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Christine Bergeron - Welcome and introduction

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Bergeron

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Christine Bergeron - Welcome and introduction

  1. 1. Colposcopy : what is going to change? Dr Christine Bergeron Laboratoire Cerba Cergy Pontoise France
  2. 2. The outcome will remain the histologic diagnosis • The biopsy should be obtained under colposcopy • The biopsy should be taken around the squamous-columnar junction • The performance of the histologic diagnosis will depend of the expertise of both the colposcopist and the pathologist
  3. 3. HPV Test - + Colposcopy 1 y Pap smear3 ys 4 ys + - p16/ki67 option if < 30 ys Pap smear + - Colposcopy 2 ys Pap smear ASC-US
  4. 4. Colposcopy 1 y + Pap smear or HPV test - p16/Ki67 Cytologic LSIL
  5. 5. Supplements to EU guidelines for quality assurance in cervical cancer screening Eds: A.Anttila, M.Arbyn, H.De Vuyst, J.Dillner, L.Dillner, S.Franceschi, J.Patnick, G.Ronco, N.Segnan, E.Suonio, S.Tornberg, L.von Karsa Guidelines can be downloaded at: http://bookshop.europa.eu/en/european-guidelines-for-quality-assurance -in-cervical-cancer-screening-pbEW0115451/?AllPersonalAuthorNames=true
  6. 6. Test HR HPV Negative Test HPV 5 ys Positive Cyto and/or HR HPV 1 yr Normal/ Neg Abnormal Colposcopy Abnormal/ Pos Cytology Normal Primary screening HPV cytological triage : Organized screening programme European guidelines for quality assurance in cervical cancer screening 2015 Colposcopy
  7. 7. Test HR HPV Negative Positive Cytology p16 / Ki 6716/18 Positive Primary screening HPV with triage strategies Combinations of different tests ? Interval between tests if negative? Test HPV 5 ys NegativeNormal or ASC-us or LSIL PositiveNegative Test HPV 3ys Test HPV3ys Test HPV 3ys HSIL Colposcopy Colposcopy Colposcopy
  8. 8. Colposcopy in the context of primary cytology or HPV screening • The diagnosis will be in the hand of the colposcopist • Will need education and training of the colposcopists • Will need evaluation

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