Glossary
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Abdomen
Part of the body between the waist and the top of the legs, often know as 'the belly' or 'tummy'.
Adjuvant treatment
Treatment of breast cancer that is additional to treatment by surgery after complete clincial removal of disease (for example, use of radiotherapy). The aim of adjuvant treatment is to destroy any cancer that may have spread.
Antenatal HIV screening
HIV is short for human immunodeficiency virus. This virus prevents the body's immune system from working properly and makes it hard to fight off infections.
Atypical hyperplasia
An abnormal incrase in the number of epithelial cells. Women with this diagnosis are at a slightly increased risk of developing breast carcinoma.
Audiologist
A university-trained professional who is specially qualified to measure hearing, diagnose and advise on the management of hearing disorders, and supply and fit hearing aids and other hearing devices to suit individual needs. The New Zealand Audiological Society is the professional body in New Zealand responsible for the clinical certification of audiologists.
Auditory Brainstem Response (ABR)
A non-invasive test that measures the brain responses to the auditory stimuli. This test can indicate whether or not sound is being detected, even in an infant.
Autosomal recessive disorder
Each cell in our body carries two copies of each gene, one inherited from each parent. In all of us, there are "mutations" in a few of the genes. For a recessive gene mutation to result in a particular disorder, both copies of the gene must carry the mutation.
Benign tumour
A tumour that is not malignant, which usually remains a uniform shape enclosed in a fibrous sac. It does not spread to other parts of the body, and usually does not recur after being removed. A benign tumour does not indicate cancer.
Biopsy
The removal of a small piece of body tissue for testing in the laboratory to assist in diagnosis of cell changes or disease.
Biotinidase Deficiency (BIO)
Biotinidase Deficiency is an enzyme deficiency that occurs in about 1in 50,000 newborns and can result in seizures, hearing loss and death in severe cases. Treatment involves doses of biotin.
Blood spot card
When newborn babies are 48 hours old, a blood sample is taken from their heel. This is sometimes referred to as the heel prick test. Blood from the baby’s heel is dropped onto a special type of filter paper (previously called a Guthrie card) and stored as a series of blood spots. A number of screening tests are then carried out on these blood spots for the purposes of newborn screening. These tests are often called newborn metabolic screening to distinguish them from other types of newborn screening.
Breast awareness
Breast awareness involves a woman knowing what her breasts are like normally, so she can notice any changes that seem different from normal.
Breast cancer
An abnormal growth of cells that is classified as ductal carcinoma in situ or invasive breast cancer.
Breast conserving surgery
Surgery when the cancer is removed together with a margin of normal breast tissue. The whole breast is not removed.
BreastScreen Aotearoa
Name of the programme overseen by the National Screening Unit that screens women for breast cancer.
Cancer
A general term for a large number of diseases in which there is an uncontrolled growth and spread of abnormal cells.
Carcinoma in situ (CIS)
High-grade cell changes confined to the surface (epithelial) layer of the cervix. Without treatment they may develop into invasive cancer.
Carcinoma squamous
Malignant lesion of the squamous portion of the cervix (the outer portion of the cervix).
Cells
The smallest living unit in the human body. The body is made up of many millions of cells built into tissues and organs.
Cervical cancer
There are two main types of cervical cancer; squamous cell cancer and adenocarcinoma (or glandular cell cancer). Squamous cell cancer is the most common form of cervical cancer. It usually arises in the transformation zone of the cervix which is where the vagina meets the cervix. Adenocarcinoma is found in the glandular cells which line the inside of the cervix.
Cervical intraepithelial neoplasia (CIN)
Abnormal changes or growth in the skin layers of the cervix. These changes are not cancer, but could develop into cancer if not treated. CIN is graded as CIN 1, 2, or 3. CIN 3 means the most severe changes.
Cervical smear test
A screening test in which cells are taken from the cervix, preserved on a slide and sent to the laboratory for examination. It is also know as a pap smear.
CIS
A high grade abnormality which has not yet become invasive. It is confined to the layer of cells (epithelium) of the cervix. It is a form of preinvasive cancer which may develop into invasive cancer if not treated. Also known as CIN-3.
Cochlear implant
An electronic device surgically implanted to stimulate nerve endings in the inner ear (cochlea) in order for the person to receive and process sound and speech.
Code of Health and Disability Services Consumers' Rights
The Code confers a number of rights on all consumers of health and disability services in New Zealand and places obligations on providers of those services. It covers all registered health professionals, such as doctors, nurses, dentists etc.
