1. Cases

2. Case 2

3. Case 3

4. Normal cervix - Spatula and brush

5. Normal cervix - Cervex Broom

6. Eversion (ectropion) Transformation zone

7. Eversion - Spatula and brush

8. Stenosis Transformation zone not visible

9. Stenosis - Spatula and brush

10. Case 4

11. 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

12. Case 5

13. 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

14. 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

15. Case 6

16. 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