Cervical screening guidelines Flashcards
How frequently is routine cervical screening performed?
3 yearly 25-49 years old
5 yearly 50-64 years old
What happens if a routine smear has high risk HPV?
Cytology is performed
If it is abnormal the patient is sent to colposcopy
If it is normal - the smear is repeated in 12 months
How many times can you get a high risk HPV result in routine screening before being referred to colposcopy?
3 strikes and your out e.g.
1) First result positive and cytology normal
2) 12 month result positive and cytology normal
3) 12 month result positive - don’t perform cytology - refer to colposcopy
What is considered inadequate colposcopy?
Entire squamocolumnar junction is not visualised
How is an inadequate colposcopy managed?
If cytology is low grade - repeat colposcopy in 12 months
If cytology is high grade or borderline - perform a LLETZ
How is a “normal” colposcopy defined?
Adequate views of entire squamocolumnar junction but no evidence of CIN
How is a “normal” colposcopy result managed?
If there is low grade cytology - smear in 3 years
IF high grade or borderline cytology - MDT in 2 months
If there is no 2nd HRHPV or cytology is inadequate - smear in 1 year
How is CIN 1 result managed?
Repeat smear in 1 year
If high risk HPV negative - repeat smear in 3 years
If high risk HPV positive - check cytology (3 strikes and your out rule applies)
How are CIN2 and CIN 3 managed?
Treatment is given and repeat smear in 6 months
If HrHPV positive - repeat colposcopy
If HrHPV negative - smear in 3 years
How is CGIN managed?
Treatment is given and repeat smear in 6 months
If High risk HPV negative, repeat in 12 months, if negative again, repeat in 3 years
If High risk HPV positive (at 6 months or 12 months) - carry out cytology and refer to colposcopy
What kind of virus is HPV?
Double stranded DNA virus
