The three-phase diagram on Practical considerations for implementing HPV primary screening lists the following:
Building a foundation: Early exploration of how to implement HPV primary screening
- initial steering committee and advisory groups
- screening registry and IT
- guidelines and pathway
- predictive models
Implementation planning: Creating implementation teams and developing concrete implementation plans
- implementation team and champions
- implementation plan
- common and unified messaging
- clinician involvement
- laboratory changes
- coloposcopy increases
- pathway pilots
Execution: Executing the implementation plan
- communication, supportive material and training
- monitoring and evaluation
This flowchart on Cervical screening pathway steps indicates the following:
- If the screening test is negative, the patient returns to routine screening.
- If the screening test is positive, the patient may have a Pap test or go for colposcopy.
- If the Pap test is positive, the patient goes for colposcopy.
- If the Pap test is negative, the patient would wait and retest after a period of time.
Overview of the factors that determine next steps after colposcopy
The diagram on Abnormal screen follow up indicates the following:
After colposcopy, factors such as adequacy of colposcopy examination, hrHPV status, biopsy results and grade of cytology, colposcopic impression of CIN, and patient preference influence what happens next. A patient could either have treatment, have another colposcopy, or undergo a period of waiting and repeat HPV testing with cytology.