Colorectal cancer
Colorectal or bowel cancer is a malignant (cancerous) growth that starts on the inside wall of the bowel. Colorectal cancer can develop in any part of the large bowel, including the colon and rectum.
Colposcope
An instrument that looks like a pair of binoculars on a stand. It has a light and magnifies the cervix so it can be examined more closely. A colposcope may have a camera attached, which allows a woman to see her cervix on a television screen.
Colposcopist
All colposcopists and obstetricians and gynaecologists specialising in and performing colposcopy.
Colposcopy
Examination of the cervix and vagina to check for abnormal cells, using a magnifying instrument called a colposcope.
Cone biopsy
Surgical removal of a cone-shaped section of the cervix to remove abnormal cells. The procedure may be used to diagnose or treat cell changes.
Congenital Adrenal Hyperplasia (CAH)
CAH is caused by decreased or absent production of certain adrenal hormones. The most prevalent type is detected by newborn screening in about 1 in 20,000 newborns. Early detection can prevent death in boys and girls and sex mis-assignments in girls. Treatment involves lifelong hormone replacement therapy.
Congenital Hypothyroidism (CH)
CH is a disorder where a baby is born with a thyroid gland that does not work properly. A normal working thyroid gland is critical for normal growth and brain development. The thyroid can be completely absent or small and underdeveloped or not in the normal position in the neck. More rarely, CH is caused by the absence of an enzyme in the thyroid gland, preventing it from making thyroid hormone (thyroxine). The treatment is daily thyroxine.
Cystic Fibrosis (CF)
CF is a disorder in which the body's secretions, especially in the lungs and gut are much more sticky than usual. These thick secretions encourage infection in the lungs and abnormal secretions from the pancreas frequently make food digestion and absorption incomplete. CF is an autosomal recessive disorder.
Dense breast tissue
Made up of less fat and more tightly packed fibrous tissue, making mammograms harder to read.
Down syndrome
Down syndrome is a genetic condition that causes delays in physical and intellectual development. It is relatively common, with a population incidence of about 1 in 1000 live births. Babies born with Down syndrome often have intellectual and growth impairment and a range of other possible medical complications.
Duct
A tube for transporting liquid. In the breast, ducts carry milk to the nipple when a woman feeds her baby.
Ductal carcinoma in situ (DCIS)
An area of abnormal cells in the breast duct that has not spread to the surrounding tissue.
Dysplasia
An abnormal growth of cells which look like cancer cells, but do not have all the reatures of cancer.
Enrolment
For NCSP: the process of entering a woman's information and results on the NCSP Register. For BSA: When a woman gives her name or allows her name to be given to BreastScreen Aotearoa to begin the registration process. The registration process is when a woman has completed a registration form which includes informed consent for screening prior to having a mammogram.
Enzyme
A product of a gene that converts one chemical into another chemical. If an enzyme is defective, because of an inherited genetic anomaly, then there can be a build up to toxic levels or insufficient production in the chain of events.
Epidemiologist
A person who studies all elements contributing to the occurence or absence of a disease in a population.
Epithelium
Cells which make up the lining of the external surface and some internal linings of the body, eg, the skin, the lining of the lungs, the genital tract, the bladder.
False negative result
A negative screening test result in a person who does have cancer at the time the screening is conducted.
Fine needle aspiration
Where a fine needle is placed in a lump removing a sample of cells from breast tissue for examination by a pathologist.
Galactosaemia
Galactosaemia is an enzyme deficiency. It causes an accumulation in the blood of galactose, a sugar which is in milk. The enzyme deficiency prevents the galactose from being changed to another sugar, glucose. Galactose and other compounds accumulate and cause lethargy, vomiting, jaundice and sepsis. The treatment is a diet which completely excludes galactose.
Gene
A gene is the amount of hereditary material (sometimes called DNA) that is required to produce one protein. Some proteins control the metabolic processes in the cell, others control the function of other genes or form part of the cell structure. There are 30,000-50,000 genes in humans.
Genetic testing
The term genetic testing is used to describe tests that reveal information about a person's genetic makeup. Sometimes the genes themselves are tested to determine the presence or absence of a change in gene structure. Newborn metabolic screening tests for the enzymes that result from a gene mutation. About 1% of samples have a test for a change in DNA (mutation) associated with cystic fibrosis, as part of routine screening. Absolutely no other DNA testing is done on samples unless authorised by the parents/guardians/individual or through legal avenues eg court order.
