Colposcopy and Programme Management - Cytology Training Centre

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Benign endometrial cells (continued) Evidence: • Normal endometrial cells in cervical smears of asymptomatic postmenopausal women have been reported with 6.5% prevalence rate of (pre) malignant uterine disease. • Diagnosis of atypical endometrial cells clinically significant. >1/3 of women with histological follow-up had significant uterine lesion <strong>and</strong> in postmenopausal women, majority of lesions (80%) endometrial in origin. – 13 to18% of cases endometrial carcinoma – 6 to 7% of cases high-grade dyskaryosis/ squamous carcinoma. Refs: Siebers AG et al. (2006) Int J Gynecol Cancer, 16: 1069-74 Saad RS et al. (2006) Acta Cytol, 50: 48-54. Chhieng DC et al. (2001) Cancer, 93: 351-6.
Cervical screening for women exposed in utero to diethylstilbestrol (DES) • Women exposed in utero to DES should have initial colposcopic examination. In absence of abnormality at 1 st examination, only routine cervical screening required. • Women whose initial examination showed abnormality/ stigmata DES exposure may require annual colposcopic examination vagina/ cervix, in specialist centres, possibly for life. – this should be considered on individual basis by woman concerned/ colposcopist. Evidence: • Epidemiological evidence shown that women exposed to DES at increased risk clear cell carcinoma of vagina but appear not to be at high risk of developing other cancers. • Review of 4536 women exposed to DES 2x increased risk developing high-grade CIN but no increase incidence cervical cancer. Increased detection rate may due to intensive follow up. Ref: Hatch EE et al. (2001) Cancer Causes Control, 12: 837-45.
Page 1 and 2: Colposcopy and Programme Management
Page 3 and 4: • No change to any data items req
Page 5 and 6: In general • No planned change to
Page 7 and 8: Diagnosis and management of cGIN
Page 9 and 10: In general (continued) Invasive dis
Page 11 and 12: In general (continued) Follow up
Page 13 and 14: In general (continued) Clinic staff
Page 15 and 16: In general (continued) • All colp
Page 17: Benign endometrial cells (continued
Page 21 and 22: Cervical cytology should not be rep
Page 23 and 24: Multidisciplinary team meetings •
Page 25 and 26: Frequency of MDT meetings • MDT s
Page 27 and 28: Information given to patients follo
Page 29 and 30: Follow-up for women after treatment
Page 31 and 32: Follow-up for women after treatment
Page 33 and 34: Follow up after hysterectomy (conti
Page 35 and 36: Follow up after hysterectomy (conti
Page 37 and 38: Management for women following trea
Page 39 and 40: Where does HPV testing fit into the
Page 41 and 42: HPV testing to triage low-grade abn
Page 43 and 44: HPV testing to triage low-grade abn
Page 45 and 46: 12 responses Austria, Belgium, Croa
Page 47 and 48: Beyond No 20 - European picture 200
Page 49 and 50: Recurrent inad cytology HPV test 12
Page 51 and 52: But… • HPV types in the UK chan
Page 53 and 54: • CDC6 - cell division cycle prot
Page 55 and 56: Summary • General tidying up •

Colposcopy and Programme Management - Cytology Training Centre

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