Mihaela Grigore

National guidelines for management of cervical squamous intraepithelial lesion: A survey of European Federation for colposcopy members

The management of women with cervical squamous intraepithelial lesions (SIL) is fundamental to prevention of cervical cancer in an organized cervical screening programme. Clinical guidance should improve quality of care and clinical effectiveness if developed and implemented appropriately. This survey provides an update on the current situation of national guidelines for management of cervical SIL amongst member countries of European Federation for Colposcopy (EFC). A questionnaire was sent to representatives of each member country of EFC. The questionnaire contained questions on: guidelines for management of cervical SIL of the National Societies/Associations of Colposcopy or others national societies/associations including the development and the consultation processes, guidelines for management of lower genital tract diseases and the regulations in each country for colposcopy practice. We received responses from all 34 member countries. Thirty countries reported a national guideline for management of cervical SIL that were developed by, or in conjunction with, their national societies or associations of colposcopy. In most cases there was adherence to the recommended steps for guideline development: they were developed by a multi-disciplinary group of specialists (29 countries) and society members were consulted before publication (21 countries). A small number of countries (8) reported to have guidelines for the management of lower genital tract dysplasia (e.g. vulval disease) developed by other national societies. In most countries (26) the colposcopists are obliged to follow the guidelines but this is regulated in only 6 and in 12 countries the colposcopists need to be certified by the national society of colposcopy in order to practice. There are advances in the development and provision of country specific guidance on the management of cervical SIL. Most EFC member countries have appropriate national guidelines that were developed using a clear methodology, are updated according to progresses in the field and are accessible online to current practitioners. These guidelines support colposcopists to follow evidence-based practice and provides understanding of best practice in guideline development and access.

European consensus statement on essential colposcopy

This European consensus statement on essential colposcopy provides standards for the general colposcopist seeing women referred for colposcopy with an abnormal cervical screening test (including cytology and HPV tests) or with a clinically suspicious cervix. The article gives guidance regarding the aims and conduct of colposcopy. Recommendations are provided on colposcopy technique, the management of common colposcopy issues, treatment and follow-up of after treatment of CIN or early stage cervical. Colposcopists should make an informed decision on the management of each individual that is referred and organize appropriate follow-up. Cervical cancer is still a major health issue and the quality of care can only improve if there is a structured guidance for women with an abnormal smear or suspicious cervix.

Are Medical Students from Across the World Aware of Cervical Cancer, HPV Infection and Vaccination? A Cross-Sectional Comparative Study

This study aims to understand and compare the level of knowledge, the attitude and the awareness of cervical cancer, HPV infection and vaccination among medical students from across the globe. It was conducted by sharing a questionnaire on medical students' Facebook groups. We successfully analysed 736 responses, of which 74.3% were females and 25.7% males. Their mean age was 23.14. As regards to the respondents' knowledge of the risk factors for cervical cancer, 28.8% of the participants identified HPV, 23.5% chose "Having many sexual partners", 15.4% identified "Starting the sexual life at a young age", 14.7% chose HIV and 13.3% answered smoking. Regarding the knowledge of the Pap test, 92.4% of the students stated that they knew what it is, although 98.5% of these respondents chose the correct answer. Concerning the knowledge of early warning signs of cervical cancer, 34.4% recognised vaginal bleeding. According to our research, American, Eastern and Western European students had more knowledge regarding the risk factors, early signs of cervical cancer and Pap test than African and Asian students. A total of 50% of the sexually active females had gone at least once to be screened by the means of a Pap test. A total of 39.8% of the participants stated that they had received the HPV vaccine. The findings of our research highlight the need for additional education measures to improve knowledge and awareness regarding HPV infection, especially among medical students, since they will be future healthcare providers.