Cervical Ca Screening
Managing results of CST
Breast Ca Screening
Communication
GP Scenarios
100

What is the age group for cervical screening? 

25 - 74 yrs 

100

What is the next step if HVP negative? 

Return to routine 5yr screening 

100

What is the target age group for routine breast screening? 

50 - 74yrs 

Women aged 40-49 and over 75 are also eligible to receive a free mammogram but do not receive an invitation

100

What is a cervical screening test? 

Test for HPV 

Extremely common - More than 80% of people contract HPV sometime in their life.

100

A 30-year-old, vaccinated, asks if she needs screening. Do you screen?

Yes 

200

How often should screening occur if HPV negative? 

5 yearly 

200

What is the management for HPV 16 or 18 detected?

Refer for colposcopy 

200
How often should routine mammogram be performed? 

2 yearly

200

Explain self collect CST vs clinician collect to patient 

  • HPV only test – taken using a swab - via self-collection 
  • A co-test – combination HPV test and Liquid Based Cytology (LBC) taken from the cervix by a clinician
200

22yr old, sexually active, asks you about getting CST 

Not required 

-- But if sexual activity before age 14 years who did not receive their HPV vaccination higher risk and offer test 

300

Under-screened or never screened. List 5 groups 

  • Aboriginal + Torres Strait Islander People 
  • Disability 
  • Culturally + linguistically diverse backgrounds 
  • LGBTQI+, transgender men, non-binary 
  • Hx of sexual violence / trauma 
  • Rural and remote areas 
  • Low socioeconomic 
  • Older people 
  • Pelvic pain with speculum exam  or prev negative screening experience 
300

What is the next step for HPV positive (non-16/18) with normal cytology?

Repeat HPV test in 12 months 

300

Do patients need a GP referral for routine BreastScreen?

No. Self referral 

300

Why do I have to do a test if there is no treatment for HPV? 

  • most HPV infections are usually transient and clear without treatment
  • progression from an HPV infection to invasive cancer is relatively rare and typically takes a decade or longer
  • the benefits of having identified the infection through screening, as this enables monitoring and intervention as appropriate to prevent invasive cancer by treating precursor lesions
300

40yr old presenting with post-coital bleeding. Management 

Investigate (not screening!!) 


400

What percentage of pts will have HPV non 16/18 detected and HPV 16/18 detected ?

HPV 16/18 dectected - around 2% 

HPV non-16/18 detected - around 6%

400

Should you wait for cytology results before referring HPV 16/18?

No. Refer immediately 

400
Name 3 symptoms that should not be managed with screening

New lump 

Skin changes 

Nipple discharge 

400

Is contact tracing necessary ? 

 NO. A new positive HPV screening test result may not indicate recent sexual transmission, but could be due to a previous latent infection.

400

54yr old presenting with new right sided breast pain 

Investigate. NOT screening 

500

Name 3 indications for a Co-Test over self collect  

Signs or symptoms suggestive of Ca 

Prev. adenocarcinoma in situ 

Exposed to diethylstilbestrol (DES) in utero

500

How to refer for colposcopy + what must you include on referral? 

HealthLinks 

- CST results + any symptoms 

500

Name 3 limitations of breast screening 

False positives 

False negatives 

Overdiagnosis / treatment 

500

Encourage an under-screened pt to participate in CST 

- More than 70% of cervical cancer cases occur in people who have never had a Cervical Screening Test or who do not screen regularly.

- offer self collect if appropriate 

500

A 76 yr old asks about CST. What determines if she can stop?

Adequate prior negative screening history

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