What should we do with invalid results?
These are mainly around samples taken prior to the implementation of HPV triage and test of cure in 2012, for which the result required early recall and/or referral to colposcopy, but had not had appropriate follow up at that time e.g. DNA.
The NHAIS software has been designed that these results should follow the previous screening pathway, and therefore cannot be returned to routine recall unless the previous test date is over 5 years old.
This should be a short term issue, and laboratories should amend codes and return to PCSE, to allow appropriate results letters and subsequent recall to be initiated.
Any ‘A’ coded test result being entered will need to be validated against the new rules. That is test results coded: 0A, 2A, B0A, E0A, G0A, M0A, N0A or X0A
The ‘ABC3’ guidelines governing a return to routine recall are as follows
Test results coded as ‘H’ and inadequate test results will be ignored when assessing if a woman may be returned to routine recall or not.
Test results are considered to be inadequate if they are coded 1 for cytology or U for HPV unreadable result. All insignificant inadequate test results are ignored when seeking to identify a woman’s last test result.
Insignificant inadequate test results are
1R, 1S, 19R, 19S, 1QR, 1QS, BUR, BUS, EUR, EUS, GUR, GUS, MUR, MUS, NUR, NUS, XUR, XUS
Private test results are: 0H, 1H & 2H
- Return to routine recall will NOT be allowed if the most recent adequate NHS test is as follows:
The test result is dated 5 or less years ago.
- The test result is coded as one of following:
4S, 49S, 4US or 4QS
5S, 59S, 5US or 5QS
6S, 69S, 6US or 6QS
7S, 79S, 7US or 7QS
3R, 8R or 9R
Please note: while it remains the case that a test result of 3R, 8R or 9R should be followed by 3 consecutive negatives at least 3 months apart, the system will continue to allow a woman to return to routine recall after five years or on her second negative result under the HPV triage/TOC protocol.
Test results that fail validation will be flagged by the Laboratory Links, CY screen, AJ-CINCD and the Cytology Integrity Checker AD-HOC option 10 in the usual way.
Return to routine recall will be allowed if
- The test result (as specified above) is dated more than 5 years ago.
- The previous adequate NHS test result was coded:
HPV Triage: HPV Primary Screening:
0A, 0R, 0S 09R, 09S, 0QR, 0QS
2A, 2R, 2S 29R, 29S, 2QR, 2QS
3S 39S, 3QS
40S, 50S, 60S, 70S
8S, 9S 89S, 8QS, 99S, 9QS
B0A, B0R, B9R, B0S, B9S X0A, X0R, X0S, X9S
E0A, E0R, E0S, E9S
G0A, G0R, G9R, G0S, G9S
M0A, M0R, M9R, M0S, M9S
N0A, N0R, N9R, N0S, N9S