Cervical Cancer Screening

Option List:
A. Repeat smear in six months
B. Repeat smear in 12 months
C. Colposcopy in the second trimester to exclude high-grade pathology
D. Wedge biopsy
E. Refer for urgent colposcopy
F. Repeat smear in three years
G. Repeat smear 3–4 months postnatally
H. Cone biopsy
I. Large loop excision of the transformation zone (LLETZ)
J. Refer for colposcopy
Match the most appropriate management plan to each scenario. Each option may be used once, more than once, or not at all.

1. A 40-year-old woman, para 1, is a renal dialysis patient. She has a routine smear and the result indicates evidence of mild dyskaryosis.

2. A 25-year-old woman is 22 weeks pregnant in her second pregnancy. She had been on routine three-yearly smears prior to her pregnancy when one had been found to show mild dyskaryosis, two months before she found herself to be pregnant.

3. A 37-year-old woman is diagnosed with HIV. Her routine smear result comes back as normal. A colposcopy also indicates no evidence of cervical pathology.

Option List:
A. Offer an appointment with a colposcopist within 2 weeks of referral
B. Refer to colposcopy x 2 wks
C. Cytology at 6 and 12 months after treatment, and then annually.
D. Offer an appointment with a colposcopist within 6 weeks
E. Recall smear x 5 years
F. Recall for colposcopy x 3 years
G. Offer an appointment with a gynaecologist within 2 weeks of referral
H. No further action needed, repeat cytology according to due invitation
I. Take smear and wait for the result
J. Refer to colposcopy x 6 wks
K. Refer to gynaecologist within 2 wks
L. Cytology + HPV at 6 and 12 months of treatment and then annually
M. Colposcopy after 6 and 12 months then annual
N. Recall smear x 3 years
O. Refer to colposcopy MDT meeting to be seen by gynaecologist+ colposcopist + histopathologist before future plan is made.
Match the most appropriate management plan to each scenario. Each option may be used once, more than once or not at all.

4. A 32 years old woman with cervical cytology is showing cells for other origin. Cytology cells are difficult to interpret. What will be the further management?

5. Conservative treatment done for stage 1a1 cervical cancer. What will be the follow up?

6. 52 years old lady treated with LLETZ for moderate dyskaryosis. Test of cure test after 6 months is negative HPV.