Management of women who have had a smear or colposcopy and treatment overseas

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Taking a full clinical history is vital.
One of the most important roles of the smear taker in cervical screening is to take a full clinical history. This includes noting in the clinical record all the laboratory and colposcopy results reported from outside New Zealand.

Overseas clinical histories and results must be reported to laboratories on the laboratory request form submitted with the cervical smear. Based on the history provided, the smear taker may decide, in consultation with the woman, to refer her directly to colposcopy without waiting for a New Zealand laboratory result. However, in doing so the smear taker must provide clear reasons and document the overseas results (where obtainable) on the colposcopy referral form.

New Zealand laboratories report results (cytology, HPV and histology) electronically to the National Cervical Screening Programme (NCSP) Register. Other results (from overseas) and relevant clinical information that smear takers hold are held in the Register’s medical notes for that woman, only if reported to the Programme.

Where a smear taker disagrees with a recall interval recommended by the Programme, (possibly due to overseas results not held by the Programme) the smear taker should notify the NCSP of the clinical history obtained from the woman and include her NHI number and date of birth for identification purposes. This will help to avoid inappropriate follow up letters, based on New Zealand recommendation codes automatically generated by the Register, being sent to the woman.

It is important to recognise that the smear taker is responsible for the ongoing clinical management of a woman who has had a cervical smear in New Zealand (NCSP Policies and Standards, section 4, Providing a Smear taking Service). The laboratory recommendation for ongoing management may sometimes differ from that of the smear taker who holds the full clinical history and examination results of a participating woman, particularly if a woman has been treated overseas. Therefore it is necessary from time to time to update a woman’s screening history as held on the Register and so avoid inappropriate letters being sent by the Programme to a participating woman.

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Page last updated: 26 February 2014