Cervical Screening Flashcards
Describe the epidemiology of cervical cancer
12th most common in Scottish women
Most common cancer in women under 35
Approx 2% of female cancer cases
Why screen for cervical cancer?
Aim is to reduce the incidence of invasive cancer of the cervix
What are the advantages of screening?
Reduced disease incidence Reduced disease mortality Earlier, less radical treatment Cost-effective Overall population benefit
What will cervical screening test for?
Identifys cell changes which may develop to be pre-cancerous in women who otherwise have no symptoms
If untreated -> cervical cancer
At the stage of screening, treatment is very effective
Do symptomatic women require screening?
No; diagnostic tests
Symptoms; unusual vaginal discharge/ bleeding, bleeding after sex/ between periods, dyspareunia
Who is screened for cervical cancer in scotland?
Women aged 25-64
Every 3 years; 25-49
Every 5 years 50-64
How is the cervical smear performed?
Speculum exam
Visual examination of the cervix
Brush sample of the cells from the transformation zone of the cervix
Liquid based cytology (soon to be primary HPV testing)
What is the screening uptake in scotland?
72.8%
How will cervical screening change in 2020?
Primary HPV testing enabling faster investigations of those at higher risk of developing cervical cancer and reassurance to those at very low risk
How is coverage calculated?
c/a x 100
Where
a = eligible population
c = screened population
How is uptake calculated?
c/b x 100
Where
c = screened population
b = invited population
What are the challenges with optimising coverage?
Minority ethnic groups Immigrants Travellers Prisoners Students Reduced uptake
What are the challenges with optimising uptake?
Change of address Communication Health literacy Deprivation Accessibility Vulnerable groups
How can coverage and uptake be increased?
Promotion in screening populations
Material in variety of languages
GP incentives
Local and national initiatives
What is the difference between the low and high risk HPV types?
Low risk; genital warts
High risk; invasive cervical cancer
What strains does the HPV vaccine cover?
6,11,16 and 18
Who is the HPV vaccine given to?
Girls in S1-3
MSM <45
Boys from 2019 in S2
How many cervical cancers does the HPV vaccine protect against?`
70%
Therefore 30% not protected, so screening still essential
What is the impact of obesity in O&G?
Increased subfecundity Increased infertility Decreased effectiveness of IVF Increased risk of miscarriage Increased risk of pregnancy complications
How many children lost a parent to a drug death in tayside last year?
31
Benefits of breastfeeding?
Immune system increased Skin; less allergic eczema in breastfed infants Juvenile rheumatoid less common Less constipation, diarrhoea and gastroenteritis, less UC and crohn's Less resp infections Lower cholesterol in adulthood Less orthodontics Higher IQ Reduced risk of diabetes Better visual acuity
What is the recommendation surrounding breastfeeding length?
Exclusively for 6 months
Within one hour of birth
