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) 20-60 only (3 yrly)
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.
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
Incidence of Cervical Cancer GG&C Age range20072008 20-2979 30-392921 40-492014 50-59311 60-6955 70-7922 80+13 6765 2004-8 36 women aged 20-24 diagnosed in whole of Scotland, 1 aged 15-19 (1471 in total)
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
Do’s and Don’ts ECTOPY Do refer if symptomatic Do refer if concerned re appearance Not if asymptomatic