Glandular cells of the cervix
Cells lining the inner canal of the cervix. Also called columnar or endocervical cells.
Guthrie card
Card on which a small amount of blood is collected from a newborn baby. The blood is tested for seven metabolic conditions. Also known as a 'blood spot card'.
Health Information Privacy Code 1994
This code of practice applies specific rules to agencies in the health sector to better ensure the protection of individual privacy. The rules in the code are enforeable by complaining to the Privacy Commissioner and, if necessasry, later to the Complaints Review Tribunal. The Code is available at the Privacy Commission's website.
Hearing impaired
Applies to those whoese hearing is not within the normal range. It may be used to refer to those for whom the primary receptive channel of communication is, even with deficits, hearing.
Hearing impairment
The following clasifications are use in New Zealand audiology clinical practice ti describe hearing loss. These hearing levels are measured over a four frequency average:
Mid: 26-40dB
Moderate: 41-65dB
Severe: 66-95dB
Profound: greater than 95dB
Hearing screening test
Two types of test may be used for a newborn hearing screening: the otoacoustic emissions (OAE) test and the auditor brainstem response (ABR) test.
High-grade abnormality (HSIL or high-grade squamous intraepithelial lesion)
The more serious cell changes in the cervix that may lead to cancer if not treated. The term 'high-grade abnormality' covers CIN 2 and CIN 3.
HIV
HIV is short for human immunodeficiency virus. This virus prevents the body's immune system from working properly and makes it hard to fight off infections.
Hormone replacement therapy (HRT)
Hormone treatment for women which eases the symptoms of menopause, or change of life.
Hormone treatment
Hormone medications which suppress the growth of hormone responsive breast cancer.
Hui
Generic term for a Maori gathering, meeting or conference and organised according to Maori protocol.
Hysterectomy
An operation in which the uterus is removed. A hysterectomy can be total (the removal of the uterus and the cervix) or subtotal (the cervix is not removed).
Incidence
The number of new cases of a condition that occur in a set period of time in a particular group of people.
Incidence rate
The number of new cases of a condition that occur in a given period in a specified population.
Independent monitoring group
(For NSCP) The role of the independent monitoring group is to collate, analyse, evaluate and prepare reports and provide recommendations concerning the performance of NCSP providers against National Indicators and associated targets.
Intraepithelial neoplasia
Abnormal cells in the epithelium of the lower genital tract. See CIN, VAIN, VIN.
Invasive cancer of the cervix
Condition where cancerous cells spread beyond the surface epithelium into the underlying tissues. It may be diagnosed by clinical examination with biopsy. Classified in four stages, from Stage I where the cance has not spread beyond the cervix, to Stage IV where it has extended beyond the pelvis.
Invasive cervical cancer
Cancer that grows from the surface layer into other tissue. It not treated the cancer cells will spread to other parts of the body.
Kaimahi
A Maori term for worker or operator. In the NCSP, the term can include cervical screening co-ordinators, educators or smeartakers.
Kaitiaki
A Maori term for protector, caretaker or trustee. Tha National Kaitiaki Group refers to the group set up under the Health (Cervical Screening (Kaitiaki)) Regulations 1995. The group's job is to oversee the disclosure, use and publication of Maori women's summary data held on the NCSP-Register.
Lay smear taker
Smear takers who have successfully completed an accredited educational course in smear-taking and have no formal medical, nursing or midwifery qualification.
Lead Maternity Carer
Person responsible for providing and co-ordinating a woman's maternity care, developing her care plan and attending labour and birth. A Lead Maternity Carer can be a midwife (independent or hospital based), a general practitioner, an obstetrician or a hospital team.
LLETZ (Large Loop Excision of the Transformation Zone)
Treatment for abnormal cervical cells using an electrical wire loop to remove abnormal cervical cells under local anaesthetic.
Low-grade abnormality (LSIL or low-grade squamous intraepithelial lesion)
Mild changes to the cells in the cervix. The term 'low-grade' abnormality includes abnormalities due to HPV changes and CIN 1. These changes need careful follow-up but may not need treatment.
Lymph nodes
A small collection of tissue along the lymphatic system which acts as a filter. Lymph nodes are found in the neck, the armpits, the groin and many other places. Lymph nodes are also know as glands.
