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Cervical Screening

Cervical Screening. Khawer Ayoub 2013. Background. Around 2,900 cases of cervical cancer diagnosed each year in the UK (approx. 2% of all cancer cases diagnosed in women) Highest incidence between ages 30-39 (under 35 ’ s more likely to be affected).

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Cervical Screening

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  1. Cervical Screening Khawer Ayoub 2013

  2. Background • Around 2,900 cases of cervical cancer diagnosed each year in the UK (approx. 2% of all cancer cases diagnosed in women) • Highest incidence between ages 30-39 (under 35’s more likely to be affected). • Number of women affected by cervical cancer steadily falls after age 40 • Slight increase in women after age 70 • It is estimated that early detection and treatment can prevent up to 75% of cervical cancers

  3. Schedule • In England, first invitation for screening aged 25 • Routine 3 yearly recall between ages 25-49 • Then 5 yearly recall until aged 65 • Consider offering smear tests to patients above the upper age limit, who have: • Not been screened since aged 50 • Had previous abnormal results

  4. How is it done? • Liquid based cytology • Specially designed brush – sample taken from the cervix • The sample is either rinsed into the preservative fluid or the brush head is removed into the sample bottle containing the fluid • Advantages of LBC includes • reduced rate of inadequate smears • increased sensitivity and specificity

  5. Interpretation of Results (1) • Normal • No abnormal cells • Routine recall • Inadequate • Repeat smear - if persistent (3 inadequate samples), assessment by colposcopy

  6. Interpretation of Results (2) • Borderline or mild dyskaryosis: • The original sample is tested for high risk subtypes of HPV: • if negative the patient goes back to routine recall • if positive the patient is referred for colposcopy • Moderate dyskaryosis • Consistent with CIN II. Refer for colposcopy • Severe dyskaryosis • Consistent with CIN III. Refer for colposcopy

  7. Colposcopy • Special microscope used to look closely at cervix • Helps identify the extent of cell abnormality and also whether treatment is needed • A biopsy sample can be taken

  8. Treatment • Aim – remove or destroy the abnormal cells • May be possible at the same time as colposcopy • LLETZ (large loop excision of the transformation zone) • Uses a fine wire and electrical current to cut away affected area • Cone biopsy • Small operation, most cases involve overnight hospital stay • Cryotherapy • Laser treatment • Cold coagulation

  9. Thank YOU Any questions?

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