Cervical screening Flashcards
Where do we take a smear from and describe the cells?
Transition zone, squamocolumnar junction.
Squamous cells-ectocervix
Columnar-endocervix
How does the risk of dying of cervical cancer decrease with screening?
without screening: 1/1280
with screening: 1/200
What are the grades of cervical intraepithelial neoplasia?
CIN 1-atypical cells in lower 1/3 of epithelium
CIN 2-atypical cells in 2/3 of epithelium
CIN3- atypical cells in full thickness
Who do we smear in NZ?
Starting at age 20 in sexually active women. 2 smears in the first 12 months to rule out a false negative. After that, every 3 years.
How do you explain an abnormal smear to a patient?
“You have some changes in the cells of your cervix. Often these changes go away by themselves, but in a small amount of women these can stay and can become pre-cancerous. If we can remove these cells we can greatly reduce the chances of cancer forming later.”
Why does age matter if a smear has low grade changes?
if the woman if younger than 35, repeat smear in one year. If the woman is over 35, HPV test. If HPV negative repeat in one year, but if positive, refer for colposcopy.
What do you do if the colposcopy confirms LSIL?
Nothing-repeat smear at 12 months then 24. If both normal, send back to 3 yearly screening
Explain what colposcopy is to a patient
A colposcopy is when a specialist examines the cervix using a special microscope. If the specialist notices something abnormal, they may decide to take a biopsy, which is a small sample of the tissue from the cervix, which will then be checked by the laboratory.
Which types of HPV cause warts and which cause cancer?
6 and 11= genital warts
16 and 18=cervical cancer
How do we treat cervical cancer?
Cone biopsy
Hysterectomy
Radiotherapy
Chemotherapy
What are some risk factors for cervical cancer?
HPV Smoking Chlamydia COCP Young at first full term pregnancy
How does a woman with cervical cancer usually present?
Post coital bleeding
Vaginal discomfort
Malodorous discharge
Dysuria
Who is allowed the funded HPV vaccine?
Men and women aged 9-26
Which women are included in breast screening?
ages 45-69
