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  1. What your cervical screening results mean. Your cervical screening results letter will explain if human papillomavirus (HPV) was found in your sample, what your result means, and what happens next. Sometimes you'll be asked to come back in 3 months to have the test again.

  2. 65+ Those aged 65 or older will not be invited for cervical screening if their last test was normal. This is because the likelihood of developing cervical cancer is low. If they are aged 65 or over and have never had cervical screening, they are entitled to a test and should speak with their GP surgery about booking an appointment. If

    • Flowchart Part 1: Sample Taking and HPV Testing and Cytology Triage
    • Flowchart Part 2: Colposcopy
    • Flowchart Part 3: Abnormal Colposcopy Result Management

    1. Send out the invitation. Does the woman opt out of screening?

    Yes: The Cervical Screening Call and Recall Service (CSAS) is notified and the woman is ceased from screening. End of screening test pathway. No: Woman attends screening. Go to question 2.

    2. Carry out the test. Is the result high risk human papillomavirus (hrHPV) negative or positive?

    hrHPVnegative: return individual to routine recall. End of screening test pathway. hrHPVpositive: carry out cervical cytology test. Go to question 3. Note: If a test result is unavailable or cervical cytology is inadequate at any stage in the screening pathway, the sample must be repeated in no less than 3 months. Allow up to 2 consecutive unavailable or inadequate repeats – always refer to colposcopy at the second.

    3. Is cytology negative or abnormal?

    Cytology negative: screen again in 12 months’ time. Go to question 4. Cytology abnormal: refer to colposcopy. End of screening test pathway.

    1. Carry out the colposcopy examination. Is the examination adequate?

    Yes: go to question 3. No: go to question 2.

    2. What were the results of the hrHPV and cytology tests (leading to colposcopy referral)?

    hrHPV positive, cytology low grade or less (excluding borderline change in endocervical cells): repeat colposcopy in 12 months. If repeat colposcopy examination has inadequate outcome, consider large loop excision of the transformation zone (LLETZ) patient choice. End of colposcopy management pathway (for this colposcopy episode). hrHPV positive, cytology high grade or worse, or borderline (endocervical): undertake LLETZ. End of colposcopy management pathway (further management based on findi...

    3. What did the colposcopy examination show?

    Abnormal biopsy showing cervical intra-epithelial neoplasia (CIN)1 or worse, or colposcopic impression of CIN1 (no biopsy): manage as an abnormal colposcopy examination. Go to Flowchart 3 (abnormal colposcopy result management pathway) below. No CIN on biopsy, no biopsy, or no colposcopic impression of CIN: go to question 4.

    1. Abnormal biopsy result: was the result CIN1?

    Yes: the CIN1 pathway only applies to individuals with CIN1 confirmed on biopsy or colposcopic impression of CIN1 (no biopsy) who were referred with low grade cytology, or hrHPVpositive/cytology negative referrals. Recall in 12 months. Go to question 2. No: CIN2, CIN3 or cervical glandular intra-epithelial neoplasia (CGIN): Go to question 6.

    2. Is screening result hrHPV negative or positive?

    hrHPV negative: recall in 36 months. End of abnormal colposcopy result pathway (for this colposcopy episode). If HPV test is negative at 36 months, return to routine screening interval. If HPVtest is positive at 36 months, follow the process outlined in pathway part 1 above. hrHPVpositive: carry out cervical cytology test. Go to question 3.

    3. Is cytology negative or abnormal?

    Cytology negative: recall in 12 months. Go to question 4. Cytology abnormal: refer to colposcopy. End of abnormal colposcopy result pathway (for this colposcopy episode). Further management based on findings from repeat colposcopy.

  3. It involves: Primary human papillomavirus (HPV) screening — to identify people with high-risk HPV (hrHPV), which has been implicated in the development of cervical cancer. Liquid-based cytology (if hrHPV is found) — to detect early abnormalities of the cervix, which if untreated could lead to cervical cancer.

  4. Usually within 2 to 6 weeks. What do the results mean? The test looks for HPV (human papillomavirus). The results will tell you if you have HPV or not. If you have HPV, the results will also tell you whether there are any changes in the cells that could lead to cancer. What happens next? It depends on what they find as to what happens next.

  5. The adoption of the USPSTF guidelines expands the recommended options for cervical cancer screening in average-risk individuals aged 30 years and older to include screening every 5 years with primary high-risk human papillomavirus (hrHPV) testing.

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  7. One of the most important updates to the guidelines is the recognition of the importance of previous human papillomavirus (HPV) test results. New abnormal screening test results after a negative HPV test within the previous 5 years indicate new, as opposed to persistent, HPV infection.

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