Cervical screening

Question 1

When is a patient first contacted for their first cervical smear?

Answer 1

they receive correspondence at the age of 24.5, but their first smear is at 25 years of age

Question 2

How often is a smear test performed for the ages 25-49?

Answer 2

Every 3 years

Question 3

How often is a cervical smear performed for women between 50-64?

Answer 3

Every 5 years

Question 4

How often are women with HIV screened?

Answer 4

Every year

Question 5

What is the name of pre-malignant changes to cervical epithelial cells?

Answer 5

Dyskaryosis (this is detected on smear)

Question 6

What is colposcopy used to detect?

Answer 6

(DYSPLASIA) Cervical Intraepithelial Neoplasia

Question 7

What does CIN I mean?

Answer 7

mild dysplasia, affecting 1/3 the thickness of the epithelial layer, likely to return to normal without treatment

Question 8

What does CIN II mean?

Answer 8

moderate dysplasia, affecting 2/3 the thickness of the epithelial layer, likely to progress to cancer if untreated

Question 9

What does CIN III mean?

Answer 9

severe dysplasia, very likely to progress to cancer if untreated
CIN III is sometimes called cervical carcinoma in situ

Question 10

If a patient has an “inadequate sample” as a smear result, what happens next?

Answer 10

repeat the smear after at least 3 months

Question 11

If the patient is HPV negative, what happens?

Answer 11

Continue with routine screening i.e. either every 3 years or 5

Question 12

HPV positive with normal cytology - what happens next?

Answer 12

Repeat HPV test after 12 months

Question 13

HPV positive with abnormal cytology

Answer 13

Refer for colposcopy

Question 14

When a cervical smear test goes to the lab, what is it tested for?

Answer 14

1. samples are initially tested for high-risk HPV before the cells are examined.
2. If the HPV test is negative (the person does not have HPV), the cells are not examined, the smear is considered negative, and the woman is returned to the routine screening program.
3. If the cells are HPV positive, the cells are then analysed to see if they have any changes e.g. dyskaryosis

Question 15

What happens if the sample is inadequate?

Answer 15

Repeat the sample in 3 months
If there are 2 conseq. inadequate samples, refer for colposcopy

Question 16

What is the time frame of normal recall in women aged 25-49?

Answer 16

every 3 years

Question 17

What is the time frame of normal recall in women aged 50-64?

Answer 17

every 5 years