Colposcopy and Programme Management - Cytology Training Centre

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In general (continued) Treatment • Standard: All patients must have a biopsy/ biopsies taken prior to local destructive treatment (100%). • Standard: All women must have had histological diagnosis established prior to destructive therapy (100%). – standard same as above so 1 st standard removed. • New standard: At least 90% of patients should have definitive treatment for high grade CIN within 4 weeks of receiving a diagnostic biopsy report and 100% must be treated within 8 weeks. Pregnancy is an exception. The reason for delay must be specified. • Proportion of women treated at 1 st visit who have evidence of CIN on histology (>90%). Add ‘CIN 2/3 or cGIN..’ rather than just CIN. • ‘CIN extending to the margins at excision does not justify repeat excision as long as..’ change to ‘CIN 3 extending to the lateral or deep margins at excision’ and add ‘(or uncertain margin status)’… providing there is no evidence of - glandular abnormality - invasive disease - the woman is under 50 years of age.
In general (continued) Invasive disease • Care should be taken not to overlook invasive disease. An excisional form of biopsy is recommended (95%) in the following circumstances: - when colposcopic appearances indicate high-grade abnormality - when low-grade colposcopic change is associated with severe dyskaryosis or worse - when a lesion extends into the canal. (Sufficient canal must be removed in these situations). Replace1 st bullet point with: ‘When most of the ectocervix is replaced with high-grade abnormality’. • All high-grade cytology to be treated within 62 days unless downgraded… ‘Referrals are to be fast-tracked with a 2 week wait if they are by standard referral from primary care unless direct referral is active. Direct referral of all cases to colposcopy is therefore strongly recommended.’ ‘If cancer is subsequently excluded either by colposcopic opinion or after the result of a biopsy and the patient is informed of a benign diagnosis they will continue on that 18-week pathway.’
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: Diagnosis and management of cGIN
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 and 18: Benign endometrial cells (continued
Page 19 and 20: Cervical screening for women expose
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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