Cervical Screening Test (CST) Resources
Order Form
Doctor Name:
Practice Name:
Phone Number:
Address:
To action the above order, please either
u Fax this form back to (07) 3318 7409 v Email this form to [email protected]
Request a follow-up visit from your Medical Liaison Manager to discuss the Cervical Screening Program
Information for patients
Changes to cervical screening
Changes to cervical screening - information for patients
Cervical Screening Test (CST) Collection guide
Collection using a cervical sampler For the majority of pre-menopausal women, it is advisable to use the cervical sampler (broom-like device) alone.
LubricantThe chemical composition of some lubricants can interfere with cervical cytology and HPV testing. If lubrication of the speculum is required, please use warm water. If additional lubrication is necessary, use only a small amount of water-soluble lubricant (available through SNP Stores), avoiding the tip of the speculum.
Visualise the cervix and obtain an adequate sample from the cervix by rotating the cervical sampler 3–5 times in the cervical os.
Vigorously rinse the sampler immediately in the vial. The sampler should hit the base of the vial 5–10 times, splaying the bristles open.
DO NOT LEAVE THE HEAD OF THE SAMPLER IN THE VIAL.
Tighten the cap of the vial. Place the vial and the request form in a specimen bag for transportation to the laboratory.
Label the ThinPrep® vial with the patient’s given name, surname and date of birth.Record patient details, test, reason for test and clinical history on the pathology request form.
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CST collection guide
A practical guide for clinicians
Improved reportsTo support the risk-based approach of the screening program, Sullivan Nicolaides Pathology has designed an entirely new suite of reports.
These reports clearly show a colour coded risk category, the component test results and an overall recommendation.
These reports will be provided electronically or in hard copy, according to your previously communicated reporting preferences.
If you wish to change your report preferences, please contact our Doctor Service Centre on (07) 3377 8629.
Personalised patient summariesSullivan Nicolaides Pathology has created optional personalised patient summary sheets for clinicians to give to patients when they return to discuss their screening results. These will only be available for routine screening tests and provide general information on cervical screening, together with a summary of the patient’s risk category and follow-up requirements. A contact number for the National Cancer Screening Register (NCSR) and directions on where to find further information are also included.
The patient summary sheets can be provided in hard copy with the report, in PDF format as an attachment in your practice management software, or via Sonic Dx where they can be emailed directly to patients using a two-factor authentication system.
If you wish to receive the patient summary sheets, please contact our Doctor Service Centre on (07) 3377 8629.
Changes to cervical screening
. Unk
DOBSexRequestedCollectedReportedReferred byPhoneLab ID
Ingrid Test
CERVICAL SCREENING TEST (CST)
RISK CATEGORY HIGHER RISK for significant cervical abnormality
SPECIMEN Cervical - ThinPrep
TEST RESULTS PCR for Oncogenic HPV and Genotype
HPV 16 Detected
HPV 18 Invalid
HPV (not 16/18) Invalid
Liquid Based Cytology (LBC) - Image Assisted
Low Grade Squamous Intraepithelial Lesion (LSIL)
Endocervical component is present
RECOMMENDATION Refer for colposcopic assessment
The clinical history is noted
Reported by Melissa Turner
H I G
H E
R R
I S K
CLINICAL NOTES
Page 1 of 1Douglass Hanly Moir | 14 Giffnock Avenue, Macquarie Park 2113 | Ph (02) 9855 5222
Accredited for compliance withNPAAC standards and ISO 15189NATA Accreditation No. 2178
Tests requested:
. Unk
DOBSexRequestedCollectedReportedReferred byPhoneLab ID
Bronwyn Test
CERVICAL SCREENING TEST (CST)
RISK CATEGORY INTERMEDIATE RISK for significant cervical abnormality
SPECIMEN Cervical - ThinPrep
TEST RESULTS PCR for Oncogenic HPV and Genotype
HPV 16 Not Detected
HPV 18 Not Detected
HPV (not 16/18) Detected
Liquid Based Cytology (LBC) - Image Assisted
Possible Low Grade Squamous Intraepithelial Lesion (pLSIL)
Endocervical component is absent
RECOMMENDATION Repeat HPV test in 12 months
No previous cervical screening history on record with the National Cancer Screening Register (NCSR)
Reported by Melissa Turner
I N T
E R
M E
D I A
T E
R I S
K
CLINICAL NOTES
Page 1 of 1Douglass Hanly Moir | 14 Giffnock Avenue, Macquarie Park 2113 | Ph (02) 9855 5222
Accredited for compliance withNPAAC standards and ISO 15189NATA Accreditation No. 2178
Tests requested:
Dr Test Doctor (M1234) Suite 15 Practice Road Brisbane QLD 4000
DOBSexRequestedCollectedReportedReferred byPhoneLab ID
30/07/1976 (41 Yrs) Female1 Dec 20171 Dec 2017 3 Dec 2017, 10:05 am Dr Test Doctor
123456789
CERVICAL SCREENING TEST (CST)
RISK CATEGORY LOW RISK for significant cervical abnormality
SPECIMEN Cervical - ThinPrep
TEST RESULTS PCR for Oncogenic HPV and Genotype
HPV 16 Not Detected
HPV 18 Not Detected
HPV (not 16/18) Not Detected
RECOMMENDATION Rescreen in 5 years
L O
W R
I S K
ROUTINE SMEAR, NO SYMPTOMSCLINICAL NOTES
Page 1 of 1
Accredited for compliance withNPAAC standards and ISO 15189NATA Accreditation No. 1964
Kate Goodhealth1 Address Street Brisbane QLD 4000
Ms Kate Goodhealth1 Address Street Brisbane QLD 4000
DOB Collected Referred byDoctor details
30/07/197601/12/2017, 10:40amDr Test DoctorSuite 15 Practice Road Brisbane QLD 4000 Kate Goodhealth
Cervical Screening Summary
Sullivan Nicolaides Pathology Pty Ltd | ABN 38 078 202 196A subsidiary of Sonic Healthcare Limited | ABN 24 004 196 909
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Please note: this sheet is provided for patient information only. Your full cervical screening result has been sent to your doctor.
