Background:

High-grade cervical screening tests (severe/moderate-dyskaryosis) corresponds to histological-grades (CINIII-CINII). Moderate- dyskaryosis accounts for 0.6% of cervical screening samples nationally with PPV for cervical cancer 0.66%. However, moderate dyskaryosis is likely to have CINII so depending on age more conservative approach taken in young women below 30 years of age. If biopsy confirms CINI discussion in MDT is interpreted in different ways by available guidance Cervical Screening and Programme Management Guidance 2020 Updated in Sep2024, London CSL 2024 and Cervical Screening: histopathology  handbook 2024

Objective: Management of women referred with moderate-dyskaryosis over 12 months period.

Methodology: All women referred to colposcopy with moderate dyskaryosis identified by Cyres, colposcopy database viewpoint and CSMS for immunisation/screening data. Time frame 1/4/22 to 31/3/23.

Results: No of moderate n=295 (10%) direct-referrals 6.3% of all-referrals.

Age: 24-30=150 (51%), 31-40=82, 41-50=25, 51-60= 9, 61-65=3

HPV Vaccination data

HPV-vaccinated n=81 (54%), HPV not-vaccinated n=69 (46%)

Among vaccinated-patients histology >CINII n= 48, LLETZ n= 46

Conservative n= 35

Colposcopy performance

Colposcopy impression HGCIN n=166

LG/N/HPV/TZ3 n=129

Biopsies

Single-biopsy n= 61 (21%)

Multiple-biopsy n= 188 (64%)

See & treat n=2

LLETZ n=215 73% repeat LLETZ n=7

Conservative n=80

Conclusion: