Cervical Screening Flashcards
Process of collecting cervical sample
Label Thinprep vial and record patient details
Visualise cervix and obtain sample by rotating cervical sampler 3-5x in cervical os
Vigorously rinse sampler in the vial. Sampler should hit base of vial 5-10 times to splay bristles open.
Tighten cap of vial.
Self-collection of cervical sample
Get in comfortable position. Can be seated, standing or lie down.
Insert swab into vagina, aiming to insert up to small red mark.
Rotate swab gently 1-3 times.
Indications for Co-Test
Symptomatic with post-coital bleeding, intermenstrual bleeding or post-menopausal bleeding
Undergoing test of cure for previous HSIL treatment.
Diethylstilbestrol exposure in-utero
Test-of-Cure interval
Co-test 12 months after treatment and annually thereafter until returns negative co-test for 2 consecutive occasions. Return to 5-yearly screening after this.
Indications for Pap Smear
- Screening of asymptomatic women >=25 <=74yo
- Early sexual debut (<14yo) with no immunisation against HPV. 1 CST covered under medicare
- Exposure to Diethylstilbestrol in-utero (Should be offered an annual Co-Test indefinitely)
- Post-coital bleeding
- Unexplained unusual PV discharge
What is diethylstilbestrol and why do we worry about it
Synthetic Oestrogen prescribed by obstetrcicians 1946-1971 in Australia
- Prescribed to prevent miscarriages
- Far-reaching effects including
- Change to reproductive tracts of both male and female children of DES mother
- Increased risk of cervical, breast cancer, reduced fertility, increased risk of preterm labour / miscarriage in DES daughters
- Increased risk of cancers as above in DES mothers
- Reduced fertility, increased risk of cryptorchidism in DES son
- No conclusive information on effect of DES grandchild currently given timeframe of DES use and studies for new generation following use by DES mother.
Screening
- Annual CST Co-Test indefinitely
- After 40yo - Annual mammogram and self-breast examination,.
