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Liquid Based Cytology Liquid Based Cytology WorkshopWorkshop

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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