Pre-invasive disease of the lower genital tract

When you have completed this course you will be able to:

• describe the basic anatomy and histology of the cervix
• explain the concept of pre-invasive disease
• describe basic knowledge of the biology of human papillomavirus
• relate the role of human papillomavirus testing in the management of CIN
• recognise the benefit of screening for pre-invasive disease
• recall the treatment options for pre-invasive disease
• identify the benefits and limitations of immunisation against human papillomavirus disease

Dr Halima Alazzani (2023)

This course is intended to help clinicians gain core knowledge for O&G training and the MRCOG examinations.

The content of this course relates to the following Capabilities in Practice (CiPs) and key skills:

CiP 1: Clinical skills and patient care
Relevant to all key skills

CiP 2: Working in health organisations
Understands ethical principles

CiP 3: Leadership
Effective use of resources

CiP 5: Human factors
Demonstrates insight into decision making
Understands systems and organisational factors

CiP 6: Developing self & others
Commits to continued learning
Promotes excellence
Performance management

CiP 8: Educator
Interprofessional learning

CiP 9: Emergency gynaecology and early pregnancy
Manages non-pregnancy vaginal bleeding
Manages complications of treatment

CiP 11: Non-emergency gynaecology and early pregnancy
Manages abnormal vaginal bleeding
Manages pelvic and vulval bleeding
Manages the abnormal cervical smear
Manages suspected cancer symptoms
Manages vulval symptoms
Manages sexual wellbeing

CiP 13: Non-discrimination and inclusion
Promotes non-discriminatory practice
Understands cultural determinants of health

CiP 14: Health promotion
Relevant to all key skills

Further details about each CiP can be found within the O&G Core Curriculum 2024 Definitive Document, available here.

National Institute of Clinical Excellence. Guidance on the Use of Liquid-Based Cytology for Cervical Screening. Technology Appraisal 69. NICE; 2003.

Royal College of Obstetricians and Gynaecologists. Progress in Cervical Screening in the UK. Scientific Impact Paper No. 7. London: RCOG; 2016.

Public Health England. Guidance: Cervical Screening. Programme and Colposcopy Management. London: PHE, 2021 [Accessed September 2022].

Morrison J, Baldwin P, Buckley L, Cogswell L, Edey K, Faruqi A et al. British Gynaecological Cancer Society (BGCS) Vulval Cancer Guidelines: Recommendations for Practice. May 2020. [Accessed October 2023] .

Gurumurthy M, Peevor R, Fiander A. Human papillomavirus update (including vaccination). Obstet Gynae Repod Med 2013;23:231–7.