Cervical screening Flashcards
When are women invited for screening and how often
24.5-49 every 3 years
50-64 every 5 years
Describe HPV triage protocol
If liquid based cytology shows borderline or low grade dyskaryosis do a HPV test before referral to colposcopy
If LBC shows high grade dyskaryosis or worse refer to colposcopy without testing for HPV
How is colposcopy referral going to change in next few years
HPV primary screening
I.e don’t do liquid based cytology unless HPV positive
Management of inadequate samples
If inadequate repeat <3 months.
Refer after 3 consecutive inadequate samples
Management of borderline cervical smear
HPV test
If positive - refer within 6 weeks
If negative - return to routine screening
If unreliable - liquid based cytology in 6 months (+ HPV if negative, borderline or low grade)
Management of low grade dyskaryosis on cervical smear
HPV test
If positive - refer within 6 weeks
If negative - return to routine screening
If unreliable - refer within 6 weeks
Management of high grade (moderate) on cervical smear
Refer to colposcopy within 2 weeks
Management of high grade (severe) on cervical smear
Refer to colposcopy within 2 weeks
Management of invasive SCC on cervical smear
Refer to colposcopy within 2 weeks as have maximum of 62 day between date of making referral and first treatment
When is ablation used to treat CIN
Can see whole transformation zone
No invasive disease or glandular involvement
When is cryocautery used for CIN
Low grade i.e CIN 1/2
Methods of CIN treatment
Freezing
Excision
Ablation
Follow up for treated CIN
Follow up in 6 months by cytology
Symptoms of cervical cancer
Intermenstrual bleeding
Postcoital bleeding
Dyspareunia
Vaginal discharge
Results of screening in cervical cancer
Usually negative, screening picks up precancerous lesions
Ask about symptoms!
