Cervical smear counselling Flashcards
why do we smear test & how does it work
stop cervical cancer developing (catch it)
collect small samples of cells from cervix, examine & look for abnormalities
when and how often
Every 3 years if 25-49
5 yearly if 50-64
3 months after pregnancy ending (live/stillbirth, miscarriage, TOP)
Don‟t need if still a virgin.
where does it happen
GP
Family Planning Clinic
GUM clinic
antenatal clinic
timing with menstrual cycle
make appt middle of cycle
practicalities of procedure itself
undress from waist down; lie back with knees up and apart
speculum inside vagina, opens up –> visualise cervix
surface of cervix brushed with a brush to collect sample
is it painful
shouldn’t hurt but a bit uncomfortable - stay relaxed
result reporting if -ve findings
may hear nothing if no abnormalities
next time in 3/5 years time
reassuring stats
9/10 normal
1/20 mild changes
1/100 moderate changes
1/200 severe
explain borderline results
borderline - near normal changes –> repeat in 6 months
explain ectropion results
erosion (ectropion) - cells from the cervical inside (canal) are seen on the outside (surface)
common in teenagers, pregnant, on pill
can cause post-coital bleeding & resolves by itself
abnormal changes (dyskariosis) results explained
mild - CIN1 - 1/3 thickness skin covering cervix has abnormal cells
moderate
severe (carcinoma in-situ - chill it’s not cancer!)
if not treated –> can cancer
tx each CIN in dyskariosis
mild - colposcopy or 4 consecutive normal 6-monthly smears
moderate/severe - tx required
colposcopy explained
similar to process of smear
additional use magnifying glass
can take biopsy
uses laser
is it (colposcopy) painful
can use paracetamol/ibuprofen if period type pain
lifestyle/risk reduction advice
stop smoking
keep sanitary towel - bleeding/discharge of up to 4 weeks
don’t use tampons or have sex for 4 weeks as ++ infection risk
