Cervical Screening and Colposcopy

Question 1

Who can do cervical smear training?

Answer 1

-Registered nurses
-Registered midwifes
-Registered physician associates
-Medical doctors

Question 2

Cervical smear training requirements

Answer 2

-Complete 20 smears (two or more must be supervised) and training completed within 9 months.
-Have had 12 months continuous experience following completion of training.
-Audit and reflect on their individual practice.
-Once training completed a unique code will be issued.
-Attend update training every three years. Same for trainers

Question 3

Targets to reduce deaths from cervical cancer

Answer 3

-NHS Plan –have skilled trained workforce
-Cancer Plan –reduce deaths form cervical cancer
-Waiting time targets:
=Borderline and low grade seen within 8 weeks.
=Moderate and severe dyskaryosis within 4 weeks.
=Glandular abnormality/suspicious cervix within 2weeks

Question 4

Does cervical screening and colposcopy work?

Answer 4

-In the UK cervical cancer is the 14th most common cancer with 3,200 new cases every year (2016-2018).
-Since the early 1990s cervical cancer rates in females decreased by 25% since cervical screening call and recall system was introduced.
-Over 5 million smears are taken in the UK annually of these approx. 100,000 are referred to colposcopy.
-80% of treatments are carried out in out-patient under local anaesthesia

Question 5

Cost to NHS for screening

Answer 5

-Smear vs cancer
-Cost of colposcopy specialists nurse/doctor.
-Clinical support workers & nurses.
-Cost of cytology & pathology staff all grades.
-Database/clerical & admin. staff/Consumables.
-Telephone calls/time to check and sign letter’s etc

Question 6

HPV vaccinations

Answer 6

-12-13 years
-Prevents 90% cervical cancers/ genital warts
HPV 6, 11, 16, 18
-Name and strains?

Question 7

Referrals to colposcopy clinics

Answer 7

-All HPV positive smears irrespective of cytology result.
=25 to 60 years
-BNA /Low grade seen with 8 weeks.
-Moderate /severe dyskaryosis -4 weeks.
-Glandular /suspicious cervix -2 weeks

Question 8

What happens in colposcopy?

Answer 8

-Repeat smears.
-What is colposcopy?
-Biopsies of the cervix including endometrial biopsies.
-LLETZ

Question 9

What is LLEZ procedure?

Answer 9

-Remove pre cancerous cells from cervix
-Risks: infection