Lymphatic system
A network of ducts throughout the body circulating fluid (lymph) that removes poisonous substances and resists disease. Some cancers can travel to other parts of the body along this system.
Malignant tumour
A cancer. A tumour that grows, invades surrounding tissue and infiltrates the blood and lymphatic vessels. It eventually destroys the surrounding tissue and may spread to other part of the body (metastasise).
Mammogram
Breast x-ray. A soft tissue x-ray of the breast which may be used to evaluate a lump or as a screening test in woman with no signs or symptoms of breast cancer.
Mammotone
Under local anaesthetic, a large needle is inserted in the area of abnormal-looking tissue. Some tissue is then gently vacuumed from the area for testing. This biopsy if often performed with the woman lying on her stomach on a table.
Maple Syrup Urine Disease (MSUD)
MSUD is a defect in the way that the body metabolizes certain amino acids and is present in about 1 in 250,000 newborns. Early detection and treatment with dietary restrictions can prevent death and severe mental retardation.
Medium Chain Acyl Co-A Dehydrogenase Deficiency (MCADD)
Medium Chain Acyl Co-A Dehydrogenase Deficiency (MCADD) is a rare hereditary disease that results from the lack of an enzyme required to convert fat to energy. Complications typically arise when the affected child has long periods between meals, requiring the body to use its own fat reserves to produce energy. When this action is blocked by the lack of the necessary enzyme, serious life threatening symptoms and even death can occur. MCADD causes no apparent symptoms at birth, but low blood sugar, seizures, brain damage, heart failure and serious illness can occur very quickly in infants who are not feeding well. Treatment for the disorder requires close monitoring of the child to determine "safe" time periods between meals and following a strict feeding schedule. With early detection and monitoring, and avoidance of fasts, children diagnosed with MCADD can lead normal lives particularly as "safe" time between meals expand as they grow older.
Metabolic diseases
A collection of disorders caused by enzyme deficiencies. Metabolic disorders are often referred to as inborn errors of metabolism. These are permanent and inherited biochemical disorders. An inborn error of metabolism is caused by a lack of a functional enzyme, transmembrane transporter, or similar protein, which then results in a blockage of the corresponding metabolic pathway. Approximately half of all inborn errors of metabolism can be treated through diet or addition of supplements.
Metastases
Malignant cells which have spread via lymph or blood vessels from the original site to another site in the body.
Mortality
The number of deaths from a specified disease during a defined period of time in a given population.
National Health Committee
Advises the Minister of Health on the kinds and relative priorities of public health services, personal health services and disability services that it believes should be publicly funded.
National Health Index (NHI) Number
The National Health Index Number is a unique number assigned ot each person using health and disability support services.
National indicators
The National Indicators are measures used to provide comparative assessments of the performance of different components of the National Cervical Screening Programme in relation to targets.
National Screening Unit
Leads, oversees and co-ordinates organised screening programmes in New Zealand.
NCSP-Register
A computer system which holds the details of women enrolled in the programme as well as details of smear takes, specialists and laboratories.
New Zealand Health Information Service
A group within the New Zealand Ministry of Health responsible for the collection and dissemination of health-related data.
Newborn hearing screening
Audiometric testing of the ability to hear in order to identify individuals who may benefit from intervention with the aim of minimising morbidity associated with hearing impairment.
Oestrogen
A naturally occurring hormone, which in women develops in the breasts and is involved in a woman's menstrual cycle.
Oestrogen cream
A cream containing the hormone oestrogen. It is sometimes prescribed for menopause women before they have a cervical smear.
Open surgical biopsy
Surgery performed under local or general anaesthetic in which a sample of breast tissue is removed so it can be examined by a pathologist.
Opportunistic screening programmes
Opportunistic screening happens when someone asks their doctor or health professional for a check or test, or a check or test is offered by a doctor or health professional. Unlike an organised screening programme, opportunistic screening may not be checked or monitored.
Organised screening programmes
Organised screening programmes have to be of a high standard, and the screening services are checked and monitored by people from outside the programme. With organised screening programmes, everyone who takes part is offered the same services, information and support. Often, large numbers of people are invited to take part in organised screening programmes. The National Screening Unit oversees national organised screening programmes.
Otoacoustic emissions (OAE)
Sounds that are produced by the healthy inner ear spontaneously or after sound stimulation. Various types of OAE are referred to as TEOAE, DPOAE and EOAE. The measurement of these sounds cab be used as an objective, passive audiological test that verifies cochlear activity. This test is often used in testing infants suspected of hearing impairment. A probe is placed in the ear canal for this measurement.
