Cervical Screening and Colposcopy Flashcards
What is cervical check and how does it work?
- Irish national screening programme for cervical cancer
- Women aged 25-60
- Aged 25-45 = smear every 3yrs
- Aged 45-60 smear every 5yrs
Define CIN
Pre-cancerous lesion which occurs at the TZ of squamous columnar junction
Screening picks up these pre-cancerous changes
What is HPV?
- Common virus that can affect the cells of the cervix and 80% of adults will have it at some point in their lives
- Usually spread by direct skin to skin contact during vaginal, anal or oral sex with someone infected
- Asymptomatic, most people never know they are infected
- Normally cleared by person’s own immune system
- Smoking reduces body’s ability to clear the virus
How many oncogenic subtypes of HPV are there and which are the most common?
- 15 oncogenic genotypes
- Types 16+18 = 70% cervical cancers
- Types 16, 18, 31 and 33 = 81% cervical cancers
What is the vaccine available for HPV and what subtypes does it vaccinate against?
- Gardasil vaccine
- Types 6, 11, 16 and 18
List the secondary risk factors for cervical cancer
- Smoking
- COCP
- Multiparity
- Immunosuppression
- STIs (Chlamydia)
Explain no abnormality detected (NAD) smear result
In the sample taken, no abnormal cells were detected at this time
Explain unsatisfactory/inadequate smear result
Lab was unable to read the sample which may be because there were not enough cells to analyse or because they were obscured by blood/discharge/lubricant
Woman must wait for 3mths from date of last smear test so that enough cells are present for repeat test
Explain atypical squamous cells of undetermined significance (ASC-US) smear result
- Test has found some minor changes in the cells of the cervix that may be referred to as borderline
- Some cells from outer cervix cannot definitely be described as normal
- Will result in HPV test for types of HPV associated with cervical cancer
- If HPV negative, routine recall
- Refer to colposcopy if HPV positive
Explain atypical squamous cells - cannot exclude HSIL (ASC-H) smear result
- Cervical cells do not appear normal
- May be abnormal changes which are high grade
- Referral to colposcopy for further assessment
Explain indeterminate HPV test smear result
- Any HPV test not processed for technical reasons generates an automatic referral to colposcopy recommendation
Explain atypical glandular cells (AGC) smear result
- Some cells in inner lining of cervix appear abnormal
- Requires referral to colposcopy as higher risk of cancer
Explain low grade squamous intraepithelial lesion (LSIL) smear result
- Found some mild changes to cells of cervix
- NOT CANCER - cells can often return to normal
- HPV test for types associated with cervical cancer
- HPV negative, routine recall
- HPV positive, colposcopy referral
Explain high grade intraepithelial lesion (HSIL) smear result
- Moderate to severe abnormal changes in the cervix
- Needs further investigation
- Does not mean woman has cancer
- Refer to colposcopy
Explain broken/damaged/expired vial or sample smear result
- Smear test could not be processed and will need to be repeated no earlier than 3mths from the date of the last smear test
