Liquid Based Cytology Workshop

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Liquid Based Cytology Workshop
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Programme 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 1

• The NHS Cervical Screening Programme
• Why Liquid Based Cytology ?

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Aims 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 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 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 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 introduced

• Continuing improvement to the CSP
• Limitations of conventional cytology

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How LBC is different

• Easier method for sample takers
• Technology diminishes unwanted materials
• Thin layer preparation
• Smaller area of the slide to screen

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What LBC can offer the CSP

• Dramatic reduction in inadequate tests
• Reduced anxiety for women
• Reduced workload for primary care labs
• Potential for increased automation

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SESSION 2

• Anatomy physiology of the cervix
• The transformation zone

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SESSION 3

• Taking the LBC sample

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Taking 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 sample

• The woman-
• Welcome
• Check identity- name, DOB, address, NHS number
  etc
• Explain new technique equipment
• Offer information leaflets
• Answer questions

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Completing the consultation

• Record the womans 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 questions
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SESSION 4

• Cytology of the sample

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SESSION 5

• Practical issues

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Cascade 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 available
• Send or fax form back to training organiser when
  training complete

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Supplies

• Supplies of consumables where to obtain them?
• Storage of vials
• Order form and recommended numbers for ordering
• Returning unused equipment how?
• Health and safety product information

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Useful contacts

• Local training organiser
• Local laboratory