|
Aims
- Clearer results
for Women.
- To improve
concordance with other terminology.
- To develop
evidence based guidelines.
- To confer
with all interested parties.
Conclusions
- with strong agreement on the following points:
- Retain the
term dyskaryosis.
- Two tier
terminology with high grade and low grade with descriptors in
free text.
- Koilocytosis
to be graded as low grade lesion with descriptors in free text.
- Inadequate
smears to be reported as unsuitable, giving reasons.
- TZ cells
not to appear on the form but to be included for audit purposes
only.
- Visualisation
of the cervix and 360o sample to be provided as a tick box on
the request form.
- Reasons for
inadequacy to be subdivided into two main groupings, (1) technical
(2) patient related.
- Negative
smear to be replaced by no dyskaryotic cells identified (or similar).
- Mandatory
management recommendations will remain.
- Optional
clinical management comments to be included.
- Borderline
category to remain but to be subdivided into three groups (1)
borderline with free text descriptor (2) borderline query high
grade (refer and manage as high grade) (3) query glandular to
refer on first or second smear.
- Ungradeable
dyskaryosis category to remain (still coded and managed as high
grade).
- Glandular
lesions (6) to attempt to suggest site of origin where possible
e.g. endocervical, endometrial, extrauterine and other.
- Query invasion
category to remain.
- Diagnostic
features of dyskaryosis to be reviewed.
- If LBC is
adopted, this terminology is considered suitable without further
adaptation.
- Endometrial
cells in a woman over 40 out of cycle is to be reported and suggest
clinical investigation.
- Infections
to be reported when seen as currently.
These points
will have to be ratified by the BSCC at their AGM in September.
Points to be discussed with NHSCSP, IBMS, NAC, RCP, DOH and Obs&Gynae.
Illustrations will be included, workshops are planned other management
issues are to be discussed and draft proposals to be put on the
website.
|