Cervical Screening and O&G Public Health Flashcards
Cervical cancer is the most common cancer in women under what age?
35
Patients over the age of 65 can still get cervical cancer. TRUE/FALSE?
TRUE
Screening only takes place between 25-64 so sometimes these patients are not identified
Why does cervical screening only take place between the ages of 25-64?
- This is the most cost effective
- most cases emerge in this age group
Why is cervical screening done?
- to reduce the incidence of invasive cases
=> to catch abnormalities earlier for treatment
What are the advantages of cervical screening?
- Reduced disease incidence
- Reduced disease mortality
- Earlier, less radical/ invasive treatment
- Cost-effective
- Overall population benefit
If a woman presents symptomatically i.e. with discharge/ bleeding/dyspareunia, should she still be offered cervical screening?
No she should be offered diagnostic testing
this is usually carried out by gynaecology
How often do women have to attend for cervical screening?
Every 3 years if aged 25 - 49 years
Every 5 years if aged 50 – 64 years
Roughly what percentage of invited women came for cervical screening in Scotland between 2017-2018?
73% uptake
In what groups is uptake of cervical screening the lowest?
- Most deprived areas
- Younger 25-49 age group (who have higher risk)
What new test will be rolled out in March 2020 to assist in cervical screening?
Primary HPV testing
What are the aims of Primary HPV Testing?
- Faster investigation of those at higher risk of developing cervical cancer
- Reduce the number of unnecessary screening/ colposcopy appointments among women with borderline/low grade cytology results
What is coverage and how is this concept different to uptake?
Coverage = percentage of those who have been screened out of all eligible for screening in the population
=> (screened pop./eligible pop. x100%)
Uptake = percentage of those who have been screened out of all patients who have been INVITED for screening
=> (screened pop./invited pop. x100%)
Why is there a difference between the population eligible for a smear test and those who are invited for a smear test?
- If patients have moved to Scotland and not engaged with healthcare services (registering with GP/ attended hospital) then they wont have a CHI number
- CHI numbers are used to send out screening reminders to all eligible
- The people this often doesnt reach are: Minority ethnic groups Immigrants Travellers Prisoners Students
Why may patients who have been invited for cervical screening not engage with booking an appointment?
- Change of address
- Health literacy not adequate
- Deprivation
- Accessibility to service
- Vulnerable groups
How are public health aiming to increase the coverage and uptake of cervical screening?
- Promotion of screening programme
- Material in various languages
- GP incentives
- Local and national initiatives
What strains of HPV does the vaccine contain and which of these protects against cervical cancer?
- Vaccine contains strains 6, 11, 16 and 18
Types 16, 18 HIGH RISK = cause 70% of cervical cancer - Due to strains 6 and 11 being included in the vaccine, this also protects against genital warts
Who is offered the HPV vaccine?
Girls S1 to S3
Boys in S1 (for herd immunity and protection from penile, oropharyngeal and rectal cancers)
Men who have Sex with Men (MSM) - offered this through the sexual health clinic
Why is cervical screening still essential even after the development of the HPV vaccine?
- Vaccine does not protect against 30% cervical cancers
What socio-economic group is least likely to be vaccinated against HPV, and why is this a risk?
Most deprived are less likely to be vaccinated
ALSO less likely to attend screening
=> high risk of developing invasive cancer that goes undetected
What public health issues are common in obs and gynae?
- Teenage pregnancy
- Lifestyle => Obesity, exercise, smoking, substance use
- Female genital mutilation (FGM)
- Breastfeeding (benefits and support)
- Increasing maternal age
- Infertility
- Screening
What is female genital mutilation and why should it ALWAYS be reported?
- FGM procedures involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons
They are:
- A violation of the human rights of girls and women.
- A violation of the rights of children.
What impact does obesity have on obs and gynae?
- Increased length of time spent trying to conceive
- Increased infertility
- Decreased effectiveness of IVF
- Increased risk of miscarriage and pregnancy complications
- Obesity contributes to uterine and ovarian cancers
HOw much physical activity is recommended for women per day during pregnancy?
150 minutes of moderate exercise
- e.g. climbing stairs, carrying shopping, swimming etc
What are the advantages of smoking cessation in pregnancy?
- Decreased risk of pregnancy complications
- Reduced risk of stillbirth, premature birth, sudden infant death syndrome
- Reduced risk of developing cervical cancer
- Improved prognosis following diagnosis of cervical cancer
Public health recommend how much folic acid should be taken daily during pregnancy?
400 micrograms every day before pre-conception, until 12 weeks pregnant.
=> Also eatfoods that contain folate (natural form of folic acid), such as green leafy vegetables
