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Understanding Cervical Cancer Screening and Treatment in the UK

Cervical cancer affects around 2,900 women annually in the UK, with the highest incidence in those aged 30-39. Early detection through screening can prevent up to 75% of cases. Women are invited for their first screening at 25, with routine checks every 3 years until age 49, then every 5 years until 65. Liquid-based cytology is used for sample collection, improving accuracy. Results can show normal, inadequate, or various levels of dyskaryosis, leading to further tests like colposcopy. Treatment options include LLETZ, cone biopsy, cryotherapy, and laser therapy.

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Understanding Cervical Cancer Screening and Treatment in the UK

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  1. Cervical Screening Khawer Ayoub 2013

  2. Background • Around 2,900 cases of cervical cancer diagnosed each year in the UK (approx. 2% of all cancer cases diagnosed in women) • Highest incidence between ages 30-39 (under 35’s more likely to be affected). • Number of women affected by cervical cancer steadily falls after age 40 • Slight increase in women after age 70 • It is estimated that early detection and treatment can prevent up to 75% of cervical cancers

  3. Schedule • In England, first invitation for screening aged 25 • Routine 3 yearly recall between ages 25-49 • Then 5 yearly recall until aged 65 • Consider offering smear tests to patients above the upper age limit, who have: • Not been screened since aged 50 • Had previous abnormal results

  4. How is it done? • Liquid based cytology • Specially designed brush – sample taken from the cervix • The sample is either rinsed into the preservative fluid or the brush head is removed into the sample bottle containing the fluid • Advantages of LBC includes • reduced rate of inadequate smears • increased sensitivity and specificity

  5. Interpretation of Results (1) • Normal • No abnormal cells • Routine recall • Inadequate • Repeat smear - if persistent (3 inadequate samples), assessment by colposcopy

  6. Interpretation of Results (2) • Borderline or mild dyskaryosis: • The original sample is tested for high risk subtypes of HPV: • if negative the patient goes back to routine recall • if positive the patient is referred for colposcopy • Moderate dyskaryosis • Consistent with CIN II. Refer for colposcopy • Severe dyskaryosis • Consistent with CIN III. Refer for colposcopy

  7. Colposcopy • Special microscope used to look closely at cervix • Helps identify the extent of cell abnormality and also whether treatment is needed • A biopsy sample can be taken

  8. Treatment • Aim – remove or destroy the abnormal cells • May be possible at the same time as colposcopy • LLETZ (large loop excision of the transformation zone) • Uses a fine wire and electrical current to cut away affected area • Cone biopsy • Small operation, most cases involve overnight hospital stay • Cryotherapy • Laser treatment • Cold coagulation

  9. Thank YOU Any questions?

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