Review of BSCCP Conference 2019
Thursday 8th August 2019
BSCCP 2019 Summary Review
HPV Screening and the Enlarging Area of
Non-Cervical HPV Disease
The annual British Society for Colposcopy and Cervical Pathology conference (BSCCP) this year was held in Bournemouth from the 8-10th May 2019. Leaders from the field shared the latest research and evidence with a focus on the introduction of HPV screening and the enlarging area of non-cervical HPV disease.
Among the hot topics of discussion at the conference were:
The Impact of Primary HPV Screening
Full coverage of primary HPV screening in England is expected by 2020, with the programme already live across Wales. This will replace the current liquid-based cytology as the primary test, which has been used in front line testing for decades.
Primary HPV screening pilot studies in both England and Wales observed an 80% increase in low-grade referrals to colposcopy,1,2 which are known to be more challenging to identify by visual inspection.1,3 This highlights the need for an assessment that does not rely on acetowhite changes alone.1 As presented by Professor John Tidy (Past President, BSCCP) in his abstract poster, ZedScan™, when used alongside colposcopy at Sheffield Teaching Hospitals NHS Foundation Trust, detected 35 cases of high-grade disease within women persistently positive for high-risk HPV with negative cytology, compared to colposcopic impression which identified just 3.1 (John Tidy at BSCCP)
The Impact of HPV Vaccination
Across England, the first women to be vaccinated are now entering the screening programme. In Scotland, results from HPV vaccinated 20-year olds (before the screening age rose to 25 in 2016) have shown a drastic decline in the number of referrals to colposcopy, compared to unvaccinated women, due to the reduction in prevalence of HPV genotypes 16 and 18.4
Worryingly, with increased vaccine hesitancy, HPV vaccination rates in Scotland have dropped to around 70%, in-line with the rest of the UK.4 It is thought that this situation is exacerbated by the language used by healthcare professionals, which differs greatly from language used by the general population.4 Increasingly patients use internet searches for health information,5 and it has been found that differing language in these searches generates contrasting results.6 This opened a discussion at the conference about the style of language the Health Service uses to communicate may need to be adapted to meet this new challenge.
Supporting the findings above, the results of Jo’s Cervical Cancer Trust’s patient survey (available here), published on the 10th June 2019 to coincide with Cervical Screening Awareness Week. They focussed on the language used by healthcare professionals and the psychological impact this has on a patient. It has been concluded that modifying the language used during appointments could be extremely beneficial to the patient in reducing stress and anxiety, while having little impact on the clinician’s timeframe.
Zilico ZedScan™ User Group Meeting
The ZedScan user group meeting, held annually at the BSCCP, was an opportunity to engage with existing and potential users of the ZedScan device, which utilises EIS (Electrical Impedance Spectroscopy) technology. Key opinion leaders within colposcopy shared their experiences with ZedScan and how it supports better patient diagnosis within the changing colposcopy pathways. This included the impact of primary HPV screening, where HPV positive women referred to colposcopy may not have visual indications of disease. Interactive sessions showed that clinicians were not always confident in their initial reactions to cases, due to the subjectivity around assessment of aceto-whitening. This encouraged conversation and positive feedback on the use of ZedScan as an adjunct to standard colposcopy for better patient management.
The Future of Colposcopy
An initial increase in colposcopy referrals is predicted as first-line HPV screening is introduced, and HPV vaccinated women come into the screening programme.1,2 Despite this initial increase, there is a predicted decrease in referrals to colposcopy long-term.5 This has led to discussions regarding the future role of colposcopy. Colposcopists are being urged to broaden their skills into other anogenital areas in order to utilise skills and bring benefit to a wider set of patients.5 This expansion of the colposcopy practitioners’ role would also reduce the requirement for multiple referrals to specialist clinics, bringing the potential to improve patient experience.6
To discuss how to bring ZedScan to your colposcopy service, use the contact details below, or fill in our contact form.
T: +44 (0)161 826 7840
- “Primary cervical screening with high-risk human papillomavirus testing: Evaluation of the English screening pilot.” Professor John Tidy, Sheffield Teaching Hospital NHS Foundation Trust. The British Society for Colposcopy and Cervical Pathway conference Bournemouth 2019. 10th May 2019.
- “Screening Performance of the HPV Primary Early Adopters Phase in Wales.” Dr Louise Pickford, Cervical Screening Wales. The British Society for Colposcopy and Cervical Pathway conference Bournemouth 2019. 10th May 2019.
- Spitzer M, Wilkinson EJ, Ferris D, Waxman AG, Hatch KD, Werner C, Bibbo M, Colgan TJ, Cornelison T, Partridge EE. Management of women with cervical cytologic results interpreted as low-grade squamous intraepithelial lesion: the foundation of the ASCCP guidelines. Journal of lower genital tract disease. 2003 Oct 1;7(4):241-9.
- An Update on the Outcomes of the HPV Vaccine in Scotland. Professor Maggie Cruickshank, University of Aberdeen, UK. The British Society for Colposcopy and Cervical Pathway conference Bournemouth 2019. 9th May 2019.
- "One in four self-diagnose on the internet instead of visiting the doctor." Accessed June 17, 2019. https://www.telegraph.co.uk/news/health/news/11760658/One-in-four-self-diagnose-on-the-internet-instead-of-visiting-the-doctor.html.
- Information cited from discussion session during “An Update on the Outcomes of the HPV Vaccine in Scotland.” Professor Maggie Cruickshank, University of Aberdeen, UK. The British Society for Colposcopy and Cervical Pathway conference Bournemouth 2019. 9th May 2019.