ONCOLOGY
screening in primary care with greater confidence and has seen a 40% reduction of follow up appointments making more appointments available to new patients.2 Subsequent data, submitted for publication, has shown that patients with a negative colposcopy and negative ZedScan result, are highly unlikely to develop CIN2 in the following three years (1 per 100 women years vs. 3.3 per 100 women years in colposcopy alone).3
The technology has also allowed
Sheffield Teaching Hospitals NHS Trust to take a more patient centred approach and reduce the number of diagnostic biopsies and associated co-morbidity while avoiding unnecessary costs.
In a recent study they were able to detect more disease (as a result of greater PPV) at a lower biopsy rate with ZedScan-directed biopsy than with colposcopic-directed biopsy when the lesion was less than CIN2.4
and colposcopy services that could have long lasting positive impacts for both patients and service providers.
CSJ This is
an effect commonly seen across clinics using ZedScan and can have a profound effect both organisationally and economically, as previously demonstrated in a 2017 study at Birmingham Women’s Hospital, a service managing around 2,000 colposcopy referrals each year over nine clinics.4
Based
upon a 109-patient study, they projected a financial benefit to the hospital by year three of implementing ZedScan, of £119k and the release of approximately 1184 clinic appointments.5
It was findings, such as these, that led East Lancashire Hospitals NHS Trust to recently accelerate adoption of ZedScan to manage the expected increase of patients they are anticipating post COVID-19 as effectively as possible.
The next 12 months are certainly set to be a challenging time across the NHS, but it could also be an opportunity for us to implement positive changes in gynaecology
References 1
https://www.theguardian.com/world/2020/may/17/ hospital-patients-england-coronavirus-covid-19
2 MacDonald, M.C., Lyon, R., Palmer, J.E., Tidy, J.A. (2015), “The routine use of ZedScan within one colposcopy service in England”, unpublished presentation at BSCCP 2015, Nottingham, UK
3 Brown, B; Tidy, JA, Unpublished longitudinal study into probability of CIN2+ development in women following a negative colposcopy with negative ZedScan result, June 2020
4 Tidy JA, Lyon R, Ellis K, Macdonald M, Palmer JE. The impact of age and high-risk human papillomavirus (hrHPV) status on the prevalence of high-grade cervical intraepithelial neoplasia (CIN2+) in women with persistent hrHPV-positive, cytology-negative screening samples: a prospective cohort study [published online ahead of print, 2020 Apr 12]. BJOG. 2020;10.1111/1471-0528.16250. doi:10.1111/1471-0528.16250
5 Byrom, J; Poster presentation BSCCP 2018, Manchester, UK
Ms Uma Krishnamoorthy Consultant gynaecologist; associate medical director (A&R)
Uma is an experienced consultant with a demonstrated history of successful working in the hospital and healthcare industry for more than 25 years and in the National Health Service for more than 20 years. She is skilled in Governance and Risk Management, Leading Change, Enhancing Quality & Safety of Healthcare through leading peer reviews and Quality Assurance review visits to NHS organisations across the North of England. She is a consultant gynaecologist at East Lancashire Hospitals NHS Trust, with a special interest in colposcopy and vulvoscopy and a strong commitment to medical education and leadership.
OCTOBER 2020
Professor John Tidy
Consultant gynaecological oncologist
Past president of the BSCCP, Prof Tidy is a consultant at Sheffield Teaching Hospitals NHS Foundation Trust and honorary professor of gynaecological oncology at the University of Sheffield. He is a certified BSCCP colposcopist and a recognised specialist in gynaecological cancer surgery. John is director of the Sheffield Trophoblastic Disease Centre. He has a proven track record in clinical research attracting funding from Cancer Research UK, World Cancer Research Fund International, NHS New and Emerging Technologies Programme and the Pharmaceutical Industry. John has published in high profile peer review medical scientific journals including Cell, Nature Genetics and the Lancet. John has been actively involved in the introduction of HPV triage and Primary HPV testing within the English cervical screening programme. He is currently the chairman of the NHS Cervical Screening Programme Professional Advisory Group for Colposcopy and chairman of the NHS Cervical Screening Programme Research Advisory Group for Colposcopy.
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