04/05/20041 liquid based cytology workshop. 04/05/20042 programme content session 1 : overview of...
TRANSCRIPT
04/05/2004 1
Liquid Based Cytology Liquid Based Cytology WorkshopWorkshop
04/05/2004 2
Programme contentProgramme 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
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SESSION 1SESSION 1
The NHS Cervical Screening ProgrammeWhy Liquid Based Cytology ?
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Aims & objectives of the CSPAims & 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.
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Facts and figuresFacts 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
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DOH 2002/3 statisticsDOH 2002/3 statistics
81.2% women aged 25-64 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
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NICE recommendation is NICE recommendation is based on: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
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Why LBC has been introducedWhy LBC has been introduced
Continuing improvement to the CSPLimitations of conventional cytology
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How LBC is differentHow LBC is different
Easier method for sample takersTechnology diminishes unwanted materialsThin layer preparationSmaller area of the slide to screen
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What LBC can offer the CSP What LBC can offer the CSP
Dramatic reduction in inadequate testsReduced anxiety for womenReduced workload for primary care & labs Potential for increased automation
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SESSION 2SESSION 2
Anatomy & physiology of the cervixThe transformation zone
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SESSION 3SESSION 3
Taking the LBC sample
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Taking the LBC sampleTaking 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
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Taking the LBC sampleTaking the LBC sample
The woman-WelcomeCheck identity- name, DOB, address, NHS
number etcExplain new technique & equipmentOffer information leafletsAnswer questions
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Completing the consultationCompleting 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
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Frequently asked questionsFrequently asked questions
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SESSION 4SESSION 4
Cytology of the sample
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SESSION 5 SESSION 5
Practical issues
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Cascade TrainingCascade 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 availableSend or fax form back to training organiser
when training complete
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SuppliesSupplies
Supplies of consumables – where to obtain them?
Storage of vialsOrder form and recommended numbers for
orderingReturning unused equipment – how?Health and safety – product information
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Useful contactsUseful contacts
Local training organiserLocal laboratory