Tell me about cervical screening § Women need regular screening to check for cervical cancer
or early signs that indicate a higher risk of developing cervical cancer in the future.
§ Cervical cancer has been linked to infection with certain types of human papillomavirus (HPV).
§ HPV viruses are very common, and are usually cleared by the body naturally.
§ In 2007, Australia began vaccinating young women against the two types of HPV with the strongest links to cervical cancer – types 16 and 18.
§ In December, 2017, Pap tests were replaced with a test for specific HPV types. This test has been found to be a better screening test for both vaccinated and unvaccinated women.
§ All women between 25 and 74 years of age will be offered HPV screening at least every 5 years.
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Information for patients
Changes to cervical screening
More informationNational Cervical Screening ProgramMore information on cervical screening can be found at www.snp.com.au/cst or www.cancerscreening.gov.au/cervical/resources
National Cancer Screening RegisterAll cervical screening results are sent to the National Cancer Screening Register. If you would like to update your contact details, change your consent status, or find out when your next Cervical Screening Test is due, please call 1800 627 701.
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What next?You will need to be rescreened in July, 2022.
The National Cancer Screening Register will send you an invitation to remind you when your next screening test is due.
Remember, if you experience any symptoms, such as pain, bleeding or discharge, you should see your doctor or healthcare professional.
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Your cervical screening summary
You need to return for your routine HPV test in 5 years' timeYour result has been categorised as low risk.
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Correct at time of printing (Nov 2017)
For further information on the new program, please contact your Medical Liaison Manager on 1300 767 284.
24 HURWORTH STREET • BOWEN HILLS • QLD 4006 • AUSTRALIAP (07) 3377 8666 | F (07) 3318 7409PO BOX 2014 • FORTITUDE VALLEY • QLD 4006 • AUSTRALIA
SULLIVAN NICOLAIDES PATHOLOGY PTY LTD • ABN 38 078 202 196A subsidiary of SONIC HEALTHCARE LIMITED • ABN 24 004 196 909
GuideforClinicians_CST_red.indd 1-2 6/11/17 8:20 am
CST clinician guide
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Self-collected HPV testPatient instructions
Your sample must be collected at your medical or healthcare clinic. Your healthcare provider will provide you with a private place to collect your sample.
Wash your hands with soap and water.Remove your underwear.
Preparation
Medicare benefits for self-collect only apply when the following criteria are met: you have declined to have a speculum examination, are 30+ years old, and are more than 2 years overdue for screening or have never been screened
Sample collection
Sit or stand in a comfortable position. Some women prefer to place one leg on the toilet seat or raised platform, while others prefer to squat down.
Twist the red cap open and pull out the swab.
Find the red mark halfway down the stem of the swab. This is the mark that you are aiming for in step 5.
After you find a comfortable position, open the folds of skin around the vaginal opening with one hand, then insert the swab into your vagina, aiming to insert it to the red mark. Gently rotate the swab for 20-30 seconds.
Remove the swab, place it back in the tube and twist gently to seal. Wash your hands, then return the sealed tube to the doctor or healthcare professional.
Meridio 234986 November 2017
Self-collected HPV test patient instructions (pack of10)
Important update – Cervical cytology collection
With the transition to routine collection of ThinPrep for cervical cytology the individual pap kits will be phased out. Alternative collection devices are now available to order from SNP Doctor Stores.
Item Number Description Unit Max
12923 Cervex sampler 50 2
46269 Cervical scraper: Plastic 50 2
12922 Endo-cervix brush 10 10
10275 Rover Cervex-Brush combi 50 2
32921 Cotton applicator: Single Tip: 15cm 100 1
11271 ThinPrep 25 4
Doctor’s request for stores GOODS TO BE USED FOR SULLIVAN NICOLAIDES PATHOLOGY COLLECTIONS ONLY.Under Medicare Australia guidelines, collection equipment is only supplied if used for pathology collection. Fortnightly ordering is recommended for efficient stock rotation. Please allow 3 working days for delivery.
