04/05/20041 Liquid Based Cytology Workshop

04/05/20042 Programme content Session 1 : Overview of the cervical screening programme & why LBC has been introduced Session 2 : Revision of anatomy & physiology of the cervix Session 3 : Taking the LBC sample Session 4 : Cytology of the sample Session 5 : Practical issues

04/05/20043 SESSION 1 The NHS Cervical Screening Programme Why Liquid Based Cytology ?

04/05/20044 Aims & objectives of the CSP The primary aim of the CSP is to reduce both incidence and mortality from cervical cancer It does this by regularly screening all women at risk so that conditions which might otherwise develop into invasive cancer can be identified and treated.

04/05/20045 Facts and figures Worldwide cervical cancer is the 2nd most common cancer affecting women 80% cases occur in developing countries Deaths from cervical cancer have fallen markedly in the UK from 8.3 per 100,000 women in 1971 to 3.3 per 100,000 in 2000 Mortality rates generally increase with age; less than 5% of cervical cancer deaths occur in women under 35 Cervical cancer is the 11th most common cause of cancer deaths in women in the UK

04/05/20046 DOH 2002/3 statistics 81.2% women aged had been screened at least once in previous 5 years 3.7 million women were screened 92.4% were negative 9.4% were inadequate 3.9% showed borderline cell changes 2.2% showed mild dyskaryosis 0.8% showed moderate dyskaryosis 0.7% showed severe dyskaryosis or worse

04/05/20047

8 NICE recommendation is based on: Systematic review of literature relating to effectiveness of LBC undertaken as part of the HTA programme Evidence from the 3 pilot sites at Bristol, Norwich and Newcastle

04/05/20049 Why LBC has been introduced Continuing improvement to the CSP Limitations of conventional cytology

04/05/ How LBC is different Easier method for sample takers Technology diminishes unwanted materials Thin layer preparation Smaller area of the slide to screen

04/05/ What LBC can offer the CSP Dramatic reduction in inadequate tests Reduced anxiety for women Reduced workload for primary care & labs Potential for increased automation

04/05/ SESSION 2 Anatomy & physiology of the cervix The transformation zone

04/05/ SESSION 3 Taking the LBC sample

04/05/ Taking the LBC sample Equipment - Speculae – reusable & disposable Cervex- Brushes R Endocervical brushes Fixative vials Latex gloves Waste disposal Sterilisation facilities Black ball point pen Sample forms and bags Leaflets

04/05/ Taking the LBC sample The woman- Welcome Check identity- name, DOB, address, NHS number etc Explain new technique & equipment Offer information leaflets Answer questions

04/05/ Completing the consultation Record the woman’s name & DOB on the vial Complete the form with any further clinical details Discuss possible results and follow up if appropriate Ensure that the woman understands about reporting any abnormal bleeding Record in notes/ on computer all necessary details Place vial & form in a specimen bag for transport to the lab Dispose of equipment and waste safely Send the sample to the lab as soon as possible

04/05/ Frequently asked questions

04/05/ SESSION 4 Cytology of the sample

04/05/ SESSION 5 Practical issues

04/05/ Cascade Training All sample takers taking LBC samples must receive some form of training Short session back at practice to train all other sample takers Training resources available Send or fax form back to training organiser when training complete

04/05/ Supplies Supplies of consumables – where to obtain them? Storage of vials Order form and recommended numbers for ordering Returning unused equipment – how? Health and safety – product information

04/05/ Useful contacts Local training organiser Local laboratory