Cervical disorders

Question 1

Who is screened for cervical cancer and how often?

how r they screened?

Answer 1

A smear test is offered to all women between the ages of

25-64 years

• 25-49 years: 3-yearly screening
• 50-64 years: 5-yearly screening

cervical screening c_annot be offered to women over 64 (_unlike breast screening, where patients can self refer once past screening age)

Question 2

How is cervical smear performed?

Answer 2

1. The test consists of a speculum examination and collection of cells from the cervix using a small brush.
2. The cells are deposited from the brush into a preservation fluid.
3. fluid is transported to a lab where the cells are examined under a microscope for precancerous changes (dyskaryosis). (This way of transporting the cells is called liquid-based cytology.)

Question 3

cervical screening

• interpretation of results
• what are the cells initially tested for?

Answer 3

samples initially tested for high-risk HPV

before the cells are examined.

• If Negative hrHPV–> continue routine screening
• If Positive hrHPV–> do cytology of cell –> if the cytology is abnormal → colposcopy

Inadequate sample – >repeat the smear after at least 3 months

Question 4

what are some exceptions to the program?

Answer 4

1. Women with HIV are screened annually
2. Women over 65 may request a smear if they have not had one since aged 50
3. Women with previous CIN may require additional tests (e.g. test of cure after treatment)
4. Certain groups of immunocompromised women may have additional screening (e.g. women on dialysis, cytotoxic drugs or undergoing an organ transplant)
5. Pregnant women due a routine smear should wait until 12 weeks post-partum

Question 5

Cytology result examples

Answer 5

• Inadequate
• Normal
• Borderline changes
• Low-grade dyskaryosis
• High-grade dyskaryosis (moderate)
• High-grade dyskaryosis (severe)
• Possible invasive squamous cell carcinoma
• Possible glandular neoplasia