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Cervical Issues Annual update 2010 Tamsin Groom. Overview of screening and management Do’s and Don’ts The “suspicious cervix” Quiz.

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Presentation on theme: "Cervical Issues Annual update 2010 Tamsin Groom. Overview of screening and management Do’s and Don’ts The “suspicious cervix” Quiz."— Presentation transcript:

1 Cervical Issues Annual update 2010 Tamsin Groom

2 Overview of screening and management Do’s and Don’ts The “suspicious cervix” Quiz

3 Screening Why?

4 Screening To identify precancerous lesions Allow early detection and prevention of progression to cancer SCSP started 1988 Incidence of cervical cancer has fallen by 47.7% (1986 to 2005) only (3 yrly)

5 Current Screening management Negative, after borderline Further repeat at 6 months Return to routine recall after 2nd negative. Negative, after mild Further repeat at 6, & 18 months Return to routine recall after 3rd negative Unsatisfactory 3 month recall. Refer after third in succession Borderline Squamous Changes +/- HPV 6 month recall. Refer after third. Borderline ?High grade – Flag as such and Refer to Colposcopy on 1st. Borderline Glandular Changes6 month recall. Refer after second.

6 Current Screening management Mild dyskaryosisRepeat in 6 months. Refer after second. OR Refer to Colposcopy on 1st 3 abnormal results within the last 10 years, refer to colposcopy

7 ,000 smears 9.9% abnormal (excluding unsatis) Unsatis rate approx 2.5% 1309 smear in <20s Why? 1 revealed severe dyskaryosis Negative90.1 Borderline6.2 Mild2.3 Mod/Severe1.2

8 Incidence of Cervical Cancer GG&C Age range women aged diagnosed in whole of Scotland, 1 aged (1471 in total)

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10 Comparison with HPV 6/11

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12 Ectopy

13 Cervical Cancer

14 And again

15 Do’s and Don’ts PCB in young women Heavy bleeding during smear taking DO take a Sexual history DO take a chlamydia/GC swab DO treat chlamydia & review before referral. Do consider changing contraceptive method if on COCP/condoms

16 Do’s and Don’ts ECTOPY Do refer if symptomatic Do refer if concerned re appearance Not if asymptomatic

17 Other cervical appearances

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19 Prolapsed fibroid polyp

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22 Nabothian follicles/cysts Normal finding No action required

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25 Cervical polyps Removal?..symtomatic/other Easy to remove…in surgery? Yes if small, polyp forceps and silver nitrate sticks Not in pregnancy!

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27 Chlamydial cervicitis Screen, treat and review

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30 Herpetic cervicitis Not seen often as may have external lesions Unwell, highly symtomatic…not consistent with cancer Can cause frank necrosis Treat and review

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32 Cervical wart Treat external warts Stop smoking Review after resolution of others…refer if still present No others, young review in 3/12 No others over 30 refer

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35 Endometriotic nodule Do nothing unless symptomatic

36 Questions?


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