Below is a summary of recent changes to the 2016 National Cervical Screening Program: Guidelines for the management of screen-detected abnormalities, screening in specific populations and investigation of abnormal vaginal bleeding
Chapter 18: Signs and symptoms of cervical cancer – identification and investigation of abnormal bleeding
The title for Chapter 18 has been changed to reflect the addition of a new subpage, Investigations of other symptoms – vaginal discharge and deep dyspareunia which provides detailed guidance for healthcare professionals on the identification of the signs and symptoms of cervical cancer.
Three new recommendations in relation to deep dyspareun ia and unexplained persistent unusual vaginal discharge have also been added to the Guidelines. The new recommendations are:
• REC18.8 Women with abnormal vaginal discharge and/or deep dyspareunia: Almost all women with vaginal discharge and/or deep dyspareunia have benign gynaecological disease. They should be investigated appropriately and if due for cervical screening a routine CST would be the most appropriate test.
• REC18.9 Women with unexplained persistent unusual vaginal discharge: Women of any age with unexplained persistent unusual vaginal discharge, especially if offensive or blood stained) should be investigated with a co-test (HPV and LBC) and referred for gynaecological assessment.
• REC18.10 Women with unexplained persistent deep dyspareunia: Women with unexplained persistent deep dyspareunia in the absence of bleeding or discharge should have a CST if due and referral for gynaecological assessment should be considered.
Chapter 14: Screening in pregnancy
The recommendations for screening in pregnancy in Chapter 14 have been modified to reflect expert opinion on the risks and benefits of self-collection of specimens for HPV testing during pregnancy. The previous recommendation stated that self-collection for HPV testing during pregnancy is not recommended. The new recommendation is:
• REC14.13 Self-collection in pregnancy: Self-collection for HPV testing may be considered during pregnancy in never-screened or under-screened women, following counselling by a health care professional regarding the risk of bleeding.
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