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After the initial
pleasure of being told that our lab had received a bursary for a
place at the NAC Conference this year, I did suspect that there
was a proviso to this gift, and that turned out to be writing this
article about the Conference.
Before
giving you our (3 of us went) version of the talks etc I must say
how amazed I am each year that it is put together so expertly by
people who only get paid their expenses. I have had some experience
of the hard work involved in organising single study days on a voluntary
basis, but organising a whole weekend is a mega-task.
On
to Saturday and we started with Dennis Williams' 'swansong'
as he retires as NAC President this year and passes the job onto
Carole Cowen. She is a Cytoscreener and it was at this Conference
that we learned about plans to make the role of Cytoscreener a profession
in its own right. I feel proud that a former colleague and a 'soon
to be' colleague are on the organising committee.
Professor
Sue Hill told us about a new 9 stage career pathway that, in
theory, anyone could start as an Assistant (?MLA) and progress up
to a Consultant Director. Hm!
There
was another 'swansong' talk - this time from Dr Jane Johnson
who has given many interesting talks over the years and this time
told us of her involvement in getting the post of Advance Practitioner
in Gynae Cytology accepted.
Dr
Mohammed Mohammed gave a talk on statistics that even the least
numerate of us could understand. By using a control chart with 3
standard deviations from the mean he showed how to produce data
for action for improvement that would generate knowledge not recognised
before.
"Looking
Back" on those false negatives was the subject of Andrew
Everard's talk and I found two phrases interesting. "Use
slide review as an educational process and not a witch hunt"
and in the difficult cases of CIN3 infiltrating crypts versus CGIN,
he believes "all are squamous unless proved otherwise".
Dr
Amanda Herbert looked at the new screening intervals and fears
that the negative message of "screening women under 25 may
do more harm than good" may reduce the uptake. She also fears
that cervical cancer in the 30-39 age range will increase and be
more advanced or that when CIN3 is picked up it will be more extensive
and hence more difficult to treat.
Simon
Pledge is an oncologist specialising in gynaecological cancers.
He told us of the different internal and external treatments for
these cancers and his message was quite clear - weekly multi-disciplinary
meetings make a huge difference to the functioning of an effective
team.
The
NHS Plan 2006 wants to ensure best care for patients and that staff
are to be professional in every way. Alison Baker explained
how this is to effect a number of jobs within the NHS such as Perfusionists,
Clinical Physiologists and, especially important to us, Cytoscreeners.
A registration committee has been formed that had one meeting with
the DoH in June and another is planned for August. Most of us would
say, "about time too" as we regard Cytoscreeners as professionals
anyway.
Josh
Sickel, an American pathologist, told us of humour therapy he
uses at his hospital in California that runs alongside aromatherapy,
massage, music and art therapy, dogs and live music by professionals
as an aid to the healing process. His quick humour was immediately
apparent and continued into Saturday evening as he was our after
dinner entertainment - come again Josh.
Dr
Durgesh Rani gave a clear talk on hyperchromatic crowded groups
with a list of 10 possible differential diagnoses - not surprising
they can be difficult to interpret. She placed emphasis on nuclear
polarity and that "cells respect one another" in the benign
conditions.
We
were brought up to date on HPV testing by Dr Ray Lonsdale.
There is a move to consider HPV testing as a primary screen, but
there are many questions, a huge number of unknowns and much yet
to be done before it could be started. Vaccination may be commercially
available in about five years, but he asked, "How long would
it last?" He mentioned immunotherapy and how this is a much
more challenging area.
Steve
Dixon told us how Quality Assurance is nationally controlled
and locally organised. Its aim is to support all of us in the Cervical
Screening Programme. He reiterated what the oncologist said,"
the multi-disciplinary approach is essential".
It
was good to hear screeners give case presentations of interesting
rare and routine cases. It's a shame that so few people stay on
to hear the Sunday talks - in my opinion they are just as interesting
and useful as the ones on Saturday.
The
conference ended with Dr Rajit Ganesan talking about glandular
lesions of the uterine cervix. Endometrial carcinoma is a disease
of the developed world and is associated with obesity, so we will
see an increase of it in our smears in the future. There is a pre-invasive
then an invasive stage, and she introduced the term Endometrial
Intra-epithelial Neoplasia (EIN).
At
the AGM we were given the news that next year's conference is back
to springtime (1-3 April) and the membership fees will rise to £25
for qualified screeners and £10 for trainees. This is pretty
good value for an excellent journal, CEC programme, first class
conference and representation on other committees.
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