and availability.

How can I book LBC or HPV testing in Gdańsk?

To arrange the test, please call +48 58 719 10 25, email kontakt@tartaczna2.pl or visit our contact page.

Appointments are available with Dr Marek Korożan, Dr Volha (Olga) Khitrun and Dr Dominika Kozikowska.

You can also book through ZnanyLekarz: Dr Marek Korożan, Dr Volha (Olga) Khitrun or Dr Dominika Kozikowska.