Cervical Screening

This section contains the clinical practice guidelines for cervical cancer screening followed in Alberta.

 

Clinical Practice Guidelines

View the PDF of the clinical practice guidelines.

Clinical Practice Summary

View the PDF of the clinical practice guidelines summary.

This section contains information for Registered Nurses (RNs) performing Cervical Cancer Screening.

 

ACCSP Cervical Cancer Screening Provided by Registered Nurses Guideline

*UPDATED July 7, 2020. This document guides RNs through the cervical cancer screening process

CARNA Practice Advice: Registered Nurse role in cervical cancer screening

This document outlines the role of Registered Nurses in Cervical Cancer Screening

ACCSP Cervical Cancer Screening Learning Module for Registered Nurses (2021)

*UPDATED June 23, 2021.

This section contains information and resources for when your patient has an abnormal Pap result, and resources for colposcopy.

 

Does your patient need a referral to colposcopy?

This algorithm will help you determine if your patient needs a referral to colposcopy.

Referral to Colposcopy form

Use this form to refer your patient to colposcopy from the Alberta Health Services website.

Information for healthcare providers about reflex HPV testing

Find out more about HPV reflex testing and what it means for your patient.

Request form for completed colposcopy record

Use this form if you are requesting a patients colposcopy record.

Booklet

Alberta Colposcopy Best Practice Guideline

Brochure

Do I really need a Pap test?

Brochure

Do I really need a Pap test? (Francais)

Info Sheet

Does my patient need a referral to colposcopy?

Form

Healthcare provider form to report ineligibility for cervical screening

Info Sheet

HPV testing information for women having Pap tests

Brochure

HPV: What You need to know and do

Info Sheet

Information for healthcare providers about reflex HPV testing

Other

Invite letter to the Alberta Cervical Cancer Screening Program

Brochure

Making sense of abnormal Pap test results

Form

Order form for blank colposcopy records

Other

Registered Nurse Pap test learning module

Form

Request form for completed colposcopy record

Poster

Should I have a Pap test?

This section contains clinical information and guidelines for Colposcopy.

Alberta Colposcopy Best Practice Guidelines

Colposcopy clinic resource for standardized patient care in Alberta.

Order form for blank colposcopy records

This section contains information on unsatisfactory results and other resources.

What does unsatisfactory Pap result mean?

This means the test was rejected/not processed by the laboratory or that the specimen was processed and examined but was unsatisfactory for evaluation of epithelial abnormality or the cells could not be seen well enough to give a result.

Why is it important?

The ACCSP monitors quality and performance indicators in the cervical cancer screening pathway. One of these is the unsatisfactory rate. The provincial target is <1%.

Causes

Unsatisfactory Pap test results are mostly due to cervical sampling and specimen collection issues. This may be due to a number of factors which includes:

  • Scant cellularity.
  • Faulty technique.
  • Post-menopausal status.
  • Excess lubricant use.
  • Interfering substances like mucus, blood and bacteria.
  • Human error

Some identified reasons for human errors are;

  • Unlabeled specimens: Name and unique identifier missing.
  • Incorrect or mislabeled specimens: For example, patient details (name or different patient ID) on requisition form and sample container don’t match.
  • Identifier incomplete: Missing fields like first or last name missing, initials only, missed numbers on patient’s PHN.
  • Significant misspelling where more than 2 letters are transposed or missing/added, letters that changes the interpretation of the name.
  • The use of incorrect containers or preservatives.
  • Test request received without a corresponding sample or vice versa.
  • Sample container not properly sealed leading to loss of sample.

What happens after an unsatisfactory result?

Every unsatisfactory Pap leads to a repeat Pap test in 3 months.

What can I do to reduce my unsatisfactory rates?

 Patient related:

  • Prepare your patients for their Pap test.
  • Book their appointments for a day they won’t have their periods (but should book an appointment if they have an abnormal bleeding). Wait at least 7 – 10 days after first day of menstrual period.
  • Avoid douching or using contraceptive creams, vaginal medicines, sprays, powders or jellies in the 48 hours before the test.
  • Avoid sexual intercourse in the 24 hours before the test.
  • Avoid the use of personal lubricants in the 48 hours before the test.
  • Avoid having a Pap test when you are being treated for cervical or vaginal infections. Wait at least 2 weeks after treatment ends before having a Pap test.

Physician related:

  • Collect sample far enough into endocervical canal to obtain an appropriate amount of cells.
  • Follow manufacturer’s instructions for choice of instrument and transferring the sample from the instrument to the liquid medium.
  • Use lukewarm water instead of lubricants.
  • When clinically indicated or for patient comfort, use dime size carbomer-free lubricants.
  • Provide all relevant clinical information.

Resources

APL:

DynaLife:

Manufacturer’s Guide

DynaLife