Pathologist
A doctor who studies changes caused by disease in body tissues, including cell and organs.
Phenylketonuria (PKU)
PKU is a condition in which the body is unable to break down one of the protein building blocks from food. These building blocks are called amino acids and one of them is phenylalanine. In PKU, the phenylalanine cannot be processed (metabolised) normally and builds up in the blood and tissues. The high phenylalanine level can prevent the brain from developing as it should. Progressive mental retardation results if the condition is not treated in early infancy. Treatment is a special low phenylalanine diet.
Punch biopsy
Very small specimen of tissue taken with special biopsy forceps for microscopic examination by a pathologist.
Radiation therapy
Also known as radiotherapy. The use of radiation, usually x-rays or gamma rays, to kill tumour cells.
Registration
The registration process for BreastScreen Aotearoa is when a woman has completed a registration form which includes informed consent for screening prior to having a mammogram. This is different from enrolment which is when a woman gives her name or allows her name to be given to BreastScreen Aotearoa to begin the registration process.
Satisfactory but limited smear
A smear of which 50% - 70% can be read by the laboratory and / or a smear with no endocervical smears present.
Screening mammogram
An x-ray of the soft tissue of the breast used as a screening test in women with no signs or symptoms of breast cancer.
Screening pathway
The screening pathway starts with health promotion, then invitation to take part, screening, recall in some cases, diagnosis and finally treatment.
Screening test
A test which is carried out on people who do not have any symptoms but are at risk of a particular disease. It predicts the likelihood of someone having or developing a particular disease.
Sensitivity
Sensitivity is a way of measuring how sensitive a test is to the condition being tested for and how good it is at finding the condition. When a test is very sensitive, it will pick up all cases of the disease. When a test is not very sensitive it will miss some of the cases. This means that a screening test which is not very sensitive will show that some people do not have the condition, when actually they do, but the test wasn't sensitive enough to pick them up. When people are told that they do not have a condition, when they in fact do, this is call a false-negative result. Tests that are not very sensitive produce more false-negative results.
Smear taker
A person who takes cervical smear tests for women. Nurses have to complete a recognised training course on cervical screening before they are able to take smears as part of the National Cervical Screening Programme.
SNOMED codes
Systematized Nomenclature of Medicine. A coding system for recording histological diagnosis.
Specialist newborn hearing screener
An individual trained to use hearing screening equipment to identify potential hearing loss in babies.
Specificity
Specificity is a way of measuring how good a test is at picking up only the people who have the condition. A test with poor specificity is one that isn't very specific and identifies people with the disease, but also some other people who don't have the disease. A screening test that is not very specific will have some results that show a person has an illness, when actually they don't. This kind of result is called a false-positive result. Tests which are not very specific produce more false positive results.
Squamo-columnar junction
The area of the cervix where the squamous cells covering the outside of the cervix meet the glandular (columnar) cells which line the cervical canal. Most cervical abnormalities in the cells start at this junction.
Squamous
The type of multi-layered cells that line the vagina and outer layers of the cervix. They are similar to cells on the skin.
Squamous cell carcinoma
The most common form of cervical cancer arising from squamous cells in the epithelium (tissue that lines the vagina and the outer layer of the cervix).
Standard
A minimum requirement to measure a service against. Services that are funded by the National Cervical Screening Programme are monitored in accordance with standards set by the National Cervical Screening Programme.
Statins
A class of drugs that reduces the amount of cholesterol made in the body and so reduces the risk of heart attacks and strokes.
Tandem Mass Spectrometer
A device that separates and quantifies chemicals based on their mass/charge ratio. A tandem mass spectrometer consists of two mass spectrometers separated by a reaction chamber or collision cell. It is capable of analysing any body fluid including extracts of blood spotted onto filter paper (blood spot card). The process of separation takes seconds. A computer then analyses these data. The newborn metabolic screening programme has been gifted a tandem mass spectrometer which will allow for improvements in the quality of the current disorders screened for.
Technical repeat film
A repeat mammogram, done because the first one was not able to be read clearly.
Transformation zone
The region of the cervix where the glandular (columnar) cells have changed or are changing to squamous cells. The process of changing from one cell type to another may become abnormal.
Vacuum-assisted biopsy
Vacuum suction is used to assist the removal of a sample of tissue through a needle.