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Authors: Amanda Herbert
The cervical chapters comprise the following material:
- Introduction
- Anatomy, histology and function of the cervix
- Cervical cancer epidemiology and aetiology
- Cervical cancer worldwide and in Europe
- HPV as a causative agent and other risk factors
- Pathogenesis of cervical cancer and its precursors
- CIN and squamous cell carcinoma
- AIS and adenocarcinoma
- Presentation, stage and treatment of invasive cancer
- Effect of screening on incidence and mortality
- Fall in incidence and mortality due to screening (US, Nordic countries, England)
- Factors affecting incidence and mortality rates
- Principles of screening and measurement of accuracy
- Requirements of screening programmes
- Measurement of accuracy
- HPV tests in cervical cancer screening
- HPV triage and test of cure
- Primary HPV testing; HPV-cytology co-testing
- Vaccination and its consequences for screening
- Collecting cellular samples from the cervix
- Guidelines for taking cellular samples
- Comparison of conventional and liquid-based cytology
- Criteria for adequacy
- Cervical cytopathology
- Terminology
- Normal cytology; benign/reactive changes
- Squamous intraepithelial lesion (SIL)
- Low-grade SIL; High-grade SIL
- Aytpical/borderline cytology
- ASC-US: bordering on LSIL
- ASC-H: suspicious for HSIL or cancer
- Squamous cell carcinoma
- Adenocarcinoma in situ/adenocarcinoma/CGIN
- Atypical glandular cells
- Pitfalls in cytology
- Potential false positives and false negatives
- Limiting borderline and atypical reports
- Quality control
- Rapid re-screening; rapid pre-screening; automation
- Comparison of reporting rates (LSIL; HSIL; ASC; AGC)
- Proficiency testing
- Invasive cervical cancer audit
- Laboratory accreditation
- Cytology in a multidisciplinary setting
- Role of the multidisciplinary team
- Accuracy of cytology and HPV tests
- Accuracy of colposcopy and punch biopsy