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Screening for cancer of the cervix

"Screening" for cervix cancer. A wooden spatula scrapes the cervix; exfoliated cells are examined at microscopy with a high "pick up" / diagnostic accuracy for cancer
"Screening" for cervix cancer. A wooden spatula scrapes the cervix; exfoliated cells are examined at microscopy with a high "pick up" / diagnostic accuracy for cancer

In the UK at present, there is a highly organised cervical screening programme. More than 80% of pre-invasive disease will be picked up if a 5 yearly screening programme is implemented, but in the UK currently once three yearly screening is recommended to all over twenty five years and who are sexually active, in the attempt to raise this to over 90%. The screening procedure is simple and performed usually by general practitioners or trained nurses, and made annually if the smear is dysplastic in any way (e.g CIN). For those smears that are suspicious, then further investigation by gynaecolgical referral is required.

 

The American College of Obstetricians and Gynaecolgists' 2009 recommendations for screening are:

 Screening should be avoided in the age group under 21 years of age. Screening should be performed every 2 years in the age  group 21 to 29 years. In the age group 30 to 65 years, the recommendation is once every three years (but this only appies to those who have had three consecutive negative smears; exceptions include those with HIV, compromised immunity and those with CIN [grades 2-3] all of whom need more frequent screening). In patient over 65 years with three consecutive negative smears (no abnormal tests in the previous decade and one sexual partner), screening may be discontinued.

 

The effects that HPV vaccination will have on the future recommendations for screening have yet to be decided.


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