Cases

Case 2

Case 3

Normal cervix - Spatula and brush

Normal cervix - Cervex Broom

Eversion (ectropion) Transformation zone

Eversion - Spatula and brush

Stenosis Transformation zone not visible

Stenosis - Spatula and brush

Case 4

LOW-GRADE (definite or possible) Repeat Pap test at 12 months NEGATIVE LOW-GRADE (definite or possible) HIGH GRADE Repeat Pap test at 12 months NEGATIVE ROUTINE SCREENING COLPOSCOPY If woman is 30+ yrs, and has no negative cytology in previous 2-3 yrs, colposcopy or repeat smear in 6 months

Case 5

Time since treatment Pap smearColposcopyHPV typing 4-6 mths 12 mths 24 mths HPV typing has been added to the MBS for this clinical use only (‘test of cure’) Test of Cure

Time since treatment Pap smearColposcopyHPV typing 4-6 mths 12 mthsNegative 24 mthsNegative  Return to routine screening interval when Pap smear and HPV typing are negative on two consecutive occasions Test of Cure

Case 6

HPV Vaccine- two types Gardasil –Quadrivalent (HPV types 6,11,16 & 18) –Licensed for Females 9 to 26 Males 9 to 15 Currently on the NIP Cost off the program $450 Cervarix –Bivalent (HPV types 16 & 18) –Licensed women for 10 to 45 Cost $450 Cross reaction 31 & 45