Doctor Services Phone (07) 3377 8629 Fax (07) 3377 1908Medical Liaison Manager 1300 767 284
DL Flyer Collection Devices_November 2017.indd 1 2/11/2017 10:59:21 AM
CST collection devices DL
Clinician flow chart 1: Routine/Abnormal
Clinician flow chart 2: Transition/Test of cure
CST request form
ONCOGENIC HPV TEST WITH PARTIAL GENOTYPING
REFLEX LBC
REPEAT HPV TEST IN 12 MONTHS
REFLEX LBC
HPV not detected
Routine5-yearly
screening
Routine5-yearly
screening
Retest for LBC only in 6–12 weeks
Retest HPV in 6–12 weeks
Refer for colposcopic assessment
Refer for colposcopic assessment
HPV not detected
HPV detected
(any type)
UnsatisfactoryLBC
Negative pLSIL/LSIL pHSIL/HSIL Any LBCresult
HPV (not 16/18)
detected
HPV16/18
detected
UnsatisfactoryHPV test
Low
Intermediate
Higher
Risk of cervicalcancer precursors
REFLEX LBC
Order a CST (HPV)– routine
Order an HPV test – follow-up
Adapted from: National Cervical Screening Program: Guidelines for the management of screen-detected abnormalities, screening in specific populations and investigations of abnormal bleeding. Cancer Council Australia, Sydney (2016)
Pathway for routine cervical screening
Flowchart_CST.indd 1 2/11/17 12:42 pm
Prior to December 2017
After December 2017
* Cytological or histological abnormalities
Adapted from: National Cervical Screening Program: Guidelines for the management of screen-detected abnormalities, screening in specific populations and investigations of abnormal bleeding. Cancer Council Australia, Sydney (2016)
WOMEN WITH ABNORMALITIES PRIOR TO DECEMBER 2017*
Pap test result pLSIL/LSIL
Treated for histologically confirmed
HSIL (CIN2 or CIN3)
Treated for histologically confirmed AIS
HPV test when due for next
screening test
HPV detected(any type)
HPV not detected
Start or continue with Test of Cure
(see over)
Annual Co-test(HPV+LBC) indefinitely
Routine 5-yearly screening with
HPV test
Refer for colposcopic assessment
Reflex LBC
Order a Co-test – Test of Cure
Order a Co-test – AIS follow-up
Order an HPV test – pLSIL/LSIL follow-up
Transition to the renewed National Cervical Screening Program
Flowchart_CST_v2.indd 1 2/11/17 12:43 pm
Cervical screening test request form clinical data requirements
Site 3 tick if cervix visualised during
collection
3 tick when the sample is taken from the vagina
3 tick if the sample is a self-collect by the patient wthin your medical or healthcare clinic
Self collect criteria:• the patient has refused a speculum examination• is 30+ years old and, • is >2 years overdue for screening or has never been screened
LNMP: Insert the date of the patient’s last normal menstrual period.
Clinical 3 tick if the patient is pregnant
3 tick if the patient is postnatal
3 tick if the patient is post-menopausal
3 tick if the patient has an IUD
3 tick when the patient is on HRT
Non-routine test detailsFollow up testing for previous abnormality
Insert the date of previous abnormality.
State the result of the abnormality.
Symptoms
3 tick if the patient has had post-menopausal bleeding
3 tick if the patient has had post-coital bleeding
3 tick if the patient has had unexplained bleeding
3 tick and specify if there are any other symptoms such as:• abnormal appearing cervix• abnormal bleeding• abnormal discharge• intermenstrual bleeding• pain during intercourse
Special circumstances
3 tick if the patient is <25 years of age and meets one of the following criteria:• immune deficient• 20-24 years, early sexual debut at less than 14 years and prior to HPV vaccination• follow up after previous positive screening test (12 month repeat)• follow up or post treatment for clinical management of HSIL, AIS or DES exposure in utero• symptomatic• repeat test following an unsatisfactory result for a claimable MBS Item
3 tick if the patient is immune-deficient
3 tick if the patient has had previous DES exposure
3 tick if the sample is being collected at colposcopy
Item /Meridio 234298 November 2017 Correct at time of publication
SULLIVAN NICOLAIDES PTY LTD • ABN 38 078 202 196 A subsidiary of Sonic Healthcare Limited • ABN 24 004 196 90924 Hurworth Street• Bowen Hills • Qld 4006• Australia • Tel (07) 3377 8666PO Box 2014 • Fortitude Valley • Qld 4006 • Australiawww.snp.com.au
How to complete CST Form_November 2017.indd 1 3/11/2017 1:56:05 PM
CST request form clinical data requirements
Item 50841 / Meridio 234942